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17C-100 (2) t MORTGAGE LOAN INSPECTION ago ��l�tl laN rl �.n JJ 1 /- u ._�ca.c.-<" �, -•t whit-'}',r:r;- s1_e 20'` 40 r' 130- I I � v K U n I hereby report that the premises shown on this plan, is not located within a Flood Hazard Area as shown on Department of H.U.D. Federal Insurance Administration Maps, Community Number 250167 0002A Identificati ate April 3, X78 TO TI-IE SPRINGFIELD INSTITUTION FOR SAVINGS OWNER' 66- RICIIARD A. AND LINDA E. Df?VTNE AND THE FIRST AMERICAN TITLE INS. CO. - on].y LOCATION' - - --_. 35 STILSON AVENUE, NORTIIr;MPTON, MASS. To the best of my knoailedge, inforina- _ � ��_ Lion and belief, i hereby report that 1 II�° INC,have examined the premises and that this !'�� H� l-��*s� {• ASSOCIATES, C inspection plat SWIS the improvement or SURVEYORS - ENGINEERS - LANDSCAPE ARtIMTECTS improvements as located on the premises de- 30 INDUSTRIAL DRIVE EAST P.O. BOX 568 scribed, that the improvement or improve- NORTHAMPTON, MASSACHUSETTS 0I060 ments are entirely within lot lines , and __._..._. that there are no encroachments upon the SCALE# premises described by the improvement or `p Of 11! Z O improvements of any adjoining premises , � ;Y- i except as indicated. I further report that t)otKs OATEN there are no easements of record affecting n W. the tract shown hereon, except as rioted. 28M Q JOB NO.: — THIS PLAT IS FOR IDENTIFICATION PURPOSES ONLY AND DOES NOT CONSTITUTE A PROPERTY SURVEY 95-7115 �OJO Wq-71DAJ Or- 37 ST/G�xl i �} i �o04 )e6 or25 /q-T- (�Fftsi z) 44VI7-1060 rsr GPI-o"i (,v�+-iEo J>Lo6-H 7)Z—b)l-)J3W6- I/ ck��o );F- tccc-��) el� A-) 3� ��c✓ f��--P2�uG- S�Sr.�/� Jeff Bott 06/14/04 K Bead Devinejob 11:20am Key Beam fl Gable Wall 1 of 1 Ke Bean®Version 4.19 Member Data Description: Member Type: Beam Application: Floor Lateral Bracing: Continuous Standard Load: Moisture Condition: Dry Building Code: NBC Live Load: 40 plf Deflection Criteria: L/360 live, U240 total 1.000"max.LL Dead Load: 10 plf Deck Connection: Nailed Member Weight: 6.8 plf DOL: 100% Filename: KYB3 Non-standard Loads Type Trib. Live Dead (Description) Begin End Width Start End Start End DOL Replacement Uniform (plf) 0' 0.00" 12' 6.00" 40 10 100% Replacement Uniform I or 0.00" 12' 6.00" 0 80 100% Bearings and Reactions Input Minimum Worst Case Location Type Brg.Length Brg.Length Total 100% Dead Total 1 0' .00" Wall N/A 1.50" 865# 253# 613# 865# 2 12'7.75" Wall N/A 1.50" 865# 253# 613# 865# Design spans 12'7.75" Product: 2.0 RigidLam LVL 1-3/4 x 7.25 2 Ply Minimum 1.50" bearing required at bearing # 1 Minimum 1.50" bearing required at bearing # 2 Allowable Stress Design Actual Allowable Capacity Location Loading Positive Moment 2735.'# 7892.'# 34% 6.32' Total load 100% Shear 782.# 4821.# 16% .01' Total load 100% LL Deflection .1035" .4215" L/999+ 6.32' Total load 100% TL Deflection .3541" .6323" U428 6.32' Total load 100% Control: TL Deflection Manufacturers installation guide MUST be consulted formulti-ply connection details and alternatives Al product names are trademaft of their respective owners John oLeary Rugg Lumber Co 24 West St Copyright(C)1989-20(2 by Keymark Enterprises,Inc.ALL RIGHTS RESERVED. Hatfdd,MA01068 (413)626-0025 Jeff Bott 06/14/04 Key'Beam Devine job 11:16am 1st Floor 1 of 1 Ke Bean®Version 4.19 � Member Data Description: Member Type: Beam Application: Floor Lateral Bracing: Continuous Standard Load: Moisture Condition: Dry Building Code: NBC Live Load: 40 plf Deflection Criteria: U360 live, L/240 total 1.000"max. LL Dead Load: 10 plf Deck Connection: Nailed Member Weight: 10.8 plf DOL: 100% Filename: KYB1 Non-standard Loads Type Trib. Live Dead (Description) Begin End Width Start End Start End DOL Replacement Uniform sf) or 0.00" 12' 6.00" 13' 0.00" 40 10 100% S Bearings and Reactions Input Minimum Worst Case Location Type Brg.Length Brg.Length Total 100% Dead Total 1 0' .00" Wall N/A 1.59" 4179# 3288# 891# 4179# 2 12'7.75" Wall N/A 1.59" 4179# 3288# 891# 4179# Design spans 12'7.75" Product: 11 7/8" 2.0E G-P LAM LVL 2 ply Minimum 1.59" bearing required at bearing # 1 Minimum 1.59" bearing required at bearing # 2 Allowable Stress Design Actual Allowable Capacity Location Loading Positive Moment 13209.'# 19559.'# 67% 6.32' Total load 100% Shear 3524.# 7897.# 44% .01' Total load 100% LL Deflection .3063" .4215" U495 6.32' Total load 100% TL Deflection .3892" .6323" U389 6.32' Total load 100% Control: LL Deflection Manufacturers installation guide MUST be consulted formulti-ply oonnection details and alternatives Al product names are trademarl¢of their respective owners John CrLeary Rugg Lumber Co Copyright(C)1989-2002 b Ke R 24 West M St y ymark Enterprises.Inc.All RIGHTS RESERVED. Hatfield,MA 01068 (41 3)626-0023 Jeff Bott 06/14/04 KeyBeam Devine j ob 11:16am 1st Floor SIR& 1 of 1 Ke Beam®Version 4.19 Member Data Description: Member Type: Beam Application: Floor Lateral Bracing: Continuous Standard Load: Moisture Condition: Dry Building Code: NBC Live Load: 40 plf Deflection Criteria: U360 live, U240 total 1.000"max. LL Dead Load: 10 plf Deck Connection: Nailed Member Weight: 10.8 plf DOL: 100% Filename: KYB1 Non-standard Loads Type Trib. Lime Dead (Description) Begin End Width Start End Start End DOL Replacement Uniform sf) 0' 0.00" 12' 6.00" 13' 0.00" 40 10 100% 12 6 E) Bearings and Reactions Input Minimum Worst Case Location Type Brg.Length Brg.Length Total 100% Dead Total 1 0' .00" Wall N/A 1.59" 4179# 3288# 891# 4179# 2 12'7.75" Wall N/A 1.59" 4179# 3288# 891# 4179# Design spans 12'7.75" Product: 11 7/8" 2.0E G-P LAM LVL 2 ply Minimum 1.59" bearing required at bearing # 1 Minimum 1.59" bearing required at bearing # 2 Allowable Stress Design Actual Allowable Capacity Location Loading Positive Moment 13209.'# 19559.'# 67% 6.32' Total load 100% Shear 3524.# 7897.# 44% .01' Total load 100% LL Deflection .3063" .4215" U495 6.32' Total load 100% TL Deflection .3892" .6323" U389 6.32' Total load 100% Control: LL Deflection Manufacturers installation guide MUST be consulted formulti-ply connection details and alternatives AI product names are trademarta of thar respective owners John O'Leary Rugg Lumber Cc 24 West St Copyright(C)1989-2002 by Keymark Enterprises,Inc.ALL RIGHTS RESERVED. Hatfidd,MA01088 (413)626.0028 Jeff Bott 06/14/04 KeyBeam Devine j ob 11:20am 1st fl Gable Wall 1 of 1 Ke Beam®Version 4.19 Member Data Description: Member Type: Beam Application: Floor Lateral Bracing:Continuous Standard Load: Moisture Condition: Dry Building Code: NBC Live Load: 40 plf Deflection Criteria: U360 live, U240 total 1.000"max. LL Dead Load: 10 plf Deck Connection: Nailed Member Weight: 6.8 plf DOL: 100% Filename: KYB3 Non-standard Loads Type Trib. Live Dead (Description) Begin End Width Start End Start End DOL Replacement Uniform (plf) 0' 0.00" 12' 6.00" 40 10 100% Replacement Uniform I 0' 0.00" 12' 6.00" 0 80 100% r Bearings and Reactions Input Minimum Worst Case Location Type Brg.Length Brg.Length Total 100% Dead Total 1 0' .00" Wall N/A 1.50" 865# 253# 613# 865# 2 12'7.75" Wall N/A 1.50" 865# 253# 613# 865# Design spans 12'7.75" Product: 2.0 RigidLam LVL 1-3/4 x 7.25 2 ply Minimum 1.50" bearing required at bearing # 1 Minimum 1.50" bearing required at bearing # 2 Allowable Stress Design Actual Allowable Capacity Location Loading Positive Moment 2735.'# 7892.'# 34% 6.32' Total load 100% Shear 782.# 4821.# 16% .01' Total load 100% LL Deflection .1035" .4215" U999+ 6.32' Total load 100% TL Deflection .3541" .6323" U428 6.32' Total load 100% Control: TL Deflection Manufacturers installation guide MUST be consulted formulti-ply connection details and alternatives Al product names are trademarks of their respective owners John O'Leary Rugg Lumber Cc 24 West St Copyright(C)1983-2002 by Keymark Enterprises,Inc.ALL RIGHTS RESER\,ED. Hatfield,MAO1W (413)626-0023 '�� tt•3a�" ea��f ar'd�e e-F Onsve�-� Z910 1/e 3 * ' f: Y G��n docJ opts� ,5 ,C 4 R l spw6n syoro•�-ed by z-Z.�c s' tiu,dcrs r'n W, 0 Sig phl IQ So i rsolxhen -- _ z x's�'3ec,N /a• � i gem I 1 appr+bk j t 1 X -5 � 64*06ei - x x • lzi ' lt�di�ror� 3'1 r�'il'son Bile. --�' 'w36'�^ 2Xtp tb" D-G* Ile f y` Win op" S R r� s''Pro.ted b� 7.-7-%V hu,au-s �j Zx I o t 6"o•cr. R 80 �r�soizhen t 1 aP�oribk � 8 yx q t x y —So�etc�be xx lx-K �� O• G . �� L 3� ENERGY CONSERVATION APPUCATIGN FORM FOR LOW-RISE RESIDENTIAL NEW CONSTRUCTION AND ADD(TIONS 780 QM-fR�A�p/pendix J1 effective 3/1/98) I ,! 4611A- AL ..PF_/!NE Site Address: 37 Sr�Sl1/�' A )r applicant f�tame: Applicant Address: �7 S l ,_-SL1/,), City/town: -�Ct / Hit O_YDb-p' Use Group: IqC� / Date of Application: A r)N!C—x n c.cK mce Pith(click a")z (=j Prascriptivie P;7-.kage (L.imitec to 1- or 2- family wood frame buildings treated with :ossil kie(s only) Pacl,ake (A throe t KK from Table J5.2. 4h}: ____ Heating Degree Days (HDD,,,$) from Taole J5.2 la: (For items d, t!,roug') i„ fill in 211 values thzt apply from Table J5.2) a. Gross Waff area sq. h f. Waif F�-Yafvc- B b. Glazincn Area c. Glazing (100 x b-+-a) �f h. Basement wall d, Side Perimeter f(• e. Ceiling R-value R i_ Heating AFUE ❑ Comilponef-it Performance: 'Manual Trade Off' (Limited to wood or metal framed buildings only) Climate-Zone-(fralm Figure J6.2.2) ❑ Zone 12 ❑ Zone 13 ❑ Zone 14 Attach Trade•Oti KIUrks�heet tiom Appendix J, [and HVAC Trade-Otr Woi,ksheei, it applicable) ❑ MAScheck Software Attach Compliance Report and Inspec-lion Checklist printouts. ❑ Jy$tCrf15 F1ftal}rSl5 { ❑ Renewable Encrgy Sources Attach Mass Registered Architect or Engin,--r Analysis 77 ALTERNATIVE FOR ADDITIONS ONLY: a. Gross Watl + Ceiling Ar��090,sq tt. b. Glazing Areal --z Sq.ft. G- Glazing %(100 x b+a) / , ❑ ADDITION with Gla2ing% (c.)up to 44;tj; may use 780 CMR Table J1.1.2.3.1 below: MAXIMUM,U-tiall..-- Minim urn R Vaducs Ferlbstration Ceiling Wall Floor Bastment Wall 1 Slab Perimeter, Dept 0:39 R 37 R 13 R 19 R•10 R•10,4 ft. ❑ `SUNPOOM' addition (,greeter than 40°x(, giazing•to-wall and ceiling gross are-e) Attach 'Consumer Information Form" from 780 CMrR-Appcndir 13. Official's N erne: Official's Signature: AppficHtron Approved ❑ Denied (] Date of Appraral,'Denisl: °va S on(S)n r Dcnia 11 (pr'de_ additional aetails as needed on back side) GilA=kr A:ea a=y be ekbi r Roat Opmaig or Unix Duxie_ttivas �� °ti Crif1� i3f :Orillamptoil = 4 Q - ��c�+ncf)ncrtte' o DEPARTI MEt•Fl- OP 3UILOt?\'G INSPECTIONS 212 Main Strcct Municipal Building Northampton, Mass. OIOGO \-1,10 IC1 R'S CONfPE iSATION MSVT-Z� Cr Al' �.� a principal place of business(residcnce at ----- _ (fhone-.,) do hereby ceru , under the pa ns and penzlties of per]U-F ( ) I mn employer providing t!le fol!owinrt wort cis comocnsadon comic-c nor my eluulovccs worming on ti>is job. :pinion, Dom) ( ) I art a sole proonctor, general cona-a(nor or homeo�yoer (c�c;- one) aid have hired the con[ac,ors Lis-Lt-� below vybo %=ve the foLlovi;-Ili2 wor .eds copper ��on pe.l_cies: (N c cc ConCamor) _ (lrs noc Co>a7oaa:rPo!ic; i�umc^r) »u-don Da ) (Name of Co=,c,,,o,-) C L-mc; Comp"Loy/POL-c Nambl:) (b:virdoo Dalc) (Name of Couaac'cr) (Iasur-,:a= Comr�y/Policy Numb-`r) ( sair ion Date) (a r.�.:��oc-1 r`—cC if ncc�..::�ek,,�a:.Fcc—.....^oc pc•"�to..:1 coc—moo:j . ( ) I awl a sole propne,Lor and have no one wor.�ng for me. I am-a home o,vner perorrg all the work myseii-. NGitt:ply—.-be esr�[fi*.w;,y�e Sccr_a+x:-a ..�o�lcy pcaa:w w c��C r—,,au�•orz va,d..c1�=;ar --j is•.--hic' the c,ce L�,tia""ti zr-•p�r'ra_=lhe�_n=ooc��.—..ilr er.��.—ci u h< x (GL I'1—=1(5)r=;qIi--6co try L•c=1 cc pc:ail Ic-�1 c,�c of�c�loyx un rur Q:n 4Jo,icd<Co¢�ac.liou Ad. ba fu---ded W C cpnr� o f Io�r n�aG��Gir o(l +m�fx h. a�vcz;v�jic�ioa aid Uu L 1— o s rc love��_ c:x oa 25^,of MOL 152 cn 1cL o vhc ^^cci oa of cvn c 1 p� b� o o(a f,n of up to 11}00.00 for a..r^� ,�,-,I o(up to ooe Y--_r L-�ci etil peulue m be form o(a Slop Wort Ordc aid e r o(S 100.09.dz-y tpa=l 1 q Pct;�t 1�iulal>G Lot ," Si(n.aturt ofLic�= c Crmiuc' -Ce �0 Lzfp of Nart4ttntptnn �I834ACtt1[4t�t4 - ,b .0 cw` DEPARTMENT OF BUILDRG INSPECTIONS INSPECTOR 212 Main Street • Muuic;ipal Builduig North<unpton,MA 01060 HOME OWNER EXEMPTION ACKNOWLEDGEMENT The State of Massachusetts allows the homeowner the right under 78OCNM 108.3.4 to act aS ias/her construction suv_:—i sor. The state defines "Homeowner" as, " Person(s) who owns a parcel on which he/she resides or intends to be, a one or two fdmity— _ dfvelling, attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a home owner." The building department for the City of Northampton wants any person(s) who seek to use the home owner exemption, to act as their own construction supervisor, to be aware that by doing so you become responsible for compliance with state building codes and regulations. The inspection process requires that the building department be called to inspect work at various stages, which include foundation/footings (before backfillh sonotube holes (before pour). a rough building inspection (before work is concealed) insulation inspection (if required) and a final building inspection.:The building department requires these inspections before the work is concealed, failure to secure these inspections can result in failure to obtain a certificate of occupancy until the work can be inspected. If the homeowner hires other trades to perform work(electrical, plumbing& gas) the homeowner will be responsible to make sure that the trades hired secure their proper permits in conjunction to the building permit issued, and that they get their required inspections. Failure of the individual trades to secure the permits and inspections as required can DELAY the project until such time as the proper permits and inspections are made I understand the above. (Home owner/resident's signature requesting exemption) I will call to schedule all required building inspections necessary for the building permit issued to me. Date Address of work _ / e location 37 S//L s,�gl Ae lC I SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable Name of License Holder: License Number Address Expiration Date Signature Telephone 9.1Ze"isti3reii Nome lrri ci3verrientCoritractor...�_' .. . - -Y r. "' Not Applicable Company Name Registration Num er -"-- Address Expiration Date Telephone SECTION 10-WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c.152,§25C(6)) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit. Signed Affidavit Attached Yes....... No...... ❑ I1....: Iome--,Ow. n The current exemption for"homeowners"was extended to include Owner-occupied Dwellings of one(1) or two(2)families and to allow such homeowner to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor.CMR 780. Sixth Edition Section 108.3.5.1. Definition of Homeowner: Person(s)who own a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two family dwelling,attached or detached structures accessory to such use and/or farm structures.A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such"homeowner"shall submit to the Building Official,on a form acceptable to the Building Official,that be/she shall be responsible for all such work performed under the building permit. As acting Construction Supervisor your presence on the job site will be required from time to time,during and upon completion of the work for which this permit is issued. Also be advised that with reference to Chapter 152(Workers' Compensation) and Chapter I53 (Liability of Employers to Employees for injuries not resulting in Death)of the Massachusetts General Laws Annotated, you may be liable for person(s) you hire to perform work for you under this permit. The undersigned"homeowner"certifies and assumes responsibility for compliance with the State Building Code,City of Northampton Ordinances,State and L Laws and State of Massachusetts General Laws Annotated. Homeowner Signature r SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable) New House ❑ Addition Replacementyyindows Alterations) Roofing Or Doors 1 Accessory Bldg. ❑ Demolition New Signs [C3] Decks (p Siding(p] Other[0] Brief Description of Proposed Wo k ar-llods6 Alteration of existing bedroom LN Yes No Adding new bedroom Yes x No Attached Narrative Renovating unfinished basement Yes _,_No Plans Attached Roll -Sheet sa.If-New house and-ot=additio� tQ.exls fin ahousind, complete thefo[Iowmg: a. Use of building: One Family Two Family_�_Other b. Number of rooms in each family unit: Number of Bathrooms—.,2— c. Is there a garage attached? //V 0 /, 1 d. Proposed Square footage of new construction. �7 y Dimensions e. Number of stories? f. Method of heating? _6A5 Fireplaces or Woodstoves Number of each g. Energy Conservation Compliance. yes Masscheck Energy Compliance form attached? y£ S h. Type of construction w000 r-)e � i. Is construction within 100 ft.of wetlands? Yes /` No. Is construction within 100 yr. floodplain Yes—X—No j. Depth of basement or cellar floor below finished grade 71 _ k. Will building conform to the Building and Zoning regulations? X Yes No,. I. Septic Tank City Sewer /` Private well City water Supply x SECTION 7a-OWNER AUTHORIZATION -TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I. as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application. Signature of Owner Date as Owner/Authorized Agent hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and belief. Signed under the pains and penalties of perjury. ' e16AW A , Print Name Signature of Owner/Agent Date ' ~ Section 4. ZONING All Informatioirl Must Be Completed. Permit Can Be Denied Due To Incomplete Information Existing Proposed Required by Zoning This column to be filled in by Building Department Lot Size za LL U2 Setbacks Front Rear 2.0 Building Height Bldg. Square Footage % Open Space Footage % (Lot area minus bldg&paved #of Parking Spaces (volume-&Location) A. Has o Special Perm it/Variance/R riding ever been issued for/on the site? �~\ � N0 \^� DON7 KNOW YES �v�_) IF YES, date issued:-, | IF YES: Was the permit recorded ut the Registry ufDeeds? �� KNOW�� DON7 KNO YES IF YES: enter Book ! i Page, and/or Document#� � \_�� _� B. Does the site contain a brook, body ofxvuterorwedands? NO ��/~ DON'T KNOW YES IF YES, has a permit been urneed to bo obtained from the Conservation Commission? ' Needs to be obtained �~� Obtained �~� Date Issued: �_� \_� ' � C. Do any signs exist on the pruport ��y? YES \.� NO 0�~� IF YES, describe size, type and location� D. Are there any proposed changes to or additions of signs intended fo the property/ YES [ i NO ! IF YES' describe size' type and location: E. Will the construction activity disturb(clearing,grading,excavation,nr filling)over 1 acre orish part ofa common plan that will disturb over 1acre? YEG [ � ) , ND `~/ ! � ^ IF YES,then a Northampton Storm Water Management Permit from the DPW is required. _ Deparfnentuseomy - - — -- of Northampton Status Of Permit z Budding Department Curb Cut1Drr1veway;Permit # 212 Main Street Sewer/SepttcAvailabdity F, Room 100 Water-Yell yAvatla6tllfy- L f Nortfl rTtpton; MA 01060 Twbi Sets of Structural Plans phone 413-587-1240 Fax 413-587-1272 Plot/stte Plans d :w Other Specify .APPLICATION TO CONSTRUCT)ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 -SITE INFORMATION 1.1 Property Address: r This section to be completed by office 3� JT O N AV Map _ _ Lot _Unit Q_ F 1.b Zone Overlay District ��1 CF Elm St.District CS District SECTION 2-PROPERTY OWNERSHIPIAUTHORIZED AGENT 2.1 Owner of Record: 'R i c A . J<<J 2 7 sn L.so Au/C Name(Print) � Ci�C.� Current Mailing Address: ff-;? - 30 l_3 Telephone Signature 2.2 Authorized Agent: Name(Print) Current Mailing Address: Signature Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by permit acolicant 1. Building (a)Building Permit Fee 2. Electrical (b)Estimated Total Cost of Construction from(6) ,r7� 3. Plumbing Building Permit Fee I 4. Mechanical (HVAC) 5. Fire Protection ! D 6. Total = (1 +2 -3 +4 + 5) Check Number This Section For Official Use Only Date Building Permit Number: I Issued: Signature: Building Commissionerlinspector of Buildings Date File#BP-2005-0530 APPLICANT/CONTACT PERSON DEVINE RICHARD A&LINDA E ADDRESS/PHONE 37 STILSON AVE FLORENCE ()587-3093() PROPERTY LOCATION 37 STILSON AVE MAP 17C PARCEL 100 001 ZONE URB THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out Fee Paid Tvpeof Construction: CONSTRUCT 12 X 12 LIVING RM ADDITION New Construction Non Structural interior renovations Addition to Existin Accessory Structure Building Plans Included: Owner/Statement or License 3 sets of Plans/Plot Plan THE F9,1,LOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INF ATION PRESENTED: Approved Additional permits required(see below) PLANNING BOARD PERMIT REQUIRED UNDER:§ Intermediate Project: Site Plan AND/OR Special Permit With Site Plan Major Project: Site Plan AND/OR Special Permit With Site Plan ZONING BOARD PERMIT REQUIRED UNDER: § Finding Special Permit Variance* Received&Recorded at Registry of Deeds Proof Enclosed Other Permits Required: Curb Cut from DPW Water Availability Sewer Availability Septic Approval Board of Health Well Water Potability Board of Health Permit from Conservation Commission Permit from CB Architecture Committee Permit from Elm Street Commissi Signature of Building Official Date Note:Issuance of a Zoning permit does not relieve a applicant's burden to comply with all zoning requirements and obtain all required permits from Board of Health,Conservation Commission,Department of public works and other applicable permit granting authorities. *Variances are granted only to those applicants who meet the strict standards of MGL 40A. Contact Office of Planning&Development for more information. 37 STILSON AVE BP-2005-0530 GIS#: COMMONWEALTH OF MASSACHUSETTS MM:Block: 17C-100 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: BUILDING PERMIT Permit# BP-2005-0530 Project# )S-2005-0694 Est. Cost: $34000.00 Fee: $72.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Groin Homeowner as Contractor Lot Size(sa.ft.): 12980.88 Owner: DEVINE RICHARD A&LINDA E Zoning:URB Applicant: DEVINE RICHARD A & LINDA E AT. 37 STILSON AVE Applicant Address: Phone: Insurance: 37 STILSON AVE O 587-3093 O FLORENCEMA01062 ISSUED ON.Mfi7/04 0:00:00 TO PERFORM THE FOLLOWING WORK.-CONSTRUCT 12 X 12 LIVING RM ADDITION POST THIS CARD SO IT IS VISIBLE FROM THE STREET Inspector of Plumbing Inspector of Wiring D.P.W. Building Inspector Underground: Service: Meter: Footings: Rough: Rough: House# Foundation: Driveway Final: Final: Final: Rough Frame: Gas: Fire Department Fireplace/Chimney: Rough: Oil: Insulation: Final: Smoke: Final: THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Certificate of Occupancy Signature: FeeType• Receipt No: Date Paid: Check No: Amount: Building 11/17/04 0:00:00 178 $72.00 212 Main Street,Phone(413) 587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo