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29-410 (3) s Timothy & Wendy Lussier 105 Sandy Hill Road Florence, Ma 01062 (413)584-5432 4� Anthony Patillo 1, (� l' V� E Building Commissioner r � City of Northampton L JAIl ^ 0 2002 212 Main Street Northampton, Ma 01060 , . UE}�(Or Bii I 4G N�INSPECTIONS ' IliI MA 01060 January 30, 2002 Dear Mr. Patillo, This letter is to confirm our intentions for use of the transformed garage. We will be converting this space into a family room and small studio. These rooms are not intended to be used as bedrooms. The sole purpose of this conversion is for more family space for the kids toys, computer, and general living space. If you have any questions or concerns, please feel free to contact us. We are open to any questions or comments you may have. Sincerely, r: Timothy VLussier Wendy E. Lussier s t 1 J WL0 W W W xxx M V)0 coo in O O N a evrr N N N o M . THIS PLAT NOT FOR RECORDING PURPOSES ss of• a e �� Qb id 0*/OS ,L SANDY H�[.[. RD. T'D : S O jv Q G F ON& M 0X7-&A6,F C OR?- C cMMONWA4A rW J.'W0 7'1TAX /NS. CO. I HEREBY REPORT THAT I HAVE D MAINED THE PREMISES,AN BASED ON DUSTING MONUMENTATION,ALL EASEMENTS,ENCROACHIMENTS AND BUILDINGS ARE LOCATED ON THE GROUND AS SHOWN AND THAT THE BUILDINGS ARE ENTIRELY WITHIN THE LOT LINES.I FURTHER REPORT THAT THE PROPE IS NOT LOCATED IN A FLOOD PRONE AREA AS SHOWN ON FEDERAL INSURANCE MAPS FOR COMMUNFTY NU1u0ER o�+?CJL�eZ , DATED: 3" -o O NOTE THIS PLAT FOR MORTGAGE LOAN PURPOSES ONLY AND DOES SURVEYOR: NOT CONSTITUTE A PROPERTY SURVEY. MORTGAGE LOAN INSPECTION PLAT �tylit of N0RrIYAMPTAV) MA&5 RICHARD 0 VV n/x-n J. ., LAWC4 sit -r1110 7-AY 5, 4 U S S /B jZ 134503 R'icAard J.LeBarpe,Sr.,Registered Prolesslonal Lind Surveyor 110 Klnp Stro.t,Northarnplon,Massachusetts WOW Z0 39tid 39�It1gd� Zi0i98SETb ZZ:01 0002/LZ/E0 4-{t�pT 1'0 �i°0 a e Gktf of WartIjampf aii �iSf at(1 ttB[tt5 , m DEPARTMENT OF BUILDING INSPECTIONS 212 Main Street ' Municipal Building ' Northampton, Mass. 01060 WORICER'S COMPENSATION INSURANCE AFFIDAVIT L p►censee/permittee) with a principal place of bu-sinessIresidence at: 414 1 b fWC,Q 0 1 61�4hone#) 1 "-3, (hrCe city/statrlap) do hereby certify, under the pains and penalties of pegury, that ( ) I am an employer providing the following worker's compensation coverage for my employees worlang on this job: (Insurancc Company) (Policy Number) (Expiration Dale) ( ) I am a sole proprietor, general contractor or homeowner (circle one) and have hired the contractors listed below who have the following worker's compensation policies: (Name of Contractor) (Insurance Company/Poky Numbcr) (Expiration Date) (Name of Contractor) (Insurance Compauy/PoGcy Number) (Expiration Date) (Name of Contractor) (Insurance Compacy/PoUcy Number) (Expiration Date) (Name of Contractor) (Insurance Company/Poky Number) (Expiration Date) (attach additiooal shod if necesvry to include infbc n oa pcxtnining to all ocatrn ) ( ) I am a sole proprietor and have no one working for me. I am a home owner performing all the work myself. NOTE:plisse be aware that while hoaxowaen who employ pazoat to do n„ imcnncc coa tn=on or rrpair work on a dwelling of not Moro than three units in which the homoowv rides or oa the grounds appurtenant thacto arc oot gcncnlly coasidarcd to be employers undo the workers ccmp==tioa Ad(GL152,s3 l(5)�application by a homeowner for a liccase or permit may evidence the legzl etsdua of an employer uodertho Workeez C.ompematiou Act- I unde stsad that a copy of this ru tcmmt maybe forwarded to the Dtpartnsmt of Indush iat Accidm&ol5oo of La Au—for the -V Mge vaificatioa and that failure to sea=coverage under soctoa 25A of MGL 152 can Iced to the imposition of criminal pcnaW- oomistmg of a fine of up to S 1,300.00 andloc imprbomnerd of up to one year and civil peaslties in the form of a Stop W orlc Order and a f=of 5100.00 a day ign inst ttx. EMap4 'l use� mber Lot# of censclPermit� e SECTIO��» COI V RUCTION SER1/ICES 8.1 Licensed Construction Su ervisor: Not Applicable Name of License Holder : License Number �5 di A Address r Expiration Date Signature Tele ho�ne . •- f/ me t1zr.. Not Applicable ❑ Company Name Registration Number Address Expiration Date Telephone SECTION 1 11 0-WORKERS' COMPENSATION INSURANCEAFFIDAVIT(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...... ❑ 'ff e U axe 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 he/she shall be responsible for all such work performed under the buildinE 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 153 (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 Local Zing Laws and State assac General Laws Annotated. omeowner Signature Al SEOQTIOhI -D R 419001 �ROROSED: ORK c cka Ira"''licab e " New House ❑ Addition ❑ Replacement Windows Alteration(s)\9( Roofing ❑ Or Doors ❑ Accessory Bldg. ❑ Demolition❑ New Signs [ j Decks [ ] Siding[ ] Other[ J Brief Description of Proposed Work: a ) / j Alteration of existing bedroom Yes No Adding new bedroom_ Yes No Attached Narrative❑ Renovating unfinished basement --Yes No Plans Attached Roll 0• Sheet C� Ifi ' ' e e o c�� tfn tae i"s�`n $" o�rssingcom�tete'�' fl'o'"�'�"n";�• a. Use of building : One Family Two Family Other b. Number of rooms in each family unit: Number of Bathrooms c. Is there a garage attached? d. Proposed Square footage of new construction. Dimensions e. Number of stories? f. Method of heating? Fireplaces or Woodstoves Number of each g. Energy Conservation Compliance. Mascheck Energy Compliance form attached? In. Type of construction i. Is construction within 100 ft. of wetlands? Yes No. Is construction within 100 yr. floodplain Yes No j. Depth of basement or cellar floor below finished grade k. Will building conform to the Building and Zoning regulations? Yes No . I. Septic Tank City Sewer Private well City water Supply SE TION t0 BE COMPLETED >WHEN. OWNERS AGENT OR CONTRACTOR PL ES 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 1, 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. . t- i Print Nam 111/ e-(,-I r, Signature of Owne gent IV Q Date Section 4. ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE DENIED DUE TO LACK OF INFORMATION Existing Proposed Required by Zoning This column to be filled in by Building Department Lot Size Frontage Setbacks Front Side L: R: L: R: Rear Building Height Bldg. Square Footage % Open Space Footage % (Lot area minus bldg&paved parking) #of Parking Spaces Fill: volume&Location A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO _ DON'T KNOW YES IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO DON'T KNOW YES IF YES: enter Book Page and/or Document # B. Does the site contain a brook, body of water or wetlands? NO DON'T KNOW YES IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained Obtained Date Issued: C. Do any signs exist on the property? YES NO IF YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the property?YES — No .IF YES, describe size, type and location: rthampton uil epartment 21 in Street JAN 2 5002 0 100 Northa pto , MA 01060 124 Fax 413-587-1272 APPLICATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION.1-SITE INFORMATION ��$This seeti o� `'�compl'�t� bjrofftc� °' 1.1 Property Address: ii - ; 1.L I /r` �j \L Zone ask; Overta is r"I Elm St.'District" = .� GCB District SECTION 2- PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: Name(P * t) t Current Mailing Add r ss: A/3 Telephone lVJ Lll [� j Si nature t 4 - 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 applicant Building /"J (a) Building Permit Fee Electrical r^ >{\ (b) Estimated Total Cost of ,J V Construction from 6 3. Plumbing Building Permit Fee 4. Mechanical (HVAC) 5. Fire Protection 6. Total = (1 + 2 + 3 +4 + 5) ~ C> > Check Number This Section For Official Use Onl Building Permit Number Date Issued: Signa#ure '` Bu'Id hng.Commissioner!_lnspector�of°.Buildings. Da- File#BP-2002-0674 APPLICANT/CONTACT PERSON LUSSIER TIMOTHY S ADDRESS/PHONE 105 SANDY HILL RD (413)584-5432 O PROPERTY LOCATION 105 SANDY HILL RD MAP 29 PARCEL 410 001 ZONE URA THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out Fee Paid , Typeof Construction: CONVERT GARAGE INTO FAMILY ROOM/STUDIO New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/Statement or License 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INF RMATION 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 Co ssion Signature of Building O Zcial 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. 105 SANDY HILL RD BP-2002.0674 GIs#: COMMONWEALTH OF MASSACHUSETTS Map.Block: 29-410 CITY OF NORTHAMPTON Lot:-001 Permit: Building CateQoU:Non structural interior renovations BUILDING PERMIT Permit# BP-2002-0674 Project# JS-2002-1086 Est.Cost: $3000.00 Fee: $50.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group Lot Size(sg. ft.): 12414.60 Owner: LUSSIER TIMOTHY S 7onina: URA Applicant: LUSSIER TIMOTHY S AT. 105 SANDY HILL RD Applicant Address: Phone: Insurance: 105 SANDY HILL RD (413) 584-5432 O FLORENCEMA01062 ISSUED ON.1/30/02 0:00.00 TO PERFORM THE FOLLOWING WORK:CONVERT GARAGE INTO FAMILY ROOM/STUDIO 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: if���� Rough Frame: e7 f- a Gas: Fire Department Fireplace/Chimney: Rough: Oil: Insulation: C7I-Ir ( -7, o 02 Final: Smoke Final: Gj_d2L- THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Certificate of Occu anc Si nature: Fee Type: Receipt No: Date Paid: Check No: Amount: Building 1/30/02 0:00:00 3374 $50.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo