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25C-214
"FROM : 'ShedWorks PHONE NO. : 413 2841900 �g/i G� ._. ..-_._1:�✓Z.._ Maw h.02:04PM P2 �O r N D O- _ A � . X Vo 3' --�` V-4- C-:A tWC-C,,CW ftVt - iRI55 -7-OOP FI-A-714C- .� �IAIC TR!AEA� V4fAJ r N 4L)fz A7ZrAl 14 7`//i -F-�^ROM : 'ShedWorks PHONE NO' 413 2841988 May. 21 2001 02:03PM P1 --__------__-__�---_--__ Az _- - nn DEFT Of BUILDING INS CTIONS N RTHAMPTON,MAtI060 ' | . 07/27/1399 12:27 4135361012 LABARGE PAGE 01 THIS PLAT NOT FOR RECORDING PURPOUS 81c,4 9 49, P0,40 p ova 50 MAY 2 W DEPT T $ING INSPECTIONS NT O ON,MA 01060 1� 1 L% oli s~ yQ G Ta�tlrtolt�wC.S SAV�+�sf ,4Nrt PINf'T M460LttA04'rM6.N 04f.C0- I HEREBY RIE V THAT I H4 X&90! THE PR�MIS>i5.AND MED ON EXISTING MONUMENTATION,ALL EASEMENTS,ENCROACHMENTS AND BUILDINGS ARE LOCATED ON THE ORMW AS SHOWN ANID THAT THE BUILDINGS ARE ENTIRELY WITHN THE LOT LINED,I FURTHER REPORT THAT THE PROPE NOT LOCATED IN A Ft DOD PRONE AREA AS SHOWN ON FEDERAL INSURANCE:MAPS FOR C OMMUNRY NUMBER 5 Of DATED: 7-Z G-99 NDTE THi8 PLAT FOR MORTGAGE LOAN PURPOSES ONLY AND DOES SURMOR: l NOT CONStITUM A PROPERTY SUR11 , MORTCIAGE LOAN INSPECTION PLAT �1M # atcHA,eo NJ O RTH k M PTO W, MASS. A OWNER UeAME,Sft. 134M vJ A R Et8►.,1 J. .1 r��I>IM1II��I� Rlahlvd J.LASWO,9t..RiGiAMM ftakukmW Land Burvo"r 110 JOV 9bat.NWftmpwn.Mnaaahumm 010E0 0 9 B �lassacflnsrtts' DEPARTMENT OF BUILDING INSPECTIONS 212 Main Street ' Municipal Building Northampton, Mass. 01060 WORKER'S COMPENSATION INSURANCE AFFIDAVIT (lipennittee) with a principal place of business/residence at: ""(phone#) (stree(/city/stafelap) do hereby certify, under the pains and penalties of perjury, that: ( ) I am an employer providing the following worker's compensation coverage for my employees working on this job: (Insurance Company) (Policy Number) (Expiration Dale) X'I am a sole proprietor, general contractor o omeowner cle one) and have hired the contractors listed below who have the following wor er s compensation policies: g' (Name of Contractor) (Insurance Comparry/Policy Number) (Expiration Date) tr , (Name of Contractor) (Insurance Company/Policy Number) (Expiration Date) (Name of Contractor) (Insurance Company/Policy Number) (Expiration Date) (Name of Contractor) (Insurance Company/Policy Number) (Expiration Date) (attach addition!sheet if necessary to innludo infvrmatioa pertaining to all ooatmaors) O I am a sole proprietor and have no one working for me. ( ) I am a home owner performing al.1 the work myself. NOTE:please be aware that while homcowucts who employ persons to do mainteamce coasts oa or repair work oa a dwelling of not more than throe units in which the homeowner resides or on the grounds apparteaaoi thereto arc not geacally coa ndacd to be employers under the worker's o mpens4on Act(GL152,ss 1(5)),application try n homeowner for a uoeuse or pond may n idmoe the legal status of an employer under the Wor c g Compamation Act. I understand that a copy of this rtatemeat may ba fasvnuded to the Deputasm2 of Industrial Aoadca&Offico of insunnoa for the coverage verification and that failure to secure coverage under section 25A of MOL 152 can Lead to the impositioa of criminal pcaaltics oomistincg of a fine of up to S1,500.00 and/or im prison of up to one year and civil pmatties in the form of a Stop W ode Or der and a firm of S100.00 a day agnin.A ma For dal use only Permit Number Map{ Lot# Signature of Li=zee/Permittee S. A �CUON 8=Ci1NSTRt)CTIQN SERVICES.. 1 Licensed Construction Supervisor: pp Not Applicable ❑ Name of License Holder License Number Address Expiration Date Signature Telephone E FF Not Applicable ❑ �..€s _., . P P Company Name Registration Number Address Expiration Date Telephone SECTION, CQMPENSA"fIQM INSURANCE DAVIT(M.G.L c,s152, 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. igned Affidavit Attached Yes....... ❑ No...... ❑ 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 Officials that he/she shall be responsible for all such work performed under the building permit. As acting Construction Supervisor your presence on the fob 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 Zonin aws and State of Massachusetts General Laws Annotated. Homeowner Signature l C TION 5 4 P D c 'ec a ale New House ❑ Addition ❑ Replacement Windows Alteration(s) ❑ Roofing ❑ Or Doors ❑ Accessory Bldg. M, Demolition❑ New Signs [ ] Decks [ ] Siding[ ] Other [ ] Brief Description of Proposed Work: BuLJ-9 'n*-T'AT-Z4-% '9 ICA(2AL'*. /$ )e 2-a Alteration of existing bedroom Yes No Adding new bedroom Yes No Attached Narrative❑ Renovating unfinished basement Yes No Plans Attached Roll ❑ - Sheet❑ 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? 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 SECTION 7a-0WN R AUTHORIZATION .TQ BiiCOMPLETED WHEN OWNERS:AGI=N'I"QR COt�TI�ACTOR APPLIES.I OR SUILDING Pt"IT 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 Fe�Authorized Agent hereby declare that the statements and information on the foregoing application are true and acc the best of my knowledge and belief. igned under the pains and penalties of perjury. -5mocbA Print Name Signature Owne /Agent Date t- 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 D9 Lot Size G / 7 0 d�0 Frontage "Z `- ` 6 • goo Setbacks Front {3 130 Side L: R: L: 3Gq, ,/f/� R: / ` Rear ' Building Height ( G Bldg.Square Footage 154'1 15 % 0-5 3 0'jp Open Space Footage % < �y-,� (Lot area minus bldg&paved n/ �2 1r� p 73453 73,q �!/b�� /�r- azkin (6 #of Parking Spaces Fill: volume&Location A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO y 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 y 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: orthampton R iEl Department 2 lain Street MAY 2 2 m 100 brt on, MA 01060 phone 413-5S7-1240 Fax 413-587.1272 DEPT OF BUILDING INSPECTIONS NOKIIAMP�ft MA 01060 1PPLICATION TO CONSTRUCT,ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION MA'TIOR 1.1 Property Address: F y This s �i�in e �rfi Y J Zane Qirerrf #rid SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: - �J 5i' t-cyg—c�A Name( rint) Current Mailing Address: � T� Telephone Signature zz 2.2 Authorized Agent: Name(Print) Current Mailing Address: Signature Telephone SECTION 3- EST[, atbiNSTOUCT`ION'-COSTS Item Estimated Cost(Dollars)to be Official Llse nfy° com leted by ermit applicant 1. Building (a) Building Permit Fee:i 2. Electrical � Estimated T4tai Cc tpf . C(lnatruction from 6 3. Plumbing i ild1ng Permit F64 4. Mechanical (HVAC) 5. Fire Protection 6. Total =(1 +2 + 3 +4 + 5) Q Q_O v Check Number his Se ion I:'or Official Use Oni Buildir► -Perrriit Nt rritaer: bate issued: Signature: Building Commissioner/tnspector of Buildings Date File#BP-2001-0964 APPLICANT/CONTACT PERSON SMITH WARREN J&NORMA J ADDRESS/PHONE 45 NORTH ST (413)584-3996 Q PROPERTY LOCATION 43 NORTH ST MAP 25C PARCEL 214 ZONE URC 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: CON TRUCT 18 X 20 DET/GARAGE 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 LLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION: Approved as presentedibased on information presented. Denied as presented: Special Permit and/or Site Plan Required under: § PLANNING BOARD ZONING BOARD Received&Recorded at Registry of Deeds Proof Enclosed Finding Required under: § w/ZONING BOARD OF APPEALS Received&Recorded at Registry of Deeds Proof Enclosed Variance Required under: § _w/ZONING BOARD OF APPEALS 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 mmission Permit from CB Architecture Committee p Y ZOO 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. 43 NORTH ST ' BP-2001-0964 GIs#: COMMONWEALTH OF MASSACHUSETTS �. a CITY OF NORTHAMPTON Lot:-001 Permit: Building Category: GARAGE BUILDING PERMIT Permit# BP-2001-0964 Project# JS-2001-1728 Est.Cost:$9000.00 Fee: $50.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor., License: Use Group: Lot Size(sq. ft.): 9975.24 Owner: SMITH WARREN J&NORMA J Zoning: URC Applicant: SMITH WARREN AT. 43 NORTH ST Applicant Address: Phone: Insurance: 45 NORTH ST (413) 584-3996 (� NORTHAMPTONMA01060 ISSUED ON.•5124101 0:00:00 TO PERFORM THE FOLLOWING WORK.-CONSTRUCT 18 X 20 DET/GARAGE POST THIS CARD SO IT IS VISIBLE FROM THE STREET Inspector of Plumbing Inspector of Wiring D.P.W. Inspector of Buildings Underground: Service: Meter: Footings: Rough: Rough: House# Foundation: 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: Fee Type: Receipt No: Date Paid: Check No: Amount: Building 5/24/010:00:00 161 $50.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo 4. A MN 1 ilk = n Kho WORT 43 NORTH ST BP-2001-0964 GIs#: COMMONWEALTH OF MASSACJUSETTS Map.-Block:25C-214 CITY OF NORTHAMPTON Lot:-001 Permit: Building Category:GARAGE BUILDING PERMIT Permit# BP-2001-0964 Project# JS-2001-1728 Est.Cost: $9000.00 Fee: $50.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: Lot Size(sq. ft.): 9975.24 Owner: SMITH WARREN J Zoning:URC Apolicant: SMITH WARREN AT. 43 NORTH ST Applicant Address: Phone: Insurance: 45 NORTH ST (413) 584-3996 (� NORTHAMPTONMA01060 ISSUED ON:5124101 0:00:00 TO PERFORM THE FOLLOWING WORK:CONSTRUCT 18 X 20 DET/GARAGE POST THIS CARD SO IT IS VISIBLE FROM THE STREET Inspector of Plumbing Inspector of Wiring D.P.W. Inspector of Buildings Underground: Service: Meter: Footings: Rough: Rough: House# Foundation: Final: Final: f%Z Rough Frame: &K Gas. � ` Fire Department Fireplace/Chimney: Rough: Oil: Insulation: © � 1 ' `7�- 6 a ✓Q"�`� Final: Smoke: Final: Of .50 O a`t THIS PERMIT MAY BE REVOKED BY THE CI 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 5/24/010:00:00 161 $50.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Building Commissioner-Anthony Patillo