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TO: THE BAYBANKS MORTGAGE CORP. &
THE FIRST AMERICAN TITLE INSURANCE COMPANY
I HEREBY REPORT THAT I HAVE EXAMINED THE PREMISES AND BASED ON EXISTING
MONUMENTATION ALL EASEMENTS, ENCROACHMENTS AND BUILDINGS ARE LOCATED ON
THE GROUND AS SHOWN AND THAT THE BUILDINGS ARE ENTIRELY WITHIN THE LOT LINES,
EXCEPT AS NOTED. I FURTHER REPORT THAT THE PROPERTY IS NOT LOCATED WITHIN
A FLOOD PRONE AREA AS SHOWN ON FEDERAL FLOOD INSURANCE MAPS FOR
COMMUNITY # 250167
�A��al.�u� �' J-� —NOTE—
SURVEYOR:
THIS PLAT FOR MORTGAGE LOAN PURPOSES ONLY
AND DOES NOT CONSTITUTE A PROPERTY SURVEY
OF —MORTGAGE LOAN INSPECTION PLAT-
R""E'�` NORTHAMPTON, MASSACHUSETTS
mm PREPARED FOR
#303 TEREZ WALDOCH
= SCALE: 1 "=30 ' MAY 25 , 1991
HAROLD L. EATON AND ASSOCIATES, INC.
REGISTERED PROFESSIONAL LAND SURVEYORS
�• -1— 235 RUSSELL STREET — HADLEY — MASSACHUSETTS
4
The Contractor under provisions of Chapter 142A of the General Laws is required to apply for and obtain all
construction-related permits. The Contractor shall not be deemed responsible for delays in the work described in this
agreement caused by regulatory, permit granting or inspectional agencies, agencies, authorities or individuals.
Notice: If the Owner obtains his own construction-related permits for the work
described under this agreement or deals with unregistered contractors, the Owner is
hereby advised that in the event of a dispute, judgment and nonpayment of the
Contractor, the Owner will not be entitled to make a claim to or collection from the
guaranty fund established by Chapter 142A,M.G.I.
MODIFICATION
This Agreement,including the provisions relating to price and payment schedule cannot be changed except by
a written statement signed by both Contractor and Owner. However, cancellation by Owner is allowed in
accordance with the Notice of Cancellation.
COMPLETENESS OF AGREEMENT FOR EXECUTION
The Owner is hereby advised that he should not sign this Agreement unless and until all blank sections have
been filled in or marked as void,deleted or not applicable,and until all exhibits and related or referenced
documents that are incorporated herein are attached hereto.
Lead paint warning.
By signing this contract,the Owner(s)acknowledge receipt of Environmental Protection Agency
publication concerning the hazards of lead based paints in remodeling work
COPY OF AGREEMENT TO BE GIVEN TO OWNER
This Agreement is governed by the Laws of Massachusetts. It must be executed in duplicate, and an original, signed
copy hereof given to the Owner at the time of execution. No work under the Agreement shall begin prior to the signing
of the Agreement and transmittal to the Owner of a copy thereof.
This proposal may be withdr n if no accepted 'thin days.
Authorized signature:
ACCEPTANCE OF PROPOSAL-I have read this doc ent and all attached documents and accept the prices,
specifications and conditions stated. I understand thavupon signing,this proposal becomes a binding contract. You are
authorized to do the work as specified. Payment will be made as outlined above.
You,the Buyer, may cancel this transaction at any time prior to midnight of the third
business day after the date of this transaction. Cancellation must be done in writing.
DO NOT IGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES.
Signature Date Q3
4gHAMPJ'
O �
ti$ Crzt r of Nart4aui rtan z
� � �assact�iisetfs -
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` DEPARTMENT OF BUILDING INSPECTIONS /=
INSPECTOR 212 Main Street • Municipal Building
Northampton,MA 01060
r
HOME OWNER EXEMPTION ACKNOWLEDGEMENT
The State of Massachusetts allows the homeowner the right under 780CMR 108.3.4 to
act as i.is/her construction sur_,::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 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
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 backfill),
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
location
� � v-iit,r nr �j>,7z`tlj�ittt}rtntt I'(}Jry�''` �.
6 �K R Il 115 r117
^r m DEPARTMENT Of' EUILDD�G INSPECTIONS
212 Maui Street ' Municipal Building
Northampton, Mass. 01060 '
NVOPUCER'S COMI'EN1SATION INSURANCE i",_F EDANrIT
------_�17 Ci,P.S"_^.•`�'f;II)1 i i ter)
v:ith a principal plau of businesslr : denc r'.
V Tt:,Lici t,Y!c-,:�11yj r,)
r
CIO 11CI'CUj' CeriLl}, llllaci Che ana 1)C:I,- ICS OI pC;fJ1111',
I am an employer providing the 011CUv:ir1L '•' 01-kcr5 C0I11I)CI1S3UoI] COVC:'2 C Of MY
emplovees working on this job:
(=ImnG Compam`) (PC lic:N1iLi1ber) --- (R>-mr--tion Date)
O I am a sole proprietor, general u: IlonieowDer (Curie Oct) and ha'��e hired
the contractors hsted below,vho ,:4 +l e llc ;: ,o ers ° �-.
.-� � ] o _ v �; r� c.ot. p,.n. ion
(,Name of Contractor) (Ins -ac Colr.�.);-Pclicr Number) Date)
(Name of Cont.ctor) Date)
(Name of Contractor) (Ira-.im cc Corr,-any/Tolicy Na llxr) _x,r:T,:noa Date)
- (Name of Contractor) — (I:�s.r�nc Comer•,};(Poli y Nu.m��r) fF -:tie- Dare;
i, I iLT] a Sold f)1 OprlCtJi ?.`11 Iltl�'� Il0
NOTIi:I,Icsc tx nw rc L,at
not uzeee t1t:0 tfzrve unity in t L dt Lie 1::i .Zr rr:�a or oc:•`w.97':.:wi5 zo•_rcrsl 1±_e,C e e rr_t Cc-rsa11V
employes uaz.�tlr tvca, _cc r- :n±irn Pr.(GLIS�yc!( }?.-.,:;':ic:ia;h;+a hntnco.n f fw,a
legal etatun of an amploye<under tL•n Workclz t,o,z,o Ilion!.cL
I ur demand than a copy of thi- tietc:s'cuy bo fcVc!od to ti-IY.Siutzicn!of IndustriJ A,66 !y 0'5-of for tlx
aovazgc va-G=ioa and that f-ulurc to!n uc cbticr C ut.3 c�"iM 25A of I{GL,t S2 can Ic_d to t1x imj>asiti0. of err ir:.l pct,&l;:rs
cnmisting of a fur_of up to S 1 S .CYD a:r"'c�i :pr;v nti;y of::p to cr. )t r r.r.I evil Ixnzllia in uc I<x n cf n S!r,1'(`ri-On& ::.d n
fires oC S 109.00 a day irain:l m..
j - for dq:uvzxztsl u.c cril y
--------------
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tnaturc c�f`.iccn:
_ s
S€CTflN CONSTRUCTION;SERVICES
8.1 Licensed Construction Su rvisor: �l // Not App li able ❑
Name of License Holder : (/v�► O 66-2-
� License Number
Add r s
Expiration bate
ignature Telephone
Re 0-01101 rJr._, .0<.e. <en n.rac o, Not Ap licable ❑
Com an Name Registration Number
Address Expiration Date
//
*L( � J rc G Telephone��
SECTl30 WORKERS' CO,MP,ENSAT)ON IN511yRANCE AFFIDAVIT(M:G:L:,c. 152,
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...... ❑
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 acecptable to the Building Official,that he/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 15') (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 Zoning Laws and State of Massachusetts General Laws Annotated.
Homeowner Signature
r.
i
J
P�F2oPOSEDMORK check I fi4a 1� ' bile
New House ❑ Addition Replacement Windows Alteration(s) ❑ Roofing ❑
Or Doors ❑
Accessory Bldg. ❑ Demolition@ - New Signs [ ] Decks [ ] Siding[ J Other [ ]
Brief Description of Proposed Work:D 6 mv YIST V Su/ru 't cc,'/D fy4tr✓ �&xv PC,()Fri.
�i1 ��,Vu-T r I T V 7 4J 0-6,-., /-L
Alteration of existing bedroom Yes _ No Adding new bedroom Yes _ No
Attached Narrative 0 Renovating unfinished basement Yes _ C No
Plans Attached Roll D. Sheet�".
6a ou �e �"� ��'�itron`�to x stin .o stn�; �omp e a °frel�:owmir:
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? �J / y /
d. Proposed Square footage of new construction. �3f Dimensions / ytCP U r
e. Number of stories? I r
f. Method of heating?(�/lf�T(� � - Fireplaces or Woodstoves /�✓Q Number of each
g. Energy Conservation ComphanceukH CAI L-D Mascheck Energy Compliance form attached?
h. Type of construction Uu
i. Is construction within 100 ft. of wetlands? Yes No. Is construction within 100 yr. floodplain Yeses 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
SSE fl 1 IM 13.1H."IZATION 70; Bpt`
D WI Ef
01h1N S E _ A CONTRACTOR A .PLIES FOR BUILDING PERTVIIT
MMU
I, as Owner of the subject property
hereby authorize to ac, 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 r the pains and penalties o - erjury.
Print Nam Z2 �•' �,
Signat re of Owner/Agent Date
w
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i
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 ( V� �/ � i pojta�)
-�-
Frontage 7.r -7
Setbacks Front 3 4-31 -
Side LAt R: L: — R:� 16-
Rear /'_
Building Height a� *�
Bldg. Square Footage S- 1/ •�°/U Y 7
Open Space Footage /V. % I
(Lot area minus bldg&paved
parking)
#of Parking Spaces
Fill: Al
volume&Location /`t'
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 tl�.ere any proposed changes to or additions of signs intended for the property ?YES _
No t/
IF-YES, describe size, type and location:
_ ity of Northampton
ilding Department
212 Main Street
Room 100
� It
hampton, MA 01060
phone 13. 87-1240 Fax 413-587-1272
L Iii Dl*,4Q INSPFC
_ 6����UCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTION 1 - SITE INFORM' ION
This section toy° omptdbaffce�
1.1 Property A :
EImStDistrict
SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
Name(Print) Current M 'ling Addres
Tele; o
Signature /
2,2 Aukhorized A ent: o �0a _ !
1 144) X H o"e-'�E7 V 14yjy pe"v 0; Ile- A/t a/O
Name(P 1 Current Address:
do
Sig ature Telephone
SECT11 N<3 - ESTIMATED CONSTRUCTI N COSTS y
Item Estimated Cost (Dollars) to be Official Use Only
completed by ermit applicant
1. Building_ (a) Building Permit Fee
2. Elec.rical
(b) _ timated Total Cost of
Constructionjrom 65
3. Plumbing Building Permit Fee
4. Mechanical (H`✓AC)
5. Fire Protection
6. Total =(1 + 2 + 3 + 4 + 5) Check Number iC7
This Section For Official Use Only
Bui'Iding Permit Number. _.. Date'Issued:
Signature`
Building Commissioner/Inspector'of';Buildings Date
T
File#BP-2004-0370
APPLICANT/CONTACT PERSON Martin Mahoney
ADDRESS/PHONE 20 Fort Hill Rd (413)268-3296
PROPERTY LOCATION 19 CAROLYN ST
MAP 17A PARCEL 083 001 ZONE URA/ cil
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out
Fee Paid "-
T_ypeof Construction: REBUILD 10 x'20 SUNROOM&ADD 10 x 21/2 BUMP OUT OF LIVING RM
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included•
Owner/Statement or License 040602
3 sets of Plans/Plot Plan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INFOPdATION 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
/d z av
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.
hampton 1_�BEL
cry of NSPEO-�IpN
•-' fir' Bv1L01NG 1 v ��
Inspector ---
pate
Im
19 CAROLYN ST
GIs#: BP-2004-0370
COMMOi, 'EALTH OF MASSACHUSETTS
Lot:-0 01 1 17A-083 CITY OF NORTHAMPTON
Lot: -0
Permit: Building
Category: BUILDING PERMIT
Permit# BP-2004-0370
Project# IS-2004-0533
Est. Cost: $25750.00
Fee: $112.50 PERMISSION IS HEREBY GRANTED TO:
Cons_ t.Class: Contractor:
Group: License:
Use
Martin Mahoney 040602
Lot size(sa ft)• 10_ $46 44 Owner: WALDOCK TEREZ
Zoning: URA/WSP Applicant: Martin Mahone,
Applicant Address• Phone:
20 Fort Hill Rd Insurance:
HAYDENVILLEMA01039 ISSUED ON.•10/6/034 0 00:00 3296
TO PERFORM THE FOLLOWING WORK:REBUILD 10 x 20 SUNROOM & ADD 10 x 21/2
BUMP OUT OF LIVING RM
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: 1�9� House#
j Foundation: J �� "� (�3
Driveway Final: !
Final: Final:
Rough Frame:CHIT �j
Gas: Fire 3-4
Department
Fireplace/Chimney:
Rough: Oil:
Insulation:O�j• �' 'oZ `'IO —0'3
Final: Smoke: /i
Final: '"� U'
THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIO ON nF
ANY OF ITS RULES AND REGULATIONS.
Certificate of Occu anc si natuz e:
FeeType: Receipt No: Date Paid Check No:
Amount:
Building 10/6/03 0:00:00
1547 $112.50
212 Main Street,Phone(413) 587-1240,Fax: (413)587-1272
Building Commissioner-Anthony Patillo