17C-243 (3) -NOTE-
THIS. PLAT IS COMPILED FROM DEEDS, PLANS AND OTHER SOURCES AND IS NOT
TO BE CONSTRUED AS AN ACCURATE SURVEY AND IS NOT TO BE RECORDED.
BUILDING LOCATION ACCURACY IS NOT GUARANTEED
C 9
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� 93
So' t v��o
6Z'{ \'-\
TO: COUNTRYWIDE HOME LOANS &
FIRST AMERICAN TITLE INSURANCE COMPANY
TO THE BEST OF MY INFORMATION, KNOWLEDGE AND BELIEF
I HEREBY REPORT THAT I HAVE EXAMINED THE PREMISES AND BASED ON EXISTING
MONUMENTATION ALL VISIBLE 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
SURVEYOR:
OF
�c
RAN DALL yG�
E.
IZER
035032
0 URV
-NOTE-
THIS PLAT FOR MORTGAGE LOAN PURPOSES ONLY
AND DOES NOT CONSTITUTE A` PROPERTY SURVEY
-MORTGAGE LOAN INSPECTION PLAT-
NORTHAMPTON, MASSACHUSETTS
PREPARED FOR
DAVID W. PARKER, JR.
SCALE: 1 "=30 ' MARCH 30 , 1999
HAROLD L. EATON AND ASSOCIATES, INC.
REGISTERED PROFESSIONAL LAND SURVEYORS
235 RUSSELL STREET - HADLEY - MASSACHUSETTS
7
Ci-
So' t v��o
6Z'{ \'-\
TO: COUNTRYWIDE HOME LOANS &
FIRST AMERICAN TITLE INSURANCE COMPANY
TO THE BEST OF MY INFORMATION, KNOWLEDGE AND BELIEF
I HEREBY REPORT THAT I HAVE EXAMINED THE PREMISES AND BASED ON EXISTING
MONUMENTATION ALL VISIBLE 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
SURVEYOR:
OF
�c
RAN DALL yG�
E.
IZER
035032
0 URV
-NOTE-
THIS PLAT FOR MORTGAGE LOAN PURPOSES ONLY
AND DOES NOT CONSTITUTE A` PROPERTY SURVEY
-MORTGAGE LOAN INSPECTION PLAT-
NORTHAMPTON, MASSACHUSETTS
PREPARED FOR
DAVID W. PARKER, JR.
SCALE: 1 "=30 ' MARCH 30 , 1999
HAROLD L. EATON AND ASSOCIATES, INC.
REGISTERED PROFESSIONAL LAND SURVEYORS
235 RUSSELL STREET - HADLEY - MASSACHUSETTS
O4.SHAAIP�O
i
�litassachnseffs
DEPARTMENT OF BUILDIT;G INSPECTIONS /;
INSPECTOR '212 Main Street • Municipal Building
Northampton,MA 01060
HOME OWNER EXEMPTION ACKNOWLEDGEMENT
The State of Massachusetts allows the homeowner the right under 78OCNIR 108.3.4 to
act as his/her construction sup{::, sor. T he state defines "Homeowner" as, " Person(s)
who owns a parcel on which he/she resides or intends to be, a dine or two ami y
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 buil mg department for the City of Northampton wants-any person(s)-who-seek-
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 r',egulations. 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.
(AOu,e of er;resi ....t'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
r
F�0 �\Tcrf zalliptoI'll -
A � � E i;a7atcrljasrltn' _
o DEPARTMEI-T OF BUILDrNG INSPECTION'S -
212 Main Strcct hSunicipal Building
Northampton, Afass. 01060
W0R1�E;R,S CONITENSATTO.N G'ZSURANCE AI'I'I7�A.�rZT'
i
%VI h a principal place: of businessfresidence zt: — -
i
(phone-')
(sn-r[Id rr/stalda p)
do hereby certify, under the.pi'inS and penalties ofpcgury, h�l
( ) I am an employer providing the following iworkcr'5 comocasadon covem-c for in),
etnplovees «roridng on ti1is job:
i (L2sur-mac Conn::=,•) (PcLie:Nu_-ter) --- (T:pirdor.Dai)
{ ) I am a sole proprctor, general coca-acor or homeowner (c cie one) and have hired
one contractors listed below cv>;o have the foilo�vi p, woFkees compep_canion policies:
i
(c;am-, of Con'_^cwr) (Ins rancr_ Cornpany/hobc) NluziLk ) D.ILC)
(Name of Concacior) (Instlra-acc Comvanvpol.ie; Nun6_r) (E:goimdon Dale)
(Name of Coaa-aelcc) (Insurane;Compan}•/Polio' Numb,-J) (E_xpirdon Date)
i -
i
i
(Name of Conaactor) (Insutanm Comraff /Policy Numtzr) (Etpirdoa Daac).
j (nL]Cb_ds�occ_i cC,irncccai'v to 6 cju<L—iafocn,jon pcta' to.11 ors-rLOz) - .._......--
'i
I
O I am-a sole proprietor and have no one woridog for me.
I am..a home owner performing all the work myself.
NOTE:plCse be at+rart:U_b-,',Js hcmc.owve:a.a ho emP1QY D�soea ea do C=_—=00 e rcPaa woric on of
got most tea i' _tests-a-icb the bomoouroe raid,,or oa the jToulxb z�puryev tbe-,e,ox C==Uy Decd.-ai 10 be
e tployes t,✓-the..uic�c -+:ea Aa(GL'152.=1(5)).ar Lica.6on try n bommava fc c 1bc=-�or p=uff o_y c%-rdeocc e1:e
Icp n_^•,of n7 etloyer uoe dao Wackoe,C.ompoosatiao Act_
i
I uodeeynd rile.a aoyy of thin cwt mw my b.foc—j do d to the DcPu,a¢of Io&icj for Lb.
cove-xz—v=-i jc=ioa aad th:t U-=,=to se=at,covcrase tmdc zoe oa 23 A or MOL 15'2=1�-d to the i_z:?OSi iOc of MMiaal prn.+lt=
e o a r i.i:r g of a r r a c or up to s 1.3oa.00.riGor o f up to oa ytr ead c va per.itia in be form ora Slop Work Ord-'nod n
fits of S 100.00 a d:y api=tae
PC=t Numb=
Far 6�.rtml,t u,c Doty
Ada p- ! [ n
Signa of i crmtucr ce
SECTION 8-CONSTRUCTION'SERVICES r
8.1 Licensed Construction Supervisor: Not Applicable ❑
Name of License Holder
License Number
Address Expiration Date
Signature Telephone
ALA
y '" 5 Not Applicable [I 9 Reaisfere'd'ti"ome-lmpresverrrert -Cant"act
r M..
Company Name Registration Num er
Address Expiration Date
Telephone
SECTION 10-WORKERS'COMPENSATION INSURANCE,AFFIDAVIT(M.G.L.c 152,S 25C(61)'
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...... ❑
IM,
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_1083.5.1.
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 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 153(Liability of Employers to
Employees for injuries not resulting in Death)of the Massachusetts General Laws Anmotated,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 Z ' wte of Massachusetts General Laws Annotated.
Homeowner Signature 14
SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable)
New House F_� Addition ❑ Replacement Windows Alteration(s) Roofing
Or Doors 171
Accessory Bldg. ® Demolition 0 New Signs [0] Decks [M Siding[0] Other[0]
Brief Description of Proposed
o
P P
Work:
Alteration of existing bedroom Yes_ 3L No Adding new bedroom Yes No
Attached Narrative Renovating unfinished basement Yes __X�_No
Plans Attached Roil -Sheet
sa (f`Ne'w hoiise��a� �+accTi�ea"�'�a€�e�rsti��iixulc��ca�iyie��=.�t�' fottouari :
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._ Masscheck Energy Compliance form attached?
h. Type of construction `
L Is construction within 100 ft.of wetlands? Yes No. Is construction within 100 yr. floodplain J Yes No
j. Depth of basement or cellar floor below finished grade
k. Will building conform to the Building and Zoning regulations? Yes No.
1. Septic Tank City Sewer Private well City water Supply
SECTION 7a-OWNER'AUTHORIZATION-R• TO BECOMPLETED WHEN
_ v.
OWNERS AGENT OR CONTRACTOAPPLIES FOR BUILDING PERMIT
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
I, 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.
Print Na
Signature of Owne e t Date
~ =
Section 4. ZONING All Informati6h Must Be Completed. Permit Can Be Denied Due To Incomplete Information
Existing Proposed Required by Zoning
This column to be filled in by
40 U Building Department
Lot Size
Frontage
Setbacks Front
Side
Rear all
Building Height
Bldg. Square Footage
Open Space Footage %
(Lot area minus bldg&paved
#of Parking Spaces
(volurne,&Location)
'
A. Hus a Special Perm it/Vahance/Findi ng ever been issued for/on the site?
i �3h DON'T KNOW 0 YES 0 �
IF YES, date issued::
IF YES: Was the permit recorded at the Registry of Deeds?
NO K � DON7KNOVV YES
��
|FYES� enter Book Pagel ond/or Document
�
'
��
B. Does the gtmcontain a brook, body of water orvvet|unds? NO v�� DON7K0OVV �~� YES
IF YES, has permit been or need to ba obtained from the Conservation Commission?
'
Needs tobeobtaimmd v~~\ ��ta�oad v�� Date
��� k_/ ' '
�� 0)C. Dn any ggnsexist on the pruper�? 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 0 NO A�Jh
IF YES, describe size, type and location:
E Will the construction activity disturb grading,excavation,or filling)over 1 acre mishpart ofo common plan
that will disturb over 1acre? YES K ) NO
~��
IF YES,then a Northampton Storm Water Management Permit from the DPW is required.
mpton
�t?CI of Nort�; f` e
�t 1
bull ing,Department e
212 Main Street
Zp052100rh 100 r� e► �, �
3 Northaynpto ; MA 01060 V Q'o I �
phone 41$-587A 240 Fax 413-587-1272 PCs�S1f�e
--',<.�• .,-J �`'�° rte N � � ��' �. *�� ���" .� ,
s i�"✓ e� l7ectK P'� U ` a
APPLI6TIO TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTION 1 -SITE INFORMATION
This section to 6e completed by office
1.1 Property Address: _
Lot Unit
�-'�j+���/�=E Zane OuerlayDisfrrct.
w
=Eliix St oistr CB Du fct
SECTION 2-PROPERTYOWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Rye/ �cord: N
f�- 1 //
Name rint) Current Mailin Address:
X19 L�/Ve'� 6M-A C3/Q �v
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 ermit applicant
1. Building (a)Building Permit Fee
2. Electrical (b)Estimated Total Cost of
O Construction from 6
3. Plumbing Building;Permit Fee
4. Mechanical(HVAC) /A
5. Fire Protection /A
6. Total=(1 +2+3+4+5) QO . Check Number
PT
This.Section'For Official Use Onl
Date
Building Permit Number.: issued:
Signature:
Building Commissioner/Inspector of Buildings Date
File#BP-2006;0287
APPLICANT/CONTACT PERSON PARKER DAVID W JR&PATRICIA M
ADDRESS/PHONE 93 NORTH MAIN ST FLORENCE Qa
PROPERTY LOCATION 93 NORTH MAIN ST o 0
MAP 17C PARCEL 243 001 ZONE URB
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Buildinp,Permit Filled out
Fee Paid
Typeof Construction: CONSTRUCT 12 X 2 SHED
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 F IL OWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
IN�� MATION 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 sion
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.
93 NORTH,MAN ST BP-2006-0287
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 17C-243 CITY OF NORTHAMPTON
Lot:-001
Permit: Building
Category: BUILDING PERMIT
Permit# BP-2006-0287
Protect# JS-2006-0415
Est.Cost: $4400.00
Fee:$25.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Groin: Homeowner as Contractor
Lot Size(sa.ft.): 10585.08 Owner: PARKER DAVID W JR&PATRICIA M
zoning.URB Applicant: PARKER DAVID W JR & PATRICIA M
AT. 93 NORTH MAIN ST
Applicant Address: Phone: Insurance:
93 NORTH MAIN ST O 585-9826 O
FLORENCEMA01062 ISSUED ON.912012005 0:00:00
TO PERFORM THE FOLLOWING WORK.-CONSTRUCT 12 X 20 SHED
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 sienature:
FeeType: Date Paid: Amount:
Building 9/20/2005 0:00:00 $25.00
212 Main Street,Phone(413)587-1240,Fax:(413)587-1272
Building Commissioner-Anthony Patillo