24D-292 (2)Official Receipt for Recording in:
Hampshire County Registry of Deeds
33 King St.
Northampton, Massachusetts 01060
Issued To:
CHRISTOPHER CHAPUT
413-341-3620
/5- Z- Cre 5CGnl�-5 j
Recording fees
Document Recording
Description Number Book/Page Amount
x----------------------------------------------
DECIS 00016909 10260 17 $75.00
CHAPUT
$75.00
Collected Amounts
Payment
Type Amount
----------------------------------------------
Cash $75.00
$75.00
Total Received : $75.00
Less Total Recordings: $75.00
Change Due $.00
Thank You
MARIANNE DONOHUE - Register of Deeds
By: Kimberly M
Receipt# Date Time
0225308 08/12/2010 09:09a
Reprinted By: Kimberly M
Reprinted On: 08/12/2010 09:10a
h
-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
NOTE:
SUBJECT TO EASEMENTS AND
RIGHTS OF WAYS OF RECORD.
1
44't
BOOK 2629, PAGE 191
PLAN BK. 26, PG. 77
52't
CRESCENT STREET
TO: APPLIED MORTGAGE SERVICES CORPORATION &
LAWYERS TITLE INSURANCE CORPORATION
TO THE BEST OF MY INFORMATION, KNOWLEDGE AND BELIEF
I HEREBY . REPORT THAT. I . NAVE 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
_ -NOTE-
SURVEYOR --�- THIS PLAT FOR MORTGAGE LOAN PURPOSES ONLY
AND DOES NOT CONSTITUTE A PROPERTY SURVEY
CRR"ANDALL
o 0.5032 H
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-MORTGAGE LOAN INSPECTION PLAT -
NORTHAMPTON, MASSACHUSETTS
PREPARED FOR
CHRISTOPHER R. CHAPUT
SCALE: 1"=20' SEPTEMBER 1, 2006
HAROLD L. EATON AND ASSOCIATES. INC.
REGISTERED PROFESSIONAL LAND SURVEYORS _
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44't
BOOK 2629, PAGE 191
PLAN BK. 26, PG. 77
52't
CRESCENT STREET
TO: APPLIED MORTGAGE SERVICES CORPORATION &
LAWYERS TITLE INSURANCE CORPORATION
TO THE BEST OF MY INFORMATION, KNOWLEDGE AND BELIEF
I HEREBY . REPORT THAT. I . NAVE 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
_ -NOTE-
SURVEYOR --�- THIS PLAT FOR MORTGAGE LOAN PURPOSES ONLY
AND DOES NOT CONSTITUTE A PROPERTY SURVEY
CRR"ANDALL
o 0.5032 H
s �U
-MORTGAGE LOAN INSPECTION PLAT -
NORTHAMPTON, MASSACHUSETTS
PREPARED FOR
CHRISTOPHER R. CHAPUT
SCALE: 1"=20' SEPTEMBER 1, 2006
HAROLD L. EATON AND ASSOCIATES. INC.
REGISTERED PROFESSIONAL LAND SURVEYORS _
GARAGE
18' X 18'
outside dimensions
23'
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cc I
Q.. f 220.'
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N
SIDEWALK 4'
i 52'f 6'
41'
House to
Fence
33'
.i
Proposed
Garage
Bump -Out 4'
x Full Width
CRESCENT- STREET
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41'
House to
Fence
33'
.i
Proposed
Garage
Bump -Out 4'
x Full Width
CRESCENT- STREET
10. Do any signs exist on the property?
IF YES, describe size, type and location:
YES NO
Are there any proposed changes to or additions of signs intended for the property? YES NO
IF YES, describe size, type and location:
11. Will the construction activity disturb (clearing, grading, excavation, or filling) over 1 acre or is it part of a common
plan of development that will disturb over 1 acre? YES NO
IF YES, then a Northampton Storm Water Management Permit from the DPW is required.
12. ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE DENIED DUE TO LACK OF INFORMATION
This column reserved
for use by the Building
13. Certification: I hereby certify that the information contained herein is true and accurate to the best of
my knowledge.
Date: Applicant's Signature
NOTE: Issuance of a zoning permit does not relieve an applicant's burden to comply with all zoning
requirements and obtain all required permits from the Board of Health, Conservation Commission,
Historic and Architectural Boards, Department of Public Works and other applicable permit granting
authorities.
W:\Documents\FORMS\original\Building-Inspector\Zoning-Permit-Application-passive.doc 8/4/2004
MA`( _ 4 2010 Ap16'7'
File No.
Please type-, r print all information and return this form to the Building
-inspector's Office with the $15 filing fee (check or money order) payable to the
1! //City ofNoo/rthampton
fb®
1. Name of Applicant: ✓/3/�G,� C`(G�� a
Address: � 5— —Telephone:,/c P13 ' d loL �
2. Owner of Property:
Address: Telephone:
3. Status of Applicant: Owner 4 - Contract Purchaser Lessee Other (explain)
4. Job Location: c5 Q1MlZ
5. Existing Use of Structure/Property: a5 t CG'o Cz
6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary):
7. Attached Plans: Sketch Plan Site Plan L�1 Engineered/Surveyed Plans
8. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO DONT KNOW YES IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO DONT KNOW / YES
IF YES: enter Book Page and/or Document # _
9.Does the site contain a brook, body of water or wetlands? NO DONT KNOW YES
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained Obtained date issued:
(Form Continues On Other Side)
W:1Documents\FORMS%original\Building-Inspector\Zoning-Permit-Application-passive.doc 8/4/2004
File # MP -2010-0077
APPLICANT/CONTACT PERSON CHAPUT CHRISTOPHER R
ADDRESS/PHONE 152 CRESCENT ST (413) 813-8604 Q
PROPERTY LOCATION 152 CRESCENT ' p
Mr ' ,CEL X92 tit3l > E URB(L4111/
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
Building Permit Filled out
Fee Paid
Typeof Construction: ZPA - GARAGE BUMP OUT
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
INFORMATION PREPNTED:
Approved f/ 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: § (-)7 3 5O — 9.3 6� 5,1 y N A'r ,(A IZ16s AL
r1 Nil /�
Finding_ Special Permit Variance*
Received & Recorded at Registry of Deeds Proof Enclosed
Other Permits Required:
Curb Cut from DPW
Septic Approval Board of Health
Water Availability Sewer Availability
Permit from Conservation Commission
Permit from Elm Street Commission
Signature of Building Official
Well Water Potability Board of Health
Permit from CB Architecture Committee
Permit DPW Storm Water Management
&//0 _
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 the Office of
Planning & Development for more information.
44'f
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18 X 18 25'
outside dimensions
Proposed
i , Garage
l� J 1 4' 1 Bump -Out 4'
a� t House tox Full Width
23'
1 Fence
j 70Vr s
z� 33,La
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17
SIDEWALK 4'
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52'± 6'
t�
CRESCENT-
Zoning Board of Appeals - Decision City of Northampton
Hearing No.: ZBA-2010-0028 Date: June 25, 2010
MINUTES OF MEETING:
Available in the Office of Planning & Development.
1, Carolyn Misch, as agent to the Zoning Board of Appeals, certify that this is a true and accurate decision made by the Zoning Board
Administrator and certify that a copy of this and all plans have been riled with the Board and the City Clerk on the date shown above.
I certify that a copy of this decision has been mailed to the Owner and Applicant.
r
The appeal period for residential findings granted by the Zoning Board of Appeals Zoning Administrator are thirty (30) days from the date
of the decision. Ali appeals are heard by the full Zoning Board of Appeals.
Zoning Board of Appeals - Decision City of Northampton
Hearing No.: ZSA-2010-0028 Date: June 25, 2010
APPLICATION TYPE: SUBMISSION DATE.
Resldenilal gnding 5J SW10
Anniicant's Name: Owner's Name:
NAME:
NAME:
CHAPUT CHRISTOPHER R
CHAPUT CHRISTOPHER R
ADDRESS:
ADDRESS:
152 CRESCENT ST
152 CRESCENT ST
TOWN:
STATE:
ZIP CODE:
TOWN:
STATE:
ZIP CODE:
NORTHAMPTON
MA
01060
NORTHAMPTON
MA
I 01060
PHONE NO.:
FAX NO.:
PHONE NO.:
FAX NO.:
413 813-8604 0
6/10/2010
(413) 813-8604 0
6/24/2010
EMAIL ADDRESS:
EMAIL ADDRESS:
Site Information: Survevor's Name:
STREET NO.:
152 CRESCENT ST
SITE ZONING:
URB(100)1
COMPANY NAME:
TOWN:
NORTHAMPTON MA 01060
ACTION TAKEN:
Grant
ADDRESS:
MAP:
240
BLOCK:
292
I LOT:
001
MAP DATE:
SECTION OF BYLAW:
Chapt. 350-9.3 (1) (D): Pre-existing
Nonconforming Structures or Uses May be
Changed, Extended or Altered with a
Finding from the Zoning Board of Appeals.
TOWN:
STATE:
ZIP CODE:
Book:
2629
Page:
191
PHONE NO.:
FAX NO.:
NATURE OF PROPOSED WORK:
EMAIL ADDRESS:
GARAGE BUMP OUT
HARDSHIP:
CONDITION OF APPROVAL:
FINDINGS:
The designated Zoning Administrator granted the Finding based on the materials and graphics submitted with the application.
The Findings of the Board Administrator under Section 9.3 for an addition to a detached garage related to the side yard setbacks as
follows:
1. The Administrator found that the change would not be substantially more detrimental to the neighborhood than the existing
nonconforming House. The garage is approximately less than 2' from the side lot line and the extension would be in the front, no closer
than existing.
2. The Administrator found that the home would not extend any closer to any front, side, or rear property boundary than the current
zoning allows and that the pre-existing structure already extends.
3. The Administrator also determined that the new construction would not create any new violation of other zoning provisions, and does
not involve a sign.
COULD NOT DEROGATE BECAUSE:
FILING DEADLINE:
MAILING DATE:
HEARING CONTINUED DATE:
DECISION DRAFT BY:
APPEAL DATE:
5125/2010
6/19/2010
7/8/2010
REFERRALS IN DATE:
HEARING DEADLINE DATE:
HEARING CLOSE DATE:
FINAL SIGNING BY:
APPEAL DEADLINE:
6/12/2010
7/29/2010
6/24/2010
7/8/2010
7/25/2010
FIRST ADVERTISING DATE:
HEARING DATE:
VOTING DATE:
DECISION DATE:
6/10/2010
6/24/2010
6/24/2010
6/25/2010
SECOND ADVERTISING DATE:
HEARING TIME:
VOTING DEADLINE:
DECISION DEADLINE:
6/17/2010
4:10 PM
9/22/2010
9/22/2010
MEMBERS PRESENT: VOTE:
Sara Northrup votes to Grant
MOTION MADE BY: SECONDED BY: VOTE COUNT: DECISION:
Sara Northrup I 1 1 Approved
HOME OWNER EXEMPTION ACKNOWLEDGEMENT
The State of Massachusetts allows the homeowner the right under 780CMJ U 08.3.4 to
act as his/her construction supervisor. 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 person(s) who seek to use
the home owner exemption, -to act as their ownconstruction 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 your), 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 insuections 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
�ermits 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
understand the above.
.(Home owner /redident'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 51—�,
rE?!� location % 2 (j .5 C
The Commonwealth of Massachusetts
Department of Industrial Accidents
Office oflnvestigations
600 Washington Street
Boston, AL4 02111
www.mass.g-ov1dia
-Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Pl7umb.ers
Name (Business/Organiza6owlIndividual);
Address:
5
010C.
City/Sta&Lp: /PhoneA:
Are you an employer?. Check the appropriate box:
Type of I prioject (required):,
1. 0 1 am aemployer with
4.. F1 I am a general contractor and 1
6. E) New construction
employees (full and/or part-time). *
2- El I am a sole proprietor or partner-
hired the sub -contractors
listed on the attached sheet
7. E] Remodeling
ship -and have. no. ex:451oyees
These sub -contractors have.
.8. 0 Demolition
worldng for -mein any capacity.
.
en4goyecs gp;lbave wod='
insura-riceJ.'.
-B.0
9� 20 addition
R4o workers?. comp. insur Mce
requind]
':
comp.
5. We are a corp oiation and its
10.0 Electrical repairs or additions
3 I am a homeowner doing all work
officers haveher-cised their
Plumbing repairs or additions
yself. [No workas'comp.
h
right of exemption . per MGL
12.0.Roof repairs
insurance required.] t
.
c. 152, § 1(4), and we have no
13
40 Other
.
employees. (No workers'
comp. insurance requited.}.
*Any applicant that checks -box 91: mustalso fin out the section below showing dickworkers'compensatim policy information.
Homeowners vho submit this zMdavit.indiC2ting they are doing all work and then him outside contractors must submit a new affidavit indicating such
1contractars that check this box mustattached an additional sheet showing the name of the sub -contractors and state Whe6cr,or notthGse cutities have
employees. If the sub -contractors bave employees, they must provide their workers' coup. policy number.
lam an employer that Lyprovidht- workers' compensation insurance for my employee& Below is the policy and job -site
information.
lumumce Company Name:
Policy # or. Self-mis. Lica A Expiration Date: -
Job Site- Address:
City/Sta&Zip.
Attach a copy of the workers'- compensation policy declaration page -(showing the p9licy number and expiration
Failure, to secure co-vera:ge.a-sr-equired .,I'�,,�ifil6�ad'to.:�ien33positionoicnmm4.Lp��ti'es of
fine up to S1.500.00 and/or one.-year.imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and -a fine
of up to S250.00 a day against the violator. Be advised that a copy of this statement may be f6rwarded-to the-015ce of
e coveraze veritcation.
Ido hereby
certify un the pains -and
penabies e72Ma& the informadonprovided-abom-
andC
lwtune: Date,
ioner*:,i��',%;
r Ir
Offidd use only. Do not write in Mis area, 10 be completed by city or town offwjal
City or Town: P6rmitUcense
Issuing Authority (circle one):
1. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical
Inspector 5. Plumbing Inspector
6. Other
Contact Person: Phone #:
SECTION 8-- CONSTRUCTION SERVICES'
8.1 Licensed Construction Supervisor:
Name of license Holder:
Not Applicable ❑
License Number
Address
Expiration Date
Signature Telephone
9=RebistereriIofYie°Ir3lrrotemettt°ririrtCtora00 �.mow .. r. ...
Not Applicable ❑
Company Name
Registration Number
Address
Telephone
Expiration Date
§ 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 buildinq permit.
I Sianed Affidavit Attached Yes....... ❑ No...... ❑ I
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
Homeowner
Annotated.
SECTION 5- DESCRIPTION OF PROPOSED WORK (check all applicablel
New House
Addition
$____
Replacement Windows Alteration(s)
Roofing
Or Doors 171Accessory
Bldg�/_
Demolition
New Signs [O] Decks [M
Siding [E3] Other [p]
Brief Description of Propose
14611
r�
Work:
kC�
�
Alteration of existing bedroom Yes -,---No Adding new bedroom Yes
--�No
Attached Narrative Renovating unfinished basement
Yes
Plans Attached Roll - Sheet
f;'� �` L�� WWI 6l>F@1f1[I�kitC a�1i>vc�cisr�alr�ncr.mltet.ihe;+{CwlCns�.
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
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 - OWNER AUTHORIZATION:.- T4 BE. COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES 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
as Owner/Authorized
Age her et -the state ents foregoing application are true and accurate, to the best of my knowledge
and ief.
Signed er the pains an penaftie of pe '
�un
Print Name
Signature of Owner/Agent Date
ISection 4. ZONING `All Information Must Be Completed. Permit Can Be Denied Due To Incomplete Information
A. Has a Special Permit/Variance/Finding ever been issuec!40rion the site?
NO Q DONT KNOW 0 YES
IF YES, date issued:,
r .Zo f C7
IF YES: Was the permit recorded at the Registry of Deeds?
NO 0 DONT KNOW YES Q
IF YES: enter Book Page? ? and/or Document #
B. Does the site contain a brook, body of water or wetlands? NO DONT KNOW Q YES 0
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 0 NO
IF YES, describe size, type and location:
D. Are there any proposed changes to or additions of signs intended for the property ? YES Q NO
IF YES, describe size, type and location:
E. Will the construction activity disturb (cleaading, ca tion, or filling) over 1 acre or is it part of a common plan
ring, gr
that will disturb over 1 acre? YES 0 NO
IF YES, then a Northampton Storm Water Manage t Permit from the DPW is required.
Existing
Proposed
Required by Zoning
This column to be filled in by
Building Department
Lot Size
L� _ --j
Frontage
Setbacks Front
i"'eV Side
Rear
/�
L: R:
L:7P�R:
1
Building Height%^)
Bldg. Square Footage
%
I
i
Open Space Footage_,
(Lot area minus bldg & paved
parking)�`
'
1
7-11
# of Parkin Spaces
EZ;
Fill:
volume & Location
A. Has a Special Permit/Variance/Finding ever been issuec!40rion the site?
NO Q DONT KNOW 0 YES
IF YES, date issued:,
r .Zo f C7
IF YES: Was the permit recorded at the Registry of Deeds?
NO 0 DONT KNOW YES Q
IF YES: enter Book Page? ? and/or Document #
B. Does the site contain a brook, body of water or wetlands? NO DONT KNOW Q YES 0
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 0 NO
IF YES, describe size, type and location:
D. Are there any proposed changes to or additions of signs intended for the property ? YES Q NO
IF YES, describe size, type and location:
E. Will the construction activity disturb (cleaading, ca tion, or filling) over 1 acre or is it part of a common plan
ring, gr
that will disturb over 1 acre? YES 0 NO
IF YES, then a Northampton Storm Water Manage t Permit from the DPW is required.
quo
City of Northampton
Building Department
212,Main Street
Room 100
Northampton, MA 01060
phone 413-587-1240 Fax 413-587-1272
6 'min
APPLICATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTION 1 =SITE INFORMATION -
1.1 Property Address.
%5'Z C✓ -5 cetyl 61f e�
Fnrs section tone completes byottrce
Lot Unit
SECTION 2 -PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
�5-z c,�S 0/ o
Name (Print)
Current Mailing Address•
/3- ;s/3 -
Telephone
Si ature
2.2 Aut orized 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
1. Building
(a) suilding Permit Fee
D U�
2. Electrical
(b) Estimated Total Cost of
Construction from 6
3. Plumbing
Building Permit Fee
4. Mechanical (HVAC)
5. Fire Protection
6. Total = (1 + 2 + 3 + 4 + 5) Check Number
This Section For Official Use Only
Date
Building Permit Number: Issued:
Signature:
Building Commissioner/Inspector of Buildings Date
N
f52 CRESCENT ST BP -2011-0091
GIs #: COMMONWEALTH OF MASSACHUSETTS
�W: ock: 24D - 292 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 -2011-0091
Project # JS -2011-000173
Est. Cost: $1000.00
Fee: $55.00
Const. Class:
Use Groin
PERMISSION IS HEREBY GRANTED TO.-
Contractor:
O.
Contractor: License:
Homeowner as Contractor
Lot Size(sq. ft.): 4965.84 Owner: CHAPUT CHRISTOPHER R
Zoning_URB(100) Applicant: CHAPUT CHRISTOPHER R
AT. 152 CRESCENT ST
Applicant Address: Phone:
152 CRESCENT ST (413) 813-8604 O
NORTHAMPTONMA01060 ISSUED ON:8/10/2010 0:00:00
TO PERFORM THE FOLLOWING WORK. -Foundation Repair
POST THIS CARD SO IT IS VISIBLE FROM THE STREET
Inspector of Plumbing Inspector of Wiring D.P.W.
Underground: Service:
Rough: Rough:
Final: Final:
Gas: Fire Department
Rough: Oil:
Final: Smoke:
Meter:
House #
Driveway Final:
RyK�l,-ew
Y,,,A
5&6r(64V
Insurance:
Building Inspector
Footings:
Foundation:
Rough Frame:
Fireplace/Chimney:
Insulation:
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: Date Paid: Amount:
Building 8/10/2010 0:00:00 $55.00
212 Main Street, Phone (413) 587-1240, Fax: (413) 587-1272
Louis Hasbrouck — Building Commissioner