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29-136 -+ 6 -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 Y 0 i J � 1 IV � , -7r. TO: FLORENCE SAVINGS BANK & 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 —NOTE— SURVEYOR THIS PLAT FOR MORTGAGE LOAN PURPOSES ONLY AND DOES NOT CONSTITUTE A PROPERTY SURVEY of ,�S MORTGAGE LOAN INSPECTION PLAT- oy NORTHAMPTON, MASSACHUSETTS RANDALL GNP PREPARED FOR u IZ. y SHARON L. WALKER /35032 SCALE: 1 "=40 ' DECEMBER 10 , 1999 R��P �° HAROLD L. EATON AND ASSOCIATES, INC. REGISTERED PROFESSIONAL LAND SURVEYORS 235 RUSSELL STREET — HADLEY — MASSACHUSETTS t 0065'V85'C 1,17 xeJ 0065'i78S'8 L17 • Z90 LO VA `OOU9JOIJ . 9niJ0 Aydun0 58 L ■ AHdtjnw , r ` 7 Y�f "C) �1 0 V d � � � 0 � � a - �;,.� -� � �- �, ��.. Ri _. �j � V r r r � . � ' �� ' i i S`� � � 0 (� Q Q 9 v.} fi ,� .--� tTi �' - Z. r t�D _� �A a ti rz, --4 C C? 0 �i CA , 0 � o A A Z `4 0 LA t o, a k (n ' nti a CA d O R`t x t 3 e Y� C ! vo M 1 T' t� r � ' mss • � f �./V A" r ()\�—�' t �' ... .. y _._ _ _ _ 3 a � ?"_ "` •• 4 u © N X HOME OWNER EXEMPTION ACKNOWLEDGEMENT The State of Massachusetts allows the homeowner the right under 780CMR 108.3.4 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 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 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 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 The Commonwealth of Massachusetts Department of Industrial Accidents {M Office of Investigations 600 Washington Street Washing A` Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): Addi-ess: ���� / )ew City/State/Zip: I ZY74 e^ . 4/44P--ghone#: .3 7'��% Are you an employer?Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. ❑ I am a general contractor and T 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2. I am a sole proprietor or partner- listed on the attached sheet. 7. �Remodelin� ``ship and have no employees These sub-contractors have g. 7 Demolition working for me in any capacity. employees and have workers' 9. ❑Building addition [No workers'comp. insurance comp. insurance.: required.] 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions officers have exercised their 11. Plumbing repairs or additions 3.❑ I am a homeowner doing all work ❑ � P myself. [No workers' comp. right of exemption per MGL 12.❑Roof repairs . insurance required.] t c. 152, §1(4),and we have no employees. [No workers' 0.F1 Other comp. insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: _ Policy#or Self-ins. Lic. #: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify a n er the pains and penalties of perjury that the information provided above is true and correct. Signature: Date: Phone#: JAZZ yy � Official use only. Do not write in this area,to be completed by city or town officiaL City or Town: Permit/License# Issuing Authority(circle one): I.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 Su Rervisor: / Not Applicable CI Name of License Holder:. r't C /�3� 7 License Number V'-lid Address l Expiration Date Signs re Telephone 9.Registered Hortie"IntprauementContracfor Not Applicable ❑ Company Name Registration Number Address Expiration Date Telephone SECTION 10-WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c.152,§.26C(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...... ❑ I l: Home o> 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-vear 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 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 SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable) I New House Addition Replacement Windows Alteration(s) 0 Roofing Q fOr Doors ❑ Accessory Bldg. F-1 Demolition New Signs [lam] Decks [M Siding[ice] Other[01 Brief Description of Proposed�-y Work: L=itil!�� �7r a Alteration of existing bedroom Yes No Adding new bedroom Yes No Attached Narrative Renovating unfinished basement Yes No Plans Attached Roll -Sheet 6a. If New, house and or add tl.an."tai exisE ct h'o ls�RCi,co"rhptefe"fFtefof tnq: 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? �S d. Proposed Square footage of new construction.`_Dimensions ��% x 4 e. Number of stories? f. Method of heating? f n? L t X 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 kNo i/�// 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-TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT ^ as Owner of the subject property hereby authorize to act on my beha in all matters rela' e rk a oriz by this building permit application. Signature Wdwnei Date as Owner/Authorized Agent hereby declare that the stateme s an formation 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 Name Signature o Owner/Agent Date s Section 4. ZONING All Information Must Be Completed. Permit Can Be Denied Due To Incomplete Information Existing Proposed Required by Zoning This column to be filled in by Building Department Lot Size ,1 ,...... _.__, .. �._ .....M Frontage Setbacks Front.' t Side R.L _ .. L R: Rear Building Height , Bldg.Square Footage o_ y Open Space Footage % (Lot area minus bldg&paved �Z . arkin ) ` �G #of Parking Spaces Fill: (volume&Location) A. Has a Special Permit/Variance/Finding ever been issued for/'on the site? NO DONT KNOW 0 YES 0 IF YES, date issued:` IF YES: Was the permit recorded at the Registry of Deeds? NO 0 DONT KNOW 0 YES 0 µ IF YES: enter Book Page and/or Document#' B. Does the site contain a brook, body of water or wetlands? NO DONT KNOW YES 0 IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained 0 Obtained 0 , 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 0 NO IF YES, describe size, type and location: E. Will the construction activity disturb(clearing,grading, xcavation, or filling)over 1 acre or is it part of a common plan that will disturb over 1 acre? YES 0 NO IF YES, then a Northampton Storm Water Management Permit from the DPW is required. • Oeparne kl5e ota �� a ` �� City of Northampton 5ats ai ire " � � Building Department 212 Main Street �r�+ ti A ilab� , I �z Room 100 Wee��aii-asiwn� '"f a `xa m ., Northampton, MA 01060 T�,�rc"seaoSttctrPla R, phone 413-587-1240 Fax 413-687-1272 E�lo t Mans es Othel✓.Speol a'3 � z-?�-;�`� x x 3"'. a « APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1-SITE INFORMATION 1.1 Property Address: This section to be completed,by office 7 ji6 �G! Map Lot Unit Zone Overlay District Elan St,District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: Name(Print) Current Mailing Address: 711-�` Telephone Signature.' 2.2 Authorized Agent: Name(Print) �- Current Mailing Address: 7— Sign ure Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by ermit applicant 1. Buildingr9`� (a)Building Permit Fee 2. Electrical r9` (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 ! T File#BP-2009-0772 APPLICANT/CONTACT PERSON MATT MURPHY ADDRESS/PHONE 329 SOUTHAMPTON RD WESTHAMPTON (413)237-4415 Q PROPERTY LOCATION 337 RYAN RD MAP 29 PARCEL 136 001 ZONE URA(100)IIWSP THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out Fee Paid zo V7 Typeof Construction: EXTEND MASTER BEDROOM(10 X 16) � New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/Statement or License �d�� -7/7 3 sets of Plans/Plot Plan FO L OWING TION HAS BEEN TAKEN ON THIS APPLICA NF9PRM TIO ENTED: Ap 0ved Additional permits required(see below) PLANNING BOARD PERMIT REQUIRED UNDER:§ Intermediate Project: Site Plan AND/OR Special Major Project: Site Plan AND/OR Specie ZONING BOARD PERMIT REQUIRED UNDER: § 11 Ai 0,7 ' Finding Special Permit Vari �1"d ),N�H Received&Recorded at Registry of Deeds Proof Enclose ��) Other Permits Required: �,t0P -110 Curb Cut from DPW Water Availability _ C', Septic Approval Board of Health Well Water F Permit from Conservation Commission Permit fron r Permit from Elm Street Commission __Permit DP' Demolition Delay 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. BP-2009-0772 GI '#: COMMONWEALTH OF MASSACHUSETTS — CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL e.142A) Category: BUILDING PERMIT Permit# BP-2009-0772 Project# JS-2009-001148 Est. Cost: $20000.00 Fee: $120.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: MATT MURPHY Lot Size(sq. ft.): 22172.04 Owner: WALKER SHARON L.&JOHN W CAMPBELL Zoning:URA(100)//WSP Applicant: MATT MURPHY AT. 337 RYAN RD Applicant Address: Phone: Insurance: 3_29 SOUTHAMPTON RD (413) 237-4415 O WESTHAMPTONMA01027 ISSUED ON:312712009 0:00:00 TO PERFORM THE FOLLOWING WORK:EXTEND MASTER BEDROOM (10 X 16) 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 Ri nature: FeeType: Date Paid: Building 3127/2009 0:00:00 $120.003041 3041 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Building Commissioner-Anthony Patillo L " 4 01 cs, b v U $ x � n I v. k tro ' a d 1 y. Z ' mil' CJS 1 1 4 � � C n LIN s ` I r El f -- -- ,