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DEPT OF BUILDING INSPECTIONS
NW"HAiNWTON,MA 01060
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THIS PUT IS FOA IDENTIFICATION PURPOSES ONLY AND DOES NM CONSTITUTE A PROPERTY SURVIiY
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SPRINGFIELD INSTITUTION FOR SAVINGS AND TI IC LAWYERS TITLE INS. CORP.—ONLY
To the best of my knowledge,information and belief,1 hereby report that I have examined the premises and that this inspection plat shows the
improvement or improvements as located on the premises described,that the improvement or improvements arc entirely within lot lines,that
there are no encroachments upon the premises described by she improvement or improvements of any adjoining premises,and that there are
no easements of record affecting the tract shown hereon,except as shown.
1 further report that a portion of the premises shown on this plan is located within a flood hlazard Area(ZoneA) X44 sf9
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and it appears that the improvements shown Wrzarc not ontcd within a Flood 1 lazard Area as shown on Department DAVID
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of H.U.D.Federal Insurance Administration Maps, ° NUNTLEY ZI
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Community Number 250167 OOOIA O9�ffSS k35401
1
Identification Date APRIL 3, 1978 NE�o
P.LS.
NUNTLEY OWNER SUSAN GRICG
ALMER IIUNTLEY,JR. ac ASSOCIATES, INC.
Surveyors • Engineers • Landscape Architects
30 Industrial Drive Last LOCATION 71 SYLVESTER ROAD NORTHAMPTON
Northampton,MA 01061 53-5
voice(413)584-7444 litx(413)586.9159 JOB NO. DATE 9/23/93 SCALE
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m DEPARTMENT OF BUILDING INSPECTIONS /
,t
INSPECTOR 212 Main Street • Municipal Building '
Northampton,MA 01060
HOME OWNER EXEMPTION ACKNOWLEDGEMENT
The State of Massachusetts allows the homeowner the right under 780CMR 108.3.4 to
act as his/her construction super-,,is 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. ( r'
Date
Address of work
location �` Sy f u s>,.c ea fC)
tV 8 L7ii�A.^.��?y /✓I4
4�tt�N•PT0
c' 'IfiT of layfljallipf1111
11 6 ��[SS ACIl Sl5rI1!
^� DEPARTMENIT 01' 1?UILDPI G INSPECTIONS
212 Alain Street ' Municipal BulUng j
Northampton, Mass. 01060
WORICER'S COMI TENSATION INSURANCE A, + AVIT
1,
(lictirs°Jrc;mittec) -
v"Ith a prm, cip d place of business/residence n r
CIO hereby Cerill}' llllaef" the priilJ' ana pc-n",tlC`.+ o- pc.. '111-Y -hilt
( ) I am an employe; providing the followint •vor_cr`s compcnsation cove.,-a--,c `or my
employ ces working on dies job:
(lIlS=Cti Compam') (Pc;-',c-,-N u-nn bcr) - (�1✓'-1 ^�Date)
( ) I am a sole prODrletor, gen°ral Goilt=-,-or Gr homcowocr (Circle one) atld .]aVe autr'Cl
the contractors listed beiovv ;,fho hi- „ the ollc,','VMz .;oriters compensa-ion -poi:"ies:
(Name of Cont:mc-mr) COITM—t—IT:rPoticy Number) Date)
(Name Of Contractor) Numtr_r) (l `:';r:i10:]Date)
(Name of Contractor) — (1T1SI'1I1C COii :?n /i?01;C NliJlllf r� . �ti,i;1"c, )_late)
- (Name of Contractor) — (Ins-uancv Comr-=ry/Policy Numbs) (E;:pi-alo-Date)
i 'cull a sole l?I Upr]CLJi i?il'1 111'rivc 110 one for i]le.
( 1 8111 1? home 01'!?1C"
*,10.11:plcsc bc A%,arc L::_.�•i]c 1'{,S KO IYT3 1 rJ G 7I 1).^ J ::> „�cc cz::: n r m cr:c;;air. •:i: _d.,c11 c:
not more than Ihroo uni+'s in«L idt;he cx ou `u ;,s z t r eryrl Lhcc n z c rr{Eat Sall}'ttr.:::;::
ca?ployca uz;cr tiv tvorl,ces c --:!icn.••r:(G:.152_-m:(5)1,-t:,•i:r..:ic:;by n hrnncon-ecr`or a Gcc_.c c(�
Icgzl ctaluc of an cuplo)w under the Wo kc%t a Coz xrr,lion!.ct
I urnde^rtand thit a copy of t2iu etate:-s_•euy bo for�-nrcial to t]»[Ytiort.'nrnt of Ir-duu riel Ar i&crltf Cfnro of for tlx
oovmtgc vc-iGcalioa and that failure to r—trc crovcr_;,,urn::crioZ 25A of?.IG1.152 can Icad to tlw iTnPasitio c ir_1 psal::a
Comisting of a fin.,of up to S 1.500.00 nnd'nr i :prier.^:-.1 of up to or.-}:ar a:-.j Civil xnzttin in dK fc nn of
L•rr-oc s 100.00'L day again:.t m:. .
- icrdq:uumYnl u•c ally
perrnit Ntimb.:r -
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:.'. �I�Daturt 0 f I ic,r1';C:f1�CClll;il cr. _....---�%.-�l-•:-:• c
5€CONbtaySRUCTIOIV SERVICES
8.1 Licensed Construction Supervisor: Not Applicable ❑
Name of License Holder
License Number
Address Expiration Date
Signature Telephone
e .; ., m en: a n ,ac: Not Applicable ❑
Company Name Registration Number
Address Expiration Date
Telephone
TAO U1N0' E,RS',COMPENSATION 1N51JRANCE AFEIDA1fIT(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)fa mi!ies
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 acccptable 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
........ ROPOSEO:RK chei �a` lica'Ule
Y4:atiUBO _M 15tP£$Fai#X4>§,AP*ex?f "°fl4'4B4 3Z%::.:. s:1
RN
New House ❑ Addition 4r,*' Replacement Windows Alteration(s) ❑ Roofing
Or Doors ❑
Accessory Bldg. ❑ Demolition❑ New Signs [ J Decks [ ] Siding[ ) Other [ ]
Brief Description of Proposed Work: 4i)D VO p 9de— C �rr7e� rrL2
Alteration of existing bedroom Yes No Adding new bedroom Yes _ No
Attached Narrative 0 Renovating unfinished basement Yes No
Plans Attached Roll 0. Sheet 0
a ®. a action #off=isti wing cRT, ea -hem oo nw
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?-- C ,
d. Proposed Square footage of new construction. 7'7� Dimensions �2
e. Number of stories?
f. Method of heating? /1/Gtn/ Fireplaces or Woodstoves Number of each
g'. Energy Conservation Compliance. Mascheck 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 AKIA
k. Will building conform to the Building and Zoning regulations? Yes No .
I. Septic Tank City Sewer Private well City water Supply
E I1ATION t,66 B;E COMPL�ED WHET
D: AC7QR APL1E5 FOR B�1;LxDNaG PEit1IIT
2M .., .
i as Owner of the subject property
hereby authorize to ac't or
my behalf, in all matters relative to work authorized by this building permit application.
Signature of Owner Date
cA V1 non as Owner/Authorized Agent
ereby 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.
a V a
Print Name
Signature of Owner/ ent Date
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 Depanment
Lot Size
Frontage j 70
Setbacks Front qX l
Side L: R: L: R: �A
C
Rear 2-450
Building Height -7 Mc Y"I 13�
Bldg. Square Footage (66V
Open Space Footage %
(Lot area minus bldg&paved
parking)
#of Parking Spaces
Fill:
volume&LocationG�
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. Aere any proposed changes to or additions of signs intended for the property?YES _
No
IF-YES, describe size, type and location:
of Northampton
4 Iding Department
1412 Main Street
2003 Room 100
i ?35 h`pmpton, MA 01060
o
87.1240 Fax 413.587-1272
"BSI�
APION TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTION 1 SITE';°INFOR'MATION
1.1 Property Address:
,his
SECT ONf 2- PROPERTY:"OWNERSHIP/AUTHQRIZED AGENT
2.1 Owner of Record:
Name(Prin _ Current Mailing Address:
Telephone
Signature
2.2 Authorized Agent:
Name(Print) Current Mailing Address:
Signature Telephone
SECTION ' ESTIMATED CONS"`fRI�CTION"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
Construction.from 6
3. Plumbing ---_____. Building Permit Fee
OGt/(9
4. Mechanical (HVAC)
5. Fire Protection WOW
6. Total =(1 + 2 + 3 + 4 + 5) �`�� ' Check Number
This Section For Official Use Onl
i3uiI u Permit Number: Dated"ssued:
Signature:
t Building Commissioner7lnspector of Buildings Date
T
File#BP-2004-0064
APPLICANT/CONTACT PERSON WEINBERGER SARA
ADDRESS/PHONE 266 GROVE ST#2 (413)587-8983 Q
PROPERTY LOCATION 71 SYLVESTER RD
MAP 35 PARCEL 041 001 ZONE RR
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 Constructio : CONVERT DECK TO SCREENED PORCH
New Construction
Non Structural interior renovations
Addition to Existini
Accesso1y Structure
Buildiniz Plans Included:
Owner/Statement or License
3 sets of Plans/Plot Plan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INFORMATION PRESENTED:
Y 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 Commission '7 743-
h� �A
Signature of Building O ial 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.
`w`rY
' BP-2004-0064
G1S#: COMMONWEALTH OF MASSACHUSETTS
A-IV 11 CITY OF NORTHAMPTON
Lot:-001
Permit: Building
Category: BUILDING PERMIT
Permit# BP-2004-0064
Project# IS-2004-0099
Est.Cost: $5500.00
Fee:$50.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: Homeowner as Contractor
Lot Size(sq. ft.): 52272.00 Owner: WEINBERGER SARA
Zoning:RR Applicant: WEINBERGER SARA
AT. 71 SYLVESTER RD
Applicant Address: Phone: Insurance:
71 SYLVESTER RD (413) 587-89830
FLORENCEMA01062 ISSUED ON.7118103 0:00:00
TO PERFORM THE FOLLOWING WORK.-REBUILD 12 X 12 & CONVERT DECK TO
SCREENED PORCH
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 Signature:
FeeType: Receipt No: Date Paid: Check No: Amount:
Building 7/18/03 0:00:00 221 $50.00
212 Main Street,Phone(413)587-1240,Fax:(413)587-1272
Building Commissioner-Anthony Patillo