35-266 THIS PLAT IS COMPILED FROM DEEDS, PLANS AND OTHER
SOURCES A14D IS NOT TO BE CONSTRUED AS AN ACCURATE
SURVEY AND IS NOT TO BE RECORDED-
CD PLAN BOOK 160, PAGE 93
10 ' WIDE EASEMENT
SEE: BOOK 3389, PAGE 63
TO: THE THE SPRINGFIELD INSTITUTION FOR SAVINGS &
THE LAWYERS TITLE INSURANCE CORPORATION
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 #
NOTE-
THIS PLAT FOR MORTGAGE LOAN PURPOSES ONLY
AND DOES NOT CONSTITUTE A PROPERTY SURVEY
,V Of -MORTGAGE LOAN INSPECTION PLAT-
RANDALL
L NORTHAMPTON, MASSACHUSETTS
IZER PREPARED FOR
#3W32 PAUL D. & NORAH B. BURNS
14 FES SCALE: 111=601 NOVEMBER 12 , 1990
HAROLD L. EATON AND ASSOCIATES, INC.
REGISTERED PROFESSIONAL LAND SURVEYORS
235 -RUSSELL STREET-�--HAaLEY - MASSACHUSETTS
'
O4'i11AMP�O
CritV of Narthaniptan
Z =
�ASSAC1t ltStttS ^ �
r
�., DEPARTMENT OF BUILDITjG INSPECTIONS
INSPECTOR 212 Main Street 0 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 1-.is/her construction sups .• 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
understand the above.
)I__e01b1ii'e'owner/resid is Pignature requesting exemption)
I will call to schedule all req red building inspections necessary for the building permit
issued to me.
Date C `:1- y (L11
Address of work
location
ki
O1lT1T I1f C�117�' lJ�I11T�Jf[1l1 Z .
6 JS11 Sl A C11115 rII 7
^� m f>EPfu2T?iENI OP 2 UILDD\IG INSPECTIONS
212 Alain Street ' Municipal Builcling
Northampton, Mass. 01060
WOMCER'S COMI'LNSATION' 1-NSUIZANCF EiFMAVIT
l
�:rith a principal place of business/r�sidenee �?:
do hereby Ccr- fti, t1n:Ier the pr:ins ,'.nd of perjury tha?_
I a-m an enlpioyer pro-,ndins the 1011ov..'InQ ',':OI'r:Ct'S coillmnsobon cover2`'•e [0- illy
elilployees wo6dng on this job:
(Inssras]cz Corn?w'ny) (?c1ic, ?�ttL tlxr) — (`r�pir lion Datc)
( j I am a sole proprietor, '.eneral c-Dn=c_or honleo��ner (c c!e one i and ha.-e cured
the contractors llsted below � o i':� i�l :Oli :il;: ' �OTI-_ C_o 011
r-
(I"' me Of Contmctor)
(Name of Cot tr Gr) 7llsar nc° Comp_,`/PG!ici Nt rl r) (F-, miion',late)
(Name of Contractor} ---_._ .....-_
I1CC t_:� ^2 .ili�Ol;C. l t]IS]1r'I� '.X; ,?i:Or fate')
- (Name of Contractor) —- (Ins anc--- Comb v;y/Policy Numb---r') - o- pate)
(�� � i�]CY`.1l S:�:Gt' .. 7 t._:..,..-.-..�K:':1::�Y•-.�.. ...I::��- '1
(. -cull a sole pi-opric"oi- 11"1(1 1Iivc 110 OI1C -•1,'vr�.iiir; for 117°_
F?i11 2 110171e 0�'1r1C" 't)f rG'I1]1I1^ pI(
NOTE:plc-zsc be aw1;c th>!
not utoce ih_o tluoo uni+-s jr-, di lx]:r, :Zr '`u :t;� _rtcc nI Lhac o c n �crrally
c=playca un��thr tvc;;:t c cc s•,.ati-n;•r.(0t,15nVa!(.j1.' :.:ic::by a hnrtro« rr:`cr e L e a p:f.^.i::: tir e t.c
�.•.:-
legal etatuc of"ezaployor under the Wo cc1t Cori-t>r—tion!.cL
I uz�dc�tand that a copy of t?'. ctilc: •r_vy to fo uwciod to tl o lYt n t rs: of Indsuirial Mire if ro of 1: `R =o for tix
ooverase veri[ciioa and that fzdure to s uc cotitr p ut :zc"iM 25A of 1.101,152 can 1`d to the impazition o,e:'rn i.-1 pe nlLu
c-11isting of a fur_of up to S I-500.0v0 n:t�'Y i :pr, r. :'_'of'.:p to ar.:}-a r.r.7 civil"-mltia in d.0 frnli c•f a S!�.t c i'-Otis ar,d a
f m of 5l Oa.W a day i ain:l ra-- .
--
For ciq:axttn^ztal uto only `
5lPnittl rC Ot 1.ICCa';C:aFICiII];it!_r:.
SECTON 8 CONSTRUCTION SERVICES
8.1 Licensed Construction Supervisor: Not Applicable ❑
Name of License Holder
License Number
Address Expiration Date
Signature Telephone
[91-ffez se>e o:, e m rue n::en .° ra -o Not Applicable ❑
Company Name Registration Number
Address Expiration Date
Telephone
SEC IO�Ir10 WOYRKERS';COMPENSATION 1NSURANCEYAFFIDAVIT(M O.L c. 152, §25 (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...... ❑
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 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 OrdinancesSIta and Local Zoning Laws and State of Massachusetts General Laws Annotated.
Homeowner Signature
'S � QN�.F�RO�OSED��YO.RK��eck�allia lica"�le
-; -..... nXr.z.P,.AS=i'iF1?,,:'! ..s,saaasa.n ., :•...s.?:z _v..
New House ❑ Addition ❑ Replacement Windows Alteration(s) ❑ Roofing ❑
Or Doors ❑
Accessory Bldg. Demolition❑ New Signs [ ] Decks [ ] Siding[ ] Other [ ]
Brief Description of Proposed Work: g�G�tre vn s a ` L! S In ut` la�.�k
Alteration of existing bedroom Yes No Adding new bedroom Yes No
Attached Narrative D Renovating unfinished basement Yes No
Plans Attached Roll❑. Sheet Ef
60- fide,± ouse" "a "d oratltlit"ion " ezistinhosin� com-;1e ee Refollow n
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 L
e. Number of stories? 6
f. Method of heating? 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
k. Will building conform to the Building and Zoning regulations? Yes No .
I. Septic Tank City Sewer �" Private well A* City water Supply
SCT � 1N ER�U�ORIZATION TO BE COMPLETED WHEN
UNEftS� EIS 1CONTRACTOR APPLIES FOR BUILDING PERMIT
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
1 _
I• C Y` ) '1 e- C as Owner/.Authorized Agent
hereby declare that the statements and infor tion on the foregoing application are true and accurate, to the best of my
knowledge and belief.
I N e nder the pains.and penalties of perjury.
a
Signature of caner/Agent Date
-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
n f Building Department
Lot Size
Frontage
Setbacks Front x ,5
r �
Side L: R: L: ? R: !0
Rear
Zb
Building Height
Bldg.Square Footage % C
Open Space Footage --34 6eu 93, %
(Lot area minus bldg&paved
parking)
#of Parking Spaces �, ,,., �b C. �w
Fill:
(volume'&Location)
A. 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#
i
B. 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?
i
Needs to be obtained Obtained , Date Issued:
C. Do any signs exist on the property? YES NO X
i
IF YES, describe size, type and location:
D. Are there any proposed changes to or additions of signs intended for the property?YES_
No
IF YES, describe size, type and location:
a
City of Northampton
Building Department
�[D) E F� E W E Main Street
i{ oom 100
-,; N�; h pton MA 01060
!!j SE11 2 rho 9413f� 1240 Fax 413-587-1272 -,
i
i AWEI lh�'T r G§tRUCT ALTER, REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTION 1 SITE INFORMATION
p � h�ssee�onnelete �jr #fce
1.1 Property Address: , M � t
I
M, t s u v
n
SECTION 2=PROPERTY-0WNERSHIPI-AUTfiIORIZED:AGENT
2.1 Owner of Record: U lu6 Z
Qa P' t) Current Mailing Address:
�"„"" Telephone
r
2.2 Authorized Agent:
Name(Print) Current Mailing Address:
Signature Telephone
SECTION 3- ES t4ATfD CONSTRUCTION'COSTS
Item Estimated Cost(Dollars)to be Officialll§e-Orly
completed by rmit applicant
1. Building , {a Building Permitee
X23 C) d,
2. Electrical (b.EstitTotal Cost of
Constructed_ion:from 6'
3. Plumbing 4 11ding,PermitFee
4. Mechanical (HVAQ
5. Fire Protection --
6. Total = (1 + 2+3 +4+ 5) 2 3 e Check Nuinber
This Seddon For Officlat Use°Oni
Building Permit Number: Date Issued:
Signature:
Building Commissioner/Inspector of Buildings Date
File#BP-2005-0353
APPLICANT/CONTACT PERSON MANGIONE LORRAINE
ADDRESS/PHONE 21 WEST PARSONS LN FLORENCE 5ktl_y 7,2 7
PROPERTY LOCATION 21 WEST PARSONS LANE
MAP 35 PARCEL 266 001 ZONE SR
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ZONING FORM FILLED OUT ENCLOSED REQUIRED DATE
Fee Paid
Buildiniz Permit Filled out
Fee Paid `-
T3Teof Construction: ERECT 8 X 12 SHED
New Construction
Non Structural interior renovations
Addition to Existing
Accesso1y Structure
Buildine Plans Included:
Owner/Statement or License
3 sets of Plans/Plot Plan
TH QLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
IN1?3nIMATION 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 Str ommission
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.
21 WEST PARSONS LANE BP-2005-0353
GIs#: COMMONWEALTH OF MASSACHUSETTS
Map:Bloek:35 266 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-2005-0353
Project# JS-2005-0467
Est.Cost: $2300.00
Fee: $25.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: Homeowner as Contractor
Lot Size(sq. ft.): 39988.08 Owner: MANGIONE LORRAINE
Zoning: SR Applicant: MANGIONE LORRAINE
AT. 21 WEST PARSONS LANE
Applicant Address: Phone: Insurance:
21 WEST PARSONS LN () 584-4727 ()
FLORENCEMA01060 ISSUED ON.1015104 0:00:00
TO PERFORM THE FOLLOWING WORK.ERECT 8 X 12 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 Signature:
FeeType• Receipt No: Date Paid: Check No: Amount:
Building 10/5/04 0:00:00 3396 $25.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Building Commissioner-Anthony Patillo