43-072 (4) jge. " BP-2003-0069
GIS it: COM',:../NWEALTH OF MASSACHUSETTS
CITY OF NORTHAMPTON
Lot-001
Permit: Building
Category; 3UILDING PERMIT
Permit ft BP•2003.0069
Pro ect# ! JS- 003-015
Est.Cost $17000.00
Fee:$50.00 PERMISSIL +- ;S HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Croup: PATIO ROOM'. : AMERICA 070998
Lot Size(sq ft.): 16552.80 Owner: p Y::- ,\ MARTIN&MARY E
Zoning: Applicant: PATIO 300MSOFAMERICA
AT.• 112 DIIL."r ';' DR
Applicant Address: Phone: Insurance:
317 MEADOW Si,UNIT 2 (413) 420-0140 0
Workers Compensation
CHICOPEEMA01013 ISSUED OV: 0:00:00
TO PERFORM THE FOLLOW/Au 1, :CONSTRUCT 12 X 12 3 SEASON ROOM
POST THIS CARD SO IT IS VISIBLE FRY STREET
Inspector of Plumbing Inspector of Wiring Building Inspector
Underground: Service:
Rough: Rough: - Foundation:
. Final:
Final: Final:
Rough Frame:
Gas: Fire Department Fireplace/Chimney:
Rough: Oil: Insulation:
Final: Smoke: Final:
THIS PERMIT MAY BE REVOKED BY ! ?' OF NORTHAMPTON UPON VIOLATION OF
ANY OF ITS RULES AND REGULATI'
Certificate of Occupancy signature;
Fee Type: Receipt No: ;): Check No: Amount:
Building _. ... 2274/2282 $10.00
212 Main Street- ' . 7-1240e Fax: (413)587-1272
sr-Anthony Patillo
File#BP-2003-0069
APPLICANT/CONTACT PERSON PATIO ROOMS OF AMERICA
ADDRESS/PHONE 317 MEADOW ST,UNIT 2 (413)420-0140 0
PROPERTY LOCATION 112 DUNPHY DR
MAP 43 PARCEL 072 001 ZONE SR
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Bui . r: Permit File. out
Fee Paid i`'• : . _ — e • ; a5' '-J$,50—
TypeofConstruction, CONSTRUCT 12 X 12 3 SEASON ROOM
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/Statement or License 070998
3 sets of Plans/Plot Plan
THE FO OWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INFO ATION 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 ssian
* 24% '2_--
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.
•
Deparonent use Dory
..y i, r-� cook of Northampton Status of Permit:
Lim Ir Fti ding Department Curb CuvDavewey Permit
Main Street Availabiely
�,�� _t„'. Room 100 WMd
ateell Availability
t gPShampton, MA 01060 Two Sets of Structural Plans
13-5i7-1240 Fax 413-5871272 PIoUSite Plana_,; r
f4I .1'331.1"o'; t Other Specify
APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTION 1-SITE INFORMATION
1.1 Property Address' ''T//hiss section to be completed by office
Map T3___ Lot 2?- Unit_
i/,2 4htzeH/ hew,- Zone_ - Overlay a.rna
/77LOec4tr 414 Elm St DisMct CS District_ _
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
Name(Print) Current mahris Address
Telephone
2.2 Authorized Agent:
_aLY(Pnn i �l ---__....... _LLe?_QI�g Address
Name(Print) Current Ma01ng Address:
Signature Telephone
SECTION S-ESTIMATED CONSTRUCTION COSTS,
Item Estimated Cost(Dollars)to be Official Use Only
completed by permit applicant
1. Building (a)Building Permit Fee
/7 coo.co
2. Electrical (b)Estimated Total Cost of
Construction from(6)
3. Plumbing Building Permit Fee
4. Mechanical(HVAC) q
5.Fire Protection �r d'6IT . as-
6. Total =(1 +2+3+4+5) 1 /z 060,(tO Check Number
This Section For Official Use Only $5
Building Permit NumbersDate........ —ro _. issued:
Signature: ..
&airing Commissioner/Inspector of Butdings Date
Section 4.
ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE DENIED
DUE TO LACK OF INFORMATION
Existing Proposed Required by Zoning
ha column to be tilled in by
tioihims Ilepanment
Lot Size /7„at s„FT /7,-20s-rt 3o,oru
frontage ion' /00 ' /as'
Setbacks Front 30
Side L R; L: SI R:,j$ 0
Rear pfd
Building Height
Bldg. Square Footage °o
Open Space Footage .�
ttga area minus htdg&paned t-; c)
parking}
H of Parking Spaces
Fill:
Ird une&I°cal ion
A. Has a Speciaai PermittYariance/Finding ever been issued for/on the site?
NO DON'T KNOW t/ 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 tt
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. Are there any proposed changes to or additions of signs intended for the property NES
No
IF YES, describe size, type and location: ..
pECTION 5-DESCRIPTION OF PROPOSED WORK(check BI applicable)
New House ❑ Addition 0 Replacement Windows Atteration(s) ❑ Roofing ❑
Or Doors ❑
Accessory Bldg. 0 Demolition❑ New Signs ( I Decks ( t Siding I Other ft
Brief D?,,cripption of Proposed
Work llQpAW) ,J 4)<zctWcW ewbP&rW Nnr t nrr✓ ter tin iisn722A;g4veicei ORm-1'
Alteration of existing bedroom Yes__✓ No Adding new bedroom - Yes _... No
Attached Narrative Renovating unfinished basement ____ __Yes
Plans Attached Roll -Sheet
ea.If New house and or addition to existing housing, complete the following:
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._ _jW f Dimensions _1d r illi
e. Number of stories? l
f. Method of heating?_.AM _., Fireplaces or Woodstoves _, -Number of each_ ___
g. Energy Conservation Compliance. /CIA Mascheck Energy Compliance form attached?_ _
h. Type of constructionf�MA_ tU�a�-YiJ{ct" ogmeo 4AtFS (Awir'1Mtott vviI* t Soni 6445_5) -_—
i. Is construction within 100 ft.of wetlands? _ Yes -_Y'" 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 f TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
i,__ Agtgrrb _ 7tJ,0/411,64 _ _., .as Owner of the subject
property
hereby authorize W'���0._frst .i __Ag
ri_ ?Y5_dY v {Q1_
to
act on my behalf, in all matters relative to work authorized by this building permit application.
Signature of Owner Date
_-Agaga- )1/j{JLA! 'may _4122ta hJPrVrii_ s$! / iZe __,es Owne#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.
Cuing r_vpin
Print Name
Signature of Owner Date
SECTION 8-CONSTRUCTION SERVICES
81 Licensed Construction Supervisor: Not Applicable ❑
Name of License Holder:y!/p/yeyrd_/YfitkayG -]JJ
License Number
rad tvs _,-_?Irs 4-as-03
Address `/-%��J Expiration Date
Signature Telephone
9.Registered Nome Improvement Contractor, Not Applicable 0
Company Name Registration Number
t•a_ .c Zcs__S2s_ tL6Q7�Rto _ iv -a/ Q,i______
Address Expiration Date
SECTION 10-WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c,152,§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 budding permit.
Signed Affidavit Attached Yes �' No 0
11. - Home Owner Exemption
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.(AIR 780, Sixth Edition Section 108.33.1.
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"shalt submit to the Building Official,on a form acceptable to the Building Official that hetshe 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 he 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
-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
V\ 'S°9 4S ., ca�.t 2�
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1{I ?
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P,ogosee7 12'^"12'
3 Se4Scs/ 5 4/Zen 9
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
1\ � ���� -NOTE-
SURVEYOR: aJr-�,.¢..XX.. E. T THIS PLAT FOR MORTGAGE LOAN PURPOSES ONLY
AND DOES NOT CONSTITUTE A PROPERTY SURVEY
Nor µs . -MORTGAGE l OAN INSPECTION PLAT-
LAS. NORTHAMPTON, MASSACHUSETTS
RANDALL e, PREPARED FOR
u CPR m BERNARD J. SUPLREA
�135032. SCALE: 1 "-30 ' SEPTEMBER 15, 1997
(1*0 ESuR}JYE,�9P HAROLD L. EATON AND ASSOCIATES, INC.
REGISTERED PROFESSIONAL LAND SURVEYORS
235 RUSSELL STREET - HADLEY - MASSACHUSETTS
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Property Owner Must Complete and Sign This Section If Using A Builder
h!-'-iC1r L1N CJ
11
1 A . as Owner of the subject property
hereby authorize Betterliving Patio Rooms ld.b.a. —Patio Rooms of America) to act on
my behalf in all matters relative to work authorized by this building permit application
for(ad ress ofjob)
r -C.Lh>u/.
/
Signature of Owne�__._�7 Date
Owner or Builder(as Agent of Owner) Must Complete and Sign This Section
h WF . as Owner/Authorized
Agent hereby declare that the statements and information on the foregoing application for
(address ofjob) l/a gU,00,1 itvr.„_cege&yee HA' are true and
accurate.to the best of my knowledge and belief
Signed under the pains and penalties of perjury.
_JitIS .U///G.t/F-
Print Name
•
Signature of Ottner-Agent Dale
7A, gnign,04:ailtzSi
sYstritts Rostd of Building Regulations snd is Lisents egistrationvalid fttrndi dut nse only
HOME IMPROVEMENT COWS f „ O D xe the ezpiration da e .f found return to:
Registration }251oE Bcard of Building 2egrulamn and Standards
Ezpuation -Y2el6One Ashburton Place Rm 1302
S ri,2i/o3s 3ostnn,, lla.02108
llltstePATIO ROOMS OE BOSTOh INCA
ANDREWS LIALONz_
100 OTIS S
. S,TH33.' J - 0',-732
Adminit _t, —..__ v yslid'Without s_<anvrs
-T� ROARS at Rtlll_DING REGULATION'S
Lice se OAE:R'II NSJ RV:SOR
Number: S70998.
Birth zte: 0112.21stt'
R Exn r s ^t/2:a i Tr. no' 7'27
Restricted to; 1G
ANDRE✓JT MA!O E � �/, �'�
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Exception Suet-ode; Addttigsns f consurntrNoFtiicatin zt:urns as c rzu 31P 780 CMR
&freendtu ii 0 iSthill fi 1 '3ei` a n i-t8 X :i
. ipt 4kU1.Y1 d%c t noir ^1ce. qtil -I .,5 t flora 7E0
ClviiR 1 and J14:3 aiavic d that lite actual orot'tr v owner(not the owner's agent of
represen d+e) of the s_uctnie onto which the s rroem addition is being made,provides a signed
copy of the Suaroom"CONSUMER PtiFORMATION ORM' (found in 780 Civa,Appendix3)
to the Building Depart_fnent litsigned"CONSUMER INFORMATION FORM' shall be
submitted to the building official as a requirement of building pe mit issr ,ce, and shall -ala as
_:of She o_____5<on d_.,..._c: s _.e h.5107 0:.772 additions are separated 'om the n*' house by
a wail and are conditioned spaces, then a readily accessible manual or automatic rieans Saall be
provided to a-a ugly restrict or shut off the he rs gd/or caolind. dont to the;redraws: addition
pnee. Thnt portion a wall Cent senrstes the wr.. ,,o:ir addition arra--the a.._ g
btf1din� +.,. thnit, if an s:tw:wsll, shehl be aislhansettf to tonnain and i -het
:.!Sfl —. _ 7 till_._-. . .
730 CM/R:12.0 D F Gait tt 1O'.•?S
SUNROOM: An addition to as existing h+:i ding/dwelling unit where the totalarea (rough one_:ing
or unit din ensions) of elated fenes ation products of:said addition exceeds 40%of the combined
gross nnA12_d net I g area of 5}e addition_
CN`i ,as;3 ,pe uans `p sgAi, o cL'...'st , 1tritz-Y`Lc-tms r+€3 d 5J'-lcEa iJ Gt^15.r-
'fit , 'GTY� .�' a ''eOd 1CtJ �O_-et 7 '-fr.✓s+. f`
I /CORD CERTIFICATE OF LIABILITY INSURANCE DATE'MmfDBm'
12/18/20001
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Joseph AACKeone ONLY AND N THE CERTIFICATE
HOLDER THIS CERTIFICATE( NO RIGHTS T
ICATE DOES NOAMEND, EXTEND OR
JP MCKeone Insurance Agency, Ino. . ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
P.O. Box 333
Ann Arbor, MI 48106-0333 j! INSURERS AFFORDING COVERAGE
INSURED Patio Rooms of America, Inc. INSURER A. HARTFORD INSURANCE SF THE MIDWEST j
John Ester '11-ssREr e' !
100 OUG St I INSURED cr
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NOChbOro.MA 01532 '.INSURER D
INSURER e.
COVERAGES
THE POLICIESOF INSURANCE USTED BELOW RAVE SEEN ISSUE D TO THE INSUREDMAMEOADOVE FOR THE POLICY PERIOD INDICATED,NOTW(fHSTANBING
ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT terrH RESPECT TO WHICH THIS CERTIFICATE MAT SE 16SI.E0 OI
MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES CISCRIBED HEREIN IS EERIEST TO ALL THE TERMS.EXCLUSIONS AND CONDITIONS CF SUCH
POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN AFOUL AD BY PAID CLAIMS.
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TYPE DF INBUAANCE POLICY NUMBE0. DATE IMNDDhTI TE(MwJUfryl wars
A EVERALV LITY '35 UUC 35019 111011200`, 1/011200. 5 10000^01
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DESCRIP➢ON OF OPEPVTONSM1OCATONSNEnp LESOC W SONS ADDED DYE,DORSEMENTISRECIL PRO VISIONS
Certificate Holder is additional insured
1
CERTIFICATE HOLDER X ADomONa BIDARED,INAIRBR LETT R! CANCELLATION
1 MOVLD ANY OP INE ABOVE U
8E5CR®ECPGCIES SE CANCELLED effORE"NE EXPIRATIONI
((( :ATE OFFERED*.TUE ISSING In TJRaR BALL EN3EAVCA-O MAIL 30 DAYS WRITTEN
INSURED COPY N O]CE TO THE CPRTIPICATE HOLDER NAMED TONE LEFT.BUT FAILURE TO 90 SO SMALL
IMFOSE ND OBLIGATION OR LIA3IL1Tv OF ANY MIND UPON THE INSURER,ITS AGENTS OR
REPRESENTATIVES.
AO HC4kI2ED REPRESEN:FTIyy
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4
ADORE)255 (7397) 0 ACORB CORPORATION I Hs
AFFIDAVIT •
In accordance with Article I Section 114.1.3 of the Massachusetts State Building Code, I
certify that al debris resulting from work associated with Permit # will
be properly disposed of at Waste Management, licensed solid waste disposal facility as
defined by MGL Cll. S 150A.
Andrew Malone / Betterliving Sunrooms of Springfield
Print Name of Applicant f Signature of Permit Applicant
/7��� 317 Meadow Street, Unit 2, Chicopee, MA
Signature of Permit Applicant Address
Effective September 12, 1991 the Department of Health/Code Enforcement acting under
Chapter 2 Article 13 of the 1986 Worcester Revised Ordinances requires proof of
disposal of debris generated as a result of this permit. The proof shall be a dated and
signed receipt from the licensed disposal facility containing the following information.
A description of the debris, the weight and volume of the debris and the location of the
disposal facility. The receipt must also have a signature of the owner/operator of the
disposal facility.
Failure to comply with the requirements of this Ordinance will result in enforcement
action by the city.
Ratmss
A Greenhowe FmThurSoul
317 Meadow Strut,Unit 2"Chicopee,MA 01013*Phone:413420-0140 Fax 413-420-0147
The enclosed permit package is for the proposed building of a three-season sunroom
on a new wood deck. There will be no Electrical Work or Plumbing Work.
Included in this Permit package:
• Building permit application
• Plot Plan
• Deck Framing Plan
• Plans for the sunroom
• Septic diagram (if applicable)
• Homeowners Permission to represent them in securing this permit
• Signed consumer information form for Sunrooms
• Proof of Workers Compensation Coverage
• Proof of Supervisor License and Home Remodeling Licensee
• Debris Removal Plan
Thank you in advance for your assistance. Please call with any additional
information you need.
Best Regards,
Michelle L Grassi
413-420-0140