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23A-093 (11) oviastnausot, f BP-2004-0125 GIS n: COMMONWEALTH OF MASSACHUSETTS OraPilitt* CITY OF NORTHAMPTON Lot:-001 Permit: Building Category: BUILDING PERMIT Permit ft BP-2004-0125 Proiectft 3S-2004-0193 Est.Cost:$3000.00 Fee: $25.00 PERMISSION IS HEREBY GRANTED TO: Const Class: Contractor: License: Use Groan: Homeowner as Contractor Lot Size(sn. ft.): 13242.24 Owner: SHAW MELINDA Zoning:URB Applicant: SHAW MELINDA AT: 17 FAIRFIELD AVE Applicant Address: Phone: Insurance: 17 FAIRFIELD AVE (413) 586-1609 0 FAIRFIELDMA01062 ISSUED ON:8/14/03 0:00:00 TO PERFORM THE FOLLOWING WORK:ERECT 12 X 20 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 8/14/03 0:00:00 1124 $25.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Building Commissioner-Anthony Patiilo File#BP-2004-0125 APPLICANT/CONTACT PERSON SHAW MELINDA ADDRESS/PHONE 17 FAIRFIELD AVE (413)586-1609 Q PROPERTY LOCATION 17 FAIRFIELD AVE MAP 23A PARCEL 093 001 ZONE URB THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out �/ Fee Paid /Jt777 7 Iypeof Construction: ERECT 12 X 20 SHED 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 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-Sits s"Co// mny;sion SI// 4,3 Signature ofBin/ding 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. City of Northampton ' .r41idr'%Ar.St'n1Pa Z . .ding Department H » a7 oc> r( i l5 S 72 Main Street (1a.li'o'3 1`{` ,fel Ip - , Room 100 �}�� lleaa gI`e F I or 1ampton, MA 01060 � „J`�-y"s�'fy�s7�"+ a'eyk,— 11�JJII Illlllllllll AUG - �f' B 4 I "7.1240 Fax 41358/ 1272 , a {Yt '"f t efIlietE DEAR'W816L9DtB711SREQI@eNSTR CT,ALTER, REPAIR, RENOVATE OR DEMOLISH A ONOR TWO FAMILY DWELLING •ryUMPIBryrMA-eIA`A ____ SECTION 1 - SITE INFORMATION I 11 Pryperty Address Tms�e$ Adn tome coss^^mPCeted LX fflc2.. (L like- MaBetel" w ® `o E5"`Rr)�3�1.sjsc ; Zone�,-d iveday"L str(c#s {o !zwct , IMA CJI©bZ ° ; ;fir"a _ Elm St..Dislr¢t CB Dis'fr5ctj SECTION 2 -PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Ownvr of Record: dwe(1Met-nal.tV _. r- ur • a a CJv14 IL aryvL' L Curran(Yzr ASdYssCz .s3.. xro fNam 1551) C---)/4r/2.0,6_( ( .__SbY•w _PPPPPP eleenlne Sign re ._ ._._.. gSb - Ib0°I (rn kr S'l/°/aj) 2.2 Authorized Agent' Name(Filet/ Current Mailing Address: Signature --_.—_— TelePecnc SECTION 1- ESTIMATED CONSTRUCTION.CQ$TS Item Estimated Gust(Dollars) to be Official Use Only completed by permit applicant S. Build;ng __ .>iCOO (a)Hu51ding Permit Fee 2 Elee:. mal (b) f?timated Total Cost of --. _ I Construction from (6) ?, Plumbing Building Permit Fee a. Mechanical (HVAC) 5. Fire Protection _ 6. Totah(I 2 + 3 + a + 5) _..__ Cheek Number _ -SSW ��`"•`�- w i/ This Section For Official Use Only _ Building Permit Number: CY �0Z Date Issued: Signature: Building CornmasianerItnspeutor ci Buildings Dale d d00 :21 ea 12 Int Section 4. ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE DENTED DUE TO LACK OF INFORMATION Existing Proposed Required by Zoning This column to Ix find in by Building Dcoapment Lot Size I`a z S X i 9) Ott. Frontage Setbacks Front g t Side L:g Li R: S/ L: R: /S Rear P`r Building Height i Bldg- Square Footage LYO Open Space Footage (Lot area minus bldg&paved parking) #of Parking Spaces • Fill: (volume&Location) 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 k B. Does the site contain a brook, body cf water or wetlands? NO ✓ 11,0N7 KNOW YES IF YES, has a permit been or need to be octained 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 ?YES _ No IF YES, describe s ze, type and location: Z -d d90 :ZI so re Inc SECT901SORIPTAON OF.PROPOSED.WORK (check all aliable New House 0 Addition ❑ Replacement Windows Alteration(s) ❑ 1 Roofing 0 Or Doors 0 Accessory Bldg. $ Demolition0 New Signs [ ] Decks [[ ] Siding( ] Other[ ] Brief Description of Proposed Work: CLr 1,v b-1 a lt( -rVf: S fuEi4d Qb Alteration of existing bedroom Yes No Adding new bedroom Yes No Attached Narrative❑ Renovating unfinished basement Yes No Plans Attached Roll❑ - Sheet❑ §a Iffletielb 'Fa "drdi dd ittDfito::ezrsTlnR=R'o'us k(t.6) I eteltlieifoll:owinp: a. Use of building : One Family Two Farn:ly _Other _ N. 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 Conservator 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 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 a AWN&R AUTHORIZATION TO BE COMPLETED WHEN OWNERSAGENT OR`CONTRACTOR APPLIES FOR BUILDING PERMIT , as Cwner of the subject property hereby authorize toad on my behalf, in all matters relative to work authorized by this building permit application. Signature of Owner Date _, as Owner/AuUior'zed Agent hereby declare that the statements avid information on the foregoing application are true and accurate, to the best of my knowledge and belief. - Signed under the pains and penalties of peryry. 1� m2/4a .Elia,, _ _-- • .t Name .(, - _ G /i/ej Signature of Owner/Agent Dal e •d d90 :21 EO 12 inc SECTION-S-:CONSTRUCTION SERVICES 8.1 Licensed ConstructionS nervisor: I Not Applicable Name of License Holder: License Number Address Expiranoe Date Signature Telephone A stIbb • `ems'-'0 -1-m:nri- if. '. - K, -`2 i `+ ^y., ;,f '- Not Applicable ❑ Company Name Registration Number AddteSs Expiration Oate Telephone SECTION 10-WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L:c 152,§25C{6)) I Workers Compensation Insurance affidavit must be cooleted and submitted with this application. Failure to provide this ni/idavit will result in the denial of the issuance of the building permit. Signed A!fidavit Attached Yes _ ❑ No 0 , II I- And 8 f �sQ '�r b'i�'h`A �3QPe�d The current exemption for"homeowners"was extended to include Owner-occupied Dwellings of one(I) 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 snperyiaor. CMR 780. Sixth Edition Section 108.3.5.1. Definition of Homeowner:Person(s)who own a parcel of land on which heishe resides or intends to reside,on which there is,or is intended m lac, a one or two family dwelling>,attached or detached structures accessory to such use and/or fans structures. A person who constructs more than Drip home in a two-yea r period shall not be considered a homeowner. Such"homeowner"shall submit to the Building Official,on a form acceptable to the Building Officialt, hat he/she shall be responsIble for all such work performed under the bedding permit. As acting construction Supervisor your presence on the job site will be segue ed from time to time,during and upon completion of the work Et=which this permit is issued. Also be advised That with reference to Chapter 152(\Yorkers' Compeusutiant and Chapter i sn tt.iability of Employers to Employees for inluries not resulting in Death)of the Massachusetts General limes Annotated, you may be liable for person(s) you hire to perform work for you under this permit Ilio undersigned `homeowner"certifies and assumes responsibility Or comp/mum with the State Building Code,City of Nonhantpton Ordinances, State and Local T7oning//Laws and State of Massachusetts General Laws Annotated. X Homeowner Signature A X > / TJ A x[i J 4� ip •d d00I2I CO IH Inc Jul 21 03 12: 07p p, s nm, . iugl( .... I nwr:1 .n! L• r � .e5l oo ILuca. W i Illflra . .. ...� ?i'dl "SIS SJ / J JLi NO 10 I ;.a...; � l rj (PIrQ _ (2711J_iLl ) "1 opll_Nj i �aFl0D11/42 io -Itrl Jir ..I :L i `^L* j ll�! / :Ilg—lam (0T_*TMni ..t n S#9734/1iT aht h it_/ C110 • (:)1C Lcn 1 ` ()NI-1'1N (:vclC!0J 1) qui snn uo hiIi.I0Av s:):*o-idnla ••.•__ , ,iv I: I s: liu:o^ c 1! r?So;dut.:! 11.112 ) tlj Ir sola (� n:1d ALU°]un( : (Ur .I.fkVQ:LLIV [JNV1If1V1 NO:(S,VSK.thI QJ S,11:1)PIOA1 09010 suul1 1 n I f IVCI y1 1`or15 lityjV ZIS SN Cu.l')9n$NI J (I rif ,r( PV 1, ti . C(._zc- `"a au{dun I� tnN' fu 1.1-1111 ,"; - / g /, is gilt ttpt{ T.,[tPfl(fitlt{TtAtT . . kJ fo'6 ,. .4,..u. _ tel— DEPARTMENT OF BUILDING INSPECTIONS " S INSPECTOR 212 Main.Street • Municipal Building sii Northampton,MA 01060 y HOME OWNER EXEMPTION ACKNOWLEDGEMENT The State of Massachusetts allows the homeowner the right under 780CMR 108.3.4 to act as his/her construction supe: isor. 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 � S I, 41e-hrtcL 4a, 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 815/0 Address of work ,d ^ location 17 Fc;rfietc{ YI7� fl«e,/trE WO- 0,6 Z._ I ORTGAGE Ii( A I ' ECTIOI� fit PLAT IS FOR IDEN(1FIC/JION PURPOSES ONLY AND DOES jd„y[ CONSTITUTE A PROPERTY SURVEY —'s-Pa }- l' 26.5'± 53.± 2,0 - . .. ._ 53'± -i r_._ w/r tLII- GARAGE LOT 23 LOT 24. ,_, I PLA OUSE i;SCREEN. PORCH +1 i �_..._...-_._ L iR ID o > { O lce o I r6 21/, STORY o Wit HOUSE U LOT 22 in i r i 11 PORCH I., 22f '. 53'3 Sri. t — — FAIRFIELD AVENUE THE PREMISES SHOWN ARE SUBJECT TO AND/OR T9GEMER WTH THE 9ENEFITS OF ANY AND ALL EASEMENTS, RIGHTS, CONDMONS, COVENANTS. AGREEMENTS, RESERVA^"MS AND RESTR'CTIONS OF RECORD. t THE SUNTRUST MORTGAGE INC. ATIMA A41 „i1. LAWYERS TITLE INSURANCE CORPORATION — ONLY TO ny know edge, nrormct on and bee hdornc "<d la ere remby ego et he women nave been evamned and not th or. in t.f f On ,On sInsa the tom r, I ave., F 06 •Cote >•le _ *,.. .pro ern improvement'ma,oy or n of any ad meg prem lot Ines. M t n-: vv ett e a c leer 4 by .r. � ce t asnst o� myavemar'.e of any ad''--lrnS kremses. and Nat Mere ore ^o msxme^tw ro'L aftxc!ng 'rr rotor im.ear. ¢sept ¢porn. I f rihor report Nat the premtbes mo limn plOr iy nt,L .1 s:eC p _ ! A'ao Cs .--v . el f1 earned a. is.D. Feda ct tneurcnce Mrs n eneMet none ,may ' C• money N,mbe. _21016.7 0002 A _ id It•mann Dote APRIL 3_I 976 !Lj('� �_ P I S An * 4. Hip TITLE 1 RTON & LOUISE H. BURTON e UNTLEY ASSOCIATES, P. C. LOCATItoN 17 FAIRFIELD AVENUE mayors - Engineers • Landscape Architects NORTHAMPTON, MASSACHUSETTS JOHN T. 30 industrint Drive East y�R NO. DATE SCALE Northampton, MA 01060 Og..536 6/25/2003 SCALE 20° woke (413 .84-7444 Jaz 013)588-P158sas-ansa OWN9211.= tic, 5