18D-004 (20) CITY OF NORTHAMPTON
BUILDING PERMIT CHECKLIST
All 1 &2 Family Projects The following items are to be
considered MINIMUM
information to be submitted with ALL permit applications
A Scaled drawings & details shall be submitted with each application proposing
construction, reconstruction, addition, alteration, or repair. The building official
may waive the requirements for filing plans when work is of a minor nature.
B. Scaled drawings & details shall indicate & describe all proposed work, including location,
size, grade of materials & equipment to be used.
C. PLOT PLAN, property address; map & lot number, zoning district & overlays (such as
wetlands)
Show well and septic locations (if applicable)
Location of lot lines, dimensions of lot, frontage
Location & dimensions of public easements, public utility easements, railroad right of ways
, and established zoning setback requirements.
Locations & dimensions of primary and accessory buildings & structures.
D. FLOOR PLANS, floor plan of each floor and intermediate levels including basements,
crawlspaces, terraces, porches garages, carports, and decks, showing existing condition and
proposed construction.
Dimensions, locations & materials of foundations, footings, columns & piers {including
reinforcing when required)
Direction, dimensions, spacing & grade of all framing {floors, roofs, walls, partitions)
Location of all walls, partitions, windows, stairs & doors
Location & description of all electrical equipment and alarm devices
Location & type of all heating and air conditioning (HVAC) equipment.
HVAC schematics (where required check with building inspector)
EXTERIOR ELEVATIONS, Front, rear & side elevations including foundation and fmish
grades.
Location & dimensions of windows & doors.
Description of exterior cladding or siding material.
Show exterior stair locations & dimensions.
Show chimney and vent locations 2 0 /v ct l b D
DETAILS & SECTIONS, Sections through exterior walls
from footing to the highest point of the building. ��
Sections through fireplaces & chimneys (show clearances) Cow
Location & details of any roof trusses, glue -lam, or engineere .. ` r '�"
details and Massachusetts professionals stamp on specificatio 7�
Exterior envelope energy requirements : Uo- of walls, roof -ceili
rolet
walls /roof/floor, also percent of window area to wall area.
;i - , . , „............, ...,:... ,.... _ ... ,..,,
-NO TE-
,nHL ""THIS
��, -PLAT IS COMPILED FROM DEEDS, PLANS AND OTHER
Liii FEB $ -OUf CES ,AND, IS .NOT TO BE CONSTRUED AS AN ACCURATE ,'
of F SURVEY AND IS NOT TO BE RECORDED.
PLAN BOOK 83, PAGE 12 ; PARCEL #3
1•
01A \ 455.92'
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A 4 \ self storage barn
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6.1°T), ' s Portinq
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L- 17 9 .71►
D A M O N
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ROAD
TO: THE HERITAGE BANK FOR SAVINGS &
THE FIRST AMERICAN TITLE INSURANCE COMPANY
I HEREBY REPORT NAT 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 NAT THE PROPERTY IS NOT LOCATED WITHIN
A FLOOD PRONE AREA AS SHOWN ON FEDERAL FLOOD INSURANCE MAPS FOR
COMMUNITY # 250167
SURVEYOR __ _ •�^ —NOTE—
THIS PLAT FOR MORTGAGE LOAN PURPOSES ONLY
AND DOES NOT CONSTITUTE A PROPERTY SURVEY
� ' F 1 — MORTGAGE LOAN INSPECTION PLAT —
/ NORTHAMPTON, MASSACHUSETTS
PREPARED FOR
I ZER WI LLIAM B. & EVELYN F. MOCK • ,,.
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'. 10 , SCALE: f " =$0' JULY 2, 1990
f tv HAROLD L. EATON AND ASSOCIATES, INC.
•
i .T REGISTERED PROFESSIONAL LAND SURVEYORS
' . Tr\ 235 RUSSELL STREET — HADLEY — MASSACHUSETTS
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Zoning
Miscellaneous Additions, Repairs, Alterations, etc. Tel. No. 5<eY - 6any Alterations
% r NORTHAMPTON, MASS. 1 9 Additions
'rl= ` APPLICATION FOR PERMIT TO ALTER Repair
' ff Garage
1. Location �ir' C r S (h i r ' 7J £ Lot No.
2. Owner's name (R)// K k Address /60 l ie r7 Rd /O
_e
3. Builder's name S/ Q 7 4 v i , P7 Address 61 Cs t1 T 157 /c ,(rr i r3 t/ /S, fife r5
Mass. Construction Supervisor's License No. C 5 r) F f_ . (-/ Expiration Date / /j(77.2 Or
4. Addition j e / cabs S / r i:
5. Alteration .�'Z £ S r ; `>') 4; ✓ r` f { < <,
6. New Porch
7. Is existing building to be demolished? /V O
8. Repair after the fire N ()
9. Garage /11 r`') No. of cars Size
10. Method of heating ) 2 rCscJ fiz / ,Zr-'
11. Distance to lot lines
12. Type of roof .ccricL /7 :5/at -,f /s
771 13 . Siding house 7 // U
14. Estimated cost - 4 1 , 0006
The undersigned certifies that the above statements are true to the best of his, her
knowledg 1 an; I ief.
"r/ L/i` `
Signature of responsible appicant
Remarks
` 6
1 ,5ItA O ' M le
• ° a Gild laf N�az ±Ev&mpton , - -___F
Vil 9 t, 4 • j gais saciinsctta '
r EB ; DEPARTMENT OP BUILDI?yG INSPECTIONS _?_! `=
\,..,L_ = f
,.,. `r 212 Main Street • Municipal Building
t•' '' Northampton, Mass. 01060 to'
WORKER'S COMPENSATION INSURANCE AFFIDAVIT
1 -, 97 e4 &71 ( (
(Lcensec/perml ttee)
with a principal place of businesslresidence at:
G / C l 7 C sr f v n % f r s 6 ( ( s (,)I j76 (ph one#) ?. r' ( /,S
(street/ ci ty /states ip)
do hereby certify, under the pains and penalties of perjury, that
( ) I am an employer providing the following worker's compensation coverage for my
employees working on this job:
(Insurance Company) (Policy Number) (Expiration Date)
( ) I am a sole proprietor, general contractor or homeowner (circle one) and have hired
the contractors listed below who have the following workers compensation policies:
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(Name of Contractor) (Insurance Comp<u y/Po[Icy Number) (Expiration Date)
(Name of Contractor) (Insurance Company /Policy Number) (Expiration Date)
(anach:dditica.l zlxct ifnocczury to include'Informitioo pertniuing to x.11 condor)
( am a sole proprietor and have no one working for me.
( ) I am a home owner performing all the work myself.
NOTE: please be aware that while, borxewocn two cmp toy pczzam to do to* R.trn. -, cctructioo or repair work on a dwelling of
not more than three units in which the bomoowncr reside or on the grounds appurtenant thereto art not generally coosidcrcd to be
employers under the wociccr`s onmpcasntioa Act (GLl52,sa t (5)), application by a homeowner for a license cc permit may evidence the
legal rt'tua of an employee under the Workers Compcmation Ant
I undcntrnd ttut a copy of this czttcmmt gray be focwnrd.od to the Dcportmcat of Industrial Amdcntie Offioe of Intuaocn for the
coverage vmfieatioo and that failure to secure covcrago ttnorr section 25A of MOL 152 can lead to the imposition of criminal penalties
comic ing of a fine of up to S1,500.00 tutd'or imprisotu of up to one year and civil penalties in the form of a Stop Wort; Order and a
find of 5100.00 ashy against tnc.
Signed this - day of t, , 199g For dcputatentaltssoonly
/ q , .w 1 Permit Number
%� �, = ... Maps _ Lot # _
Signature of Liccnsce/Pcniaitfcc
'am. �i% '
10 Do any signs exist on the property? YES f- NO
IF YES, describe size, type and location:
Are there any proposed changes to or additions of signs intended for the property? YES V NO
IF YES, describe size, type and location: 5, 21 lCQS:o ; e 7 -- (_,. Ici Cr°,cP - t �CD 1 rcp,
11. ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE DENIED DUE TO
LACK OF INFORMATION.
This co lama to be filled in
by the Building Department
6., 4 Drat S£c` i ) Required 1
Existing Proposed By Zoning
i Co ' i- L
Lot size r
;71: d=G s4c r (5 _SCE. fir E 7, /c.), r
Frontage , 2 9 2 ,c
Setbacks - front 1 7 / Sq m 7. /0
- side L: 6 R: /S L: 1, R: 9, 6
- rear -? 6 2, 6
Building height ; 3 ' Dv /47E 6/6
—
Bldg Square footage
/7, (.?e) 3? 5 . 616,x6
%Open Space:
Lot area minus bldg c� �,/
&pac�sd parking) /0, (� /" 2 , 5
# of - Parking Spaces 7 /
# of Loading Docks
Fill:
(volume & location) G e0
Olaf( Sicfbs
13. Certification: I hereby certify that the information contained herein
G is true and accurate to the best of my know r
+
DATE: Z / APPLICANT'S SIGNATURE Al f I � / , U
p
NOTE: Issu no of a zoning permit does not relieve an e ., ioant's • urden to oomply with aJl
zoning requirements and obtain all required permits from the Board of Health, Conservation
Commission, Department of Publio Works and other applioable permit granting authorities.
FILE
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4 /
FEB FEB ,s File No. 960 9A
'' ` ` � 1 ' � kONI TG PERMIT APPLICATION ( §10.2)
PLEASE TYPE OR PRINT ALL INFORMATION ,72 /f) —
_ �'`� 7
1. Name of Applicant: ge. 6 1 iO41 5 T
A Address: ' /06 Dr, /VkD , /V „ Telephone: .c y , 0',�� " `- 7
2. Owner of Property: Yak_
Address: cZ a2 j Telephone: cj ekoi
3. Status of Applicant: X Owner Contract Purchaser Lessee
Other (explain):
4. Job Location: ' _s it/ . ,
OQ s . / .a gi ♦ o . - f'JP - a 0 ._411
Parcel Id: Zoning Map# f p Parcel# y District(s): C-- E . ,
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/Property t X ice s"t .. if! i i c L_ ' - .J ow' C /
Gi ,�f�
6. Description of Proposed Use/Work/Project /Occupation: (Use additional sheets if necessary):
l ti► I ;-) r ( '
7. Attached Plans: ` Sketch Plan Site Plan Engineered /Surveyed Plans
Answers to the following 2 questions may be obtained by checking with the Building Dept or Planning Department Files.
8. Has a Special PermitNariance/Finding ever been issued for /on the site?
c{ „._
NO DON'T KNOW YES l/ IF YES, date issued: �'D-
IF YES: Was the permit recorded at the Registry of Deeds?
NO DON'T KNOW YES
IF YES: enter Bool(Q0) ..35%/ Page t oo and /or Document #
`O `�t�3Y9 ao63 ,
9. Does the site contain a bro ody of water or wetlands? NO t/ 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:
(FORM CONTINUES ON OTHER SIDE)
(�' ( mi l (� 0 f� _. . .
� . y F tJ N O W ;_ FILE f J<
#d 7 Og
d i �
APP�L'�L ONTACT PERSON: ,,AfII 2t' � ; � `%/ /L 3 — ' /5
ADDRESS/PHONE: i f t ,12t0)- -t...� -e' -0 - 13 7 4,
PROPERTY LOCATION: D . -e- ,6te _
MAP /4 PARCEL: ZONE 60
THIS SECTION FOR - OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
7.ONTNG FORM FTT,T.F.D OPT a./..-
Fee Paid C/
- Building Permit Filled nut /79 4 fi
Fee Paid `�'
• • t III 11 • t 1 • ' I. W ,„ 4 er _ .
Remodeling Interior / Cr - rte " -ek-
Addition to FYicting ,V �{ t' ' / 'Z
A rrecenry Structure
Building Plane Tnrinded•
wner /Ocrnpant Statement n ,hence �a c
JJ
c l)
Sete of Plane / Plot Plan 1/
FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION:
Approved as presented/based on information presented
Denied as presented:
Special Permit and/or Site Plan Required under: §
PLANNING BOARD ZONING BOARD
Received & Recorded at Registry of Deeds Proof Enclosed
Finding Required under: § w /ZONING BOARD OF APPEALS
Received & Recorded at Registry of Deeds Proof Enclosed
Variance Required under: § w /ZONING BOARD OF APPEALS
Received & Recorded at Registry of Deeds Proof Enclosed
Other Permits Required:
Curb Cut from DPW Water Availability Sewer Availability
Septic Approval -Bd of Health Well Water Potability -Bd Health
Permit from Conservation missi n
2— // 2 - k
Signature of Building Insp, or Date
NOTE: Issuance of a zoning permit does not relieve an applioant's burden to oompty with ail
_ zoning requirements and obtain all required permits from the Board of Health, Conservation
Commission, Department of Publio Works and other applioable permit granting authorities.
uz.
o(- 1.vv fr7
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` �� � �I- I, . T . i N ` e iX ` . • RE QUIRED INSPECTIONS
'
4 Er: :• iii - - , A 3 r,° 1. Footings and Walls
. 1.,, ^ ` � __,_.;;i ._ ' ___ ._ ._____:....•:. .., . .a 2. Structural Components in Place*
`'' 3. Complete Building*
No. 1284
. nce t' the iIi .b Inspector
Zoning Form No 963192 Date 2/12/98 Fee $48.00 Check # 1743
Page, 18D Parcel 4 ,Zone 02 Section 127 ❑ Yes III No
,:?, ;::i ; ,, ,., .., p: : .-. i: , --: ,,,,
:. :'
'mot -,
* Plumbing and Electrical Inspections required
THIS CERTIFIES THAT S:ephoh Smith before Building Inspections
has permission to remodel it _ 2. io - .. nd floor abov _.ore for living space Inspection on Site— Foundations
situated on 100 Damon Ro - h � Nock Inspection of Plumbing —Rough 5- -':
if
provided that the person accep� ti permit s!,: it in e� - respect Inspection of Plumbing — Finish s .
conform to the terms of the application i't; file in this office, :Intl to the Gas Inspection
provisions of the Statutes and the Ordina ices relating to the Cons ruction, Inspection of Wiring —Rough / / ,5�/ / //7
Maintenance and Inspection of Buildirn-s in the City of No, ihampton.
Any violation of any of the terms above i ated is an immediate revocation >6 Inspection of Wiring — Finish ,�� �� %r� /�
of this permit. Expires six months :writ late of issuance, if not started. /' ; " Building Inspection —Rough Kr - 6 / 5 -? $.'�
Note: A certificate of occupancy will be =.sued by this office a) .n return Insulation Inspection 6 - I g 4 8- °"'
of this card signed by the Plumbing, Wing and Building Inspectors. A3 -�
* *30 DAY TEMPORARY OCCUPANCY - EXPIRES - 7/18/98 Building Inspection — Finish
Smoke Detectors (Fire Department) �^ /6- 3 Q'l
�
Needs Electrical
re Other
J uis ni lin fix
i s was ercon f; *. ,., , t
Y ;
'# � - $ t .. y ^a
3)Alarm - imcomple % .; w 4,. x... _...
THIS CARD M '`. , ! ,1► I N A CONSPICUOU PI ACE O ► .f ,Z)� ' MISES
Certificate of Occupancy _mss -�:��
Building Inspector
._ -
p +o op''', City of Northam ton REQU RED INSPECTIONS
1. Footings d Walls
- � ��r� • a BUILDING DEPARTMENT 2. Strutural Components in Place*
��� w4
�c�„ 3. Complete Building*
No. 1284 Office of the Building Inspector
Zoning Form No. 963192 Date 2/12/98 Fee $48.00 Check # 1743
Page, 18D Parcel 4 , Zone GB Section 127 ❑ Yes 0 No
BUILDING PER1VLIT ,
* Plumbing and Electrical Inspections required
THIS CERTIFIES THAT Stephen Smith before Building Inspections
has permission to remodel interior 2nd floor above store for living space Inspection on Site — Foundations
situated on 100 Damon Road - Bill Mock Inspection of Plumbing —Rough � -
Inspection of Plumbing—Finish r `�I�l .'
provided that the person accepting this permit shall in every respect g
conform to the terms of the application on file in this office, and to the Gas Inspection >>
provisions of the Statutes and the Ordinances relating to the Construction, Inspection of Wiring —Rough //41 S /'i/ yy
Maintenance and Inspection of Buildings in the City of Northampton.
Any violation of any of the terms above noted is an immediate revocation Sc2�/ I nspection of Wiring — Finish , . lt' s / 'I
of this permit. Expires six months from date of issuance, if not started. 6'r Building Inspection — Rough kt 6 / 6 $
e
Note: A certificate of occupancy will be issued by this office upon return % �� L Insulation Inspection _ I $ _ q, g
of this card signed by the Plumbing, Wiring and Building Inspectors.
c7//b I f ' Building Inspection— Finish O if 7- / 7-1 r
Smoke Detectors (Fire Department) r' /G.°9f Al g -
1 Other
THIS CARD MUST BE DI A in IN A CONSPICUO PL - 0 , / 1. ' ' MISES
Certificate of Occupanc - /% __ 1 i. ,.' / if'
Building Inspector