29-468 -NOTE- stulck-F� TQ
THIS PLA!_1.5 COMPILED FROM DEEDS, PLANS AND OTHER A nv M I-R-k
IS NOT TO BE CONSTRUED AS AN ACCURATE ?Co n
Y AND IS NOT TO BE RECORDED. � �vm ' 1YR r
r tl'LD',"Gt"ISPECTIONS
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TO: EASTHAMPTON SAVINGS BANK &
FIRST AMERICAN TITLE INSURANCE COMPANY
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 # 25036:7
SURVEYOR: R aA," '�F' - _ -NOTE-
THIS PLAT FOR MORTGAGE LOAN PURPOSES ONLY
AND DOES NOT CONSTITUTE A PROPERTY SURVEY
Of At. -MORTGAGE LOAN INSPECTION PLAT-
���' RANDALL NORTHAMPTON, MASSACHUSETTS
PREPARED FOR
v #35032 JAMES W. & DEBRA J. YOUNG
pis SCALE: 1 ��_ �30 MAY 10 , 1996
.moo
lAaO sum` HAROLD L. EATON AND ASSOCIATES, INC.
REGISTERED PROFESSIONAL LAND SURVEYORS
L �. -1- 235 RUSSELL STREET - HADLEY - MASSACHUSETTS
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m DEPARTMENT OF BUILDING INSPECTIONS
212 Main Street ' Municipal Building '
Northampton, Mass. 01060
WORKER'S COMPENSATION INSURANCE AFFIDAVIT
(licensee/permittce}
with a principal place of business/residence at:
CrQJ` I/JP.0► 0/�f �(,Q(�'/1 ' - /a d�a4 `(phone#) J A 2M
!�' (street/city/statr/ap)
do hereby certify, under the pains and penalties of peg u y, that:
(lyfam an employer providing the following worker's compensation coverage for my
employees working on this job:
tnpany) (po r (Expiration Date)
am a sole proprietor, general contractor r homeowner ( e one) and have hired
the contractors listed below who have the follo e s compensation policies:
(Name of Contractor) (Insurance Compary/Policy Number) (Expiration Date)
(Name of Contractor) (Insurance Company/PoUcy Number) (Expiration Date)
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(-Bach additioml slxet ifntoCssary to include information p=uining to all ooritracton)
( ) I am a sole proprietor and have no one working for me.
( ) I am a home owner performing all the work myself.
NOTE:pie--e be aware thRi while homeowner-who employ pusom to do mss.fmz not suction or repair work on a dwelling of
not mote than throe units in wbicfa the homeoavcr r mdcs or on the grounds apputt,ny thereto an not gcomi ly ooandcrcd to be
employers undo the works ox:rp cn Act(GL152,ss 1(5)),application by a homeownr for a liccosc or permit may evidence the
legal ctatu of an amployer under the Worlcor's Compaxsation AcL
I understand thst a copy of this rutemrnt may be forwarded to the Dcparta c of Ind we id Ac6do,&Offioc of lanWsnce for tbo
covaxge venficrlioo and that failure to seatre covttago tmder section 25A of MOL 152 can lead to the imposition of criminal penalties
ooasisting of a fmc of up to S1,500.00 anNor imps isoameat of tip to one year and civn pemltie,in the form of a Stop Work order and a
fins of 5100.00 a day agniust me-
For dal trso only
permit Number
Mai Lot#
,�y� SiPature of Li Pcr=ttce e f
SECTION 8 r CONSTEII)CTIDN SERVICES
8.1 Licensed Construction Supervisor: Not Applicable ❑
Name of License Holder
License Number
Address Expiration Date
Signature Telephone
Not Applicable ❑
Company Name Registration Number
Address Expiration Date
Telephone
'SECTJON 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 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 acceptable 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.
t
Homeowner Signature / ��
f
3
S°EC c +Yc icable:
;fit ✓d.
New House ❑ Addition ❑ Replacement Windows Alteration(s)❑ Roofing ❑
Or Doors ❑
Accessory Bldg. ❑ Demolition❑ New Signs [ ] Decks [ ] Siding[ ] Other
Brief Description of Proposed Work:
Alteration of existing bedroom Yes No Adding new bedroom Yes No
Attached Narrative❑ Renovating unfinished basement Yes No
Plans Attached Roll 0 - Sheet 0
UN.
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
e. Number of stories?
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 City water Supply
SECTION Tar=°OWNER°AUTHORIZATION -,TO$I 'COIWIPLETED WHEN
QWOEIRIS AGENt 0R CONTRALTO 2 APPLIES FOR BU""DING PERMIT'
as Owner of the subject property
hereby authorize to act on
my behalf, in all matters relative to work authorized by this building permit application.
Signature of Owner Date
as Owner/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.
Print Name t ,a,
Signature of Owner/Agent Date f
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 Department
Lot Size 16l Cff 16i
Frontage
Setbacks Front
Side L: R: L30 R:e 16-
Rear 3a4-
Building Height v
Bldg. Square Footage %
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 `'ng 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 e 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. Ar-there any proposed changes to or additions of signs intended for the property ?YES
No ,/
IF YES, describe size, type and location:
i
VP.- 4
® rthampton
Builc q Department
JUN - 3, 2001212 in Street
Roo 100
DEPIKOF!3Ul'L0INGVAWMMMPt , MA 01060
W"' It'd&', I '- Fax 413.587.1272 �t
APPLICATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTION 1-SITE INFORMATION
,�
Pis,
sects nto be carnplet _�iyfc
1.1 Property Address:
f�
1,14
EIrnS
,t, District CB distriit s
SECTION 2-:PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 O aver of Record:
Name(Print) Current Mailing Address: r _ J��/ o
Telephone
Signature
2.2 Authorized Agent:
Name(Print) Current Mailing Address:
Signature Telephone
SECTION 3..- ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollars)to be Official Use Only
com feted b ermit ;;nnlicant
1. Building (a) Building Permit Fee
2. Electrical (b) Estimated Total Cost of
Construction from; 6
3. Plumbing Building Permit Fee
4. Mechanical (HVAC)
5. Fire Protection It
6. Total = (I + 2 + 3 +4 + 5) Check Number
This Section For Official Use Only
Building Permit Number: ��l'I Q tJ� date Issued:
Si
gnature:
Building Commissioner/Inspector of Buildings Date
01 911W
WWI-
File#BP-2001-1034
APPLICANT/CONTACT PERSON TEED BRUCE E&DEANA M
ADDRESS/PHONE 8 CRESTVIEW DR (413)586-7360 Q
PROPERTY LOCATION 8 CRESTVIEW DR
MAP 29 PARCEL 468 ZONE URA
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 Construction: REPLACE 24'ABOVE GROUND POOL
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 LOWING 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 Board of Health Well Water Potability Board of Health
Permit from Conservatio mmission Permit from CB Architecture Committee
oe
v
Signature of Buildin fficial 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.
8 CRESTVIEW DR BP-2001-1034
GIS#: COMMONWEALTH OF MASSACHUSETTS
M : oek:-29'-468 ` CITY OF NORTHAMPTON
Lot: -001
Permit: Building
Category:Above ground pool BUILDING PERMIT
Permit# BP-2001-1034
Project# JS-2001-1837
Est.Cost:
Fee: $25.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Gronp:
Lot Size(sq.ft.): 10018.80 Owner: TEED BRUCE E&DEANA M
Zoning URA Applicant: TEED BRUCE E & DEANA M
AT. 8 CRESTVIEW DR
Applicant Address: Phone: Insurance:
8 CRESTVIEW DR (413) 586-7360 O
FLORENCEMA01062 ISSUED ON.61141010:00:00
TO PERFORM THE FOLLOWING WORK.-REPLACE 24' ABOVE GROUND POOL
POST THIS CARD SO IT IS VISIBLE FROM THE STREET
Inspector of Plumbing Inspector of Wiring D.P.W. Inspector of Buildings
Underground: Service: Meter:
Footings:
Rough: Rough: House# Foundation:
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:
Fee Type: Receipt No: Date Paid: Check No: Amount:
Building 6/14/010:00:00 2226 $25.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Building Commissioner-Anthony Patillo