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I hereby report that the premises shown on this plan is not located within a Flood
Hazard Area as shown on Department of H.U.D. Federal Insurance Administration Maps,
Community er 250167-000IA
Identifica o Dat aril
By:
TO THE FLORENCE SAVINGS BANK OWNER'
Natale, James F. , Jr. & Claudia J.
AND THE FIRST AMERICAN TITLE INS. - ONLY
LOCATION= 382 Acrebrook Drive
To the best of my knowledge,. informs- Florence, Mass.
ti and belief, I hereby report that I R KATLE
have ve examined the premises and that this . Y•JR.4k ASSOCIATES, INC.
inspection plat shows the improvement or SURVEYORS*ENGINEERS*PLANNERS
improvements as Eocazea on the premises ae- : ""T r `A"
L..I. 44.n�Axo v •r�.�,i f.v. DIVA dG.r1
scribed, that the improvement or improve- NORTHAMPTON, MASSACHOSETTS 01060
ments are entirely within lot lines, and
that there are no encroachments upon the ISCALES
premises described by the improvement or
O O
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$ 6 �xssacbnsrtta
DEPARTMENT OF BUILDrNG INSPECTIONS
212 Main Street ' Municipal Building 'e
Northampton, Mass. 01060
WORKER'S COMPENSATTON INSURANCE AFFIDAVrr
with a principal place of business/residence at:
7/V'�A !
(s-treet/city/stalr/ap)
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) (Polity Number) (Expiration Daze)
kill O I am a sole proprietor, general contractor or homeowner (circle one) and have hired
., the contractors listed below who have the following worker's compensation policies:
l
a (Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
+f
(Name of Contractor) (Insurance Compam/Policy Number) (Expiration Date)
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(attach additional shoot ifnecrssary to inchsdo informati on pertaining to aE coats )
I 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 whilo homeowuera who employ persons to do mamtenac.,eonstu oo or repair work on a dweUiag of
not more than throe uads is which the homoowner residers or on the grounds appurtenaai thereto arc as geacraity 000sidard to be
employtn under the vmr1ces's oompeau4ca Ad(GL I52,ss 1(5)),application by a homeowner for a Uoeasc or permit may cvidcaoe tho
legit starve of an employer under dw workeez Compensation Ad.
I uaderd d that a oopy of this ru temeut maybe forwarded to the Depwtnxos of Industrial Accidents'Offioo of Insurance forth*
coverage verification and that failure to secure coven V under section 25A of MC1L 152 can lead to the imposition of erimi al penalties
coasisting of a fine of up to S1,500.00 and/or imprisorm of up to one year cad civil pcmriies in the form of a Stop Work Ondtr and a
find of S 100.00 a day against rno.
For dgrutm�trio only
Permit Number
-1 —4�V Map#—_—Lot#
i of Licensee/Permittee
M O'f101 .8 � U i'It 1; ' ICES
.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
E TION,10-WORKERS"COMPENSATION INSURANCE AFFIDAVIT MG L.c: 152,§2SC(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.
igned 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"homeo er"certifies and assumes responsibility for compliance with the State Building Code,City of
Northampton Ordinances 'ate and Local Zo g Laws and tate of Massachusetts General Laws Annotated.
Homeowner Signature
E
New House ❑ Addition ❑ Replacement Windows Alteration(s) ❑ Roofing 0
Or Doors ❑
Accessory Bldg. ❑ Demolition❑ New Signs [ ] Decks Siding[ ] Other [ ]
Brief Description of Proposed Work: / plea !4 ' C, &ck ,S l6yr n o -e
Alteration of existing bedroom Yes No Adding new bedroom Yes k No
Attached Narrative❑ Renovating unfinished basement Yes x No
Plans Attached Roll ❑ - Shee0s
�.
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?
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
S GT1Q 7 WNI R AU7f]0IRJ ATION -TD B9 COM04tED.,WkV4
GWNBRS AG N OR, �NTRAq,,TT ; 4R PLIES.1;C�R:B1JIl+Dl 1 ,PE�tM1T
l 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.
igned under the pains and penalties of perjury.
Print Name
Signature of Owner/Agent Date
r
4
y
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
�j Building Department
Lot Size � 7 7 e.-
IsA
Frontage
Setbacks Front Q f
Side L: R: L: '75/R: 40/ ! -
Rear �d 30
Building Height '36�o
Bldg.Square Footage 40 % c9 F//� 6/l
(O�' d
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 #
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?YES_
No
IF YES, describe size, type and location:
y
4 F.
01l�3dSNf W01
mpt n
B ll ing Dep rtm nt
APR 2X%n
Room
oq 1060
U 4 13-587-1272
APPLICATION TO CONSTRUCT,ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECT[QN',A."S,1TE°[NFpEtMATCIN
1.1 Progerty Address: This s i a o9 o y F
i,
61
,z / �"3 iii / stiff it m
n
q
SECTIaN =PROPERTY OWNERS"Hlp/AUTHORIZED AGENT
2.1 Owner of Record:
v
Nam Print) Current Mailing Ad
Telephone
Si at e
A A thorized Agent
Name(Print) Current Mailing Address:
Signature Telephone
ETtNIATD'CON 5TRU"CTION COSTS
71
Item Estimated Cost(Dollars)to be gffeialUsi"0'ni�+
completed by ermit applicant
1. Building &1900 (a) Building Permitfee
2. Electrical (b) Estimated Total Cost of
Construction fro m=6.
3. Plumbing Buitding Permit Fee
4. Mechanical (HVAC)
5. Fire Protection
6. Total = (1 +2 + 3 +4+ 5) Check Number
This Sect grn�,Farbfficial'Use C?h ly
t �allIding PermtfAurober Efate Issued
Signatures '
Buil �r�g
Date
Conrrilss� ner/Inspector"of Bui dings
r
File#BP-2001-0804
APPLICANT/CONTACT PERSON NATALE JAMES F JR&CLAUDIA J
ADDRESS/PHONE 382 ACREBROOK DR (413)586-0358()
PROPERTY LOCATION 382 ACREBROOK DR
MAP 29 PARCEL 307 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 _
Tvpeof Construction:_CONSTRUCT 20 X 16 DECK
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/Statement or License
3 sets of Plans/Plot Plan
TH 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 Board of Health Well Water Potability Board of Health
Permit from Conservation Co sion Permit from CB Architecture Committee
i
8 �
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.
382 ACREBROOK DR BP-2001-0804
GIS#: COMMONWEALTH OF MASSACHUSETTS
MM Block:29-307 CITY OF NORTHAMPTON
Lot: -001
Permit: Building
Category:Deck Addition BUILDING PERMIT
Permit# BP-2001-0804
Project# JS-2001-1511
Est.Cost: $1000.00
Fee: $50.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group:
Lot Size(sq.ft.): 44300.52 Owner: NATALE JAMES F JR&CLAUDIA J
Zoning.URA Applicant: NATALE JAMES F JR & CLAUDIA J
AT. 382 ACREBROOK DR
Applicant Address: Phone: Insurance:
382 ACREBROOK DR (413) 586-0358 ()
FLORENCEMA01062 ISSUED ON:4119101 0:00:00
TO PERFORM THE FOLLOWING WORK:CONSTRUCT 20 X 16 DECK
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 4/19/010:00:00 6649 $50.00
212 Main Street,Phone(413)587-1240,Fax:(413)587-1272
Building Commissioner-Anthony Patillo