32C-234 (4) —IYIJ 11...—
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.
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TO: SOURCE ONE MORTGAGE SERVICES CORPORATION &
FIRST AMERICAN TITLE INSURANCE COMPANY
1 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 # a A 1 b
SURVEYOR: ^ �' —1— � —NOTE-
low THIS PLAT FOR MORTGAGE LOAN PURPOSES ONLY
AND DOES NOT CONSTITUTE A PROPERTY SURVEY
0f —MORTGAGE LOAN INSPECTION PLAT—
cg PANDALL NORTHAMPTON, MASSACHUSETTS
IZER PREPARED FOR
;35032 DONALD S. MELLO
SCALE: 1 "=50 ' JUNE 10 , 1997
�A = HAROLD L. EATON AND ASSOCIATES, INC.
y� . REGISTERED PROFESSIONAL LAND SURVEYORS
235 RUSSELL STREET — HADLEY — MASSACHUSETTS
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f, DEPARTMENT OF BUILDDNIG INSPECTIONS
INSPECTOR 212 Main Street • Mui icipil Buildinb
Northampton, MA 01060
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HOME OWNER EXEMPTION ACKNOWLEDGEMENT
The State of Massachusetts allows the homeowner the right under 78OCNM 108.3.4 to
act as has/her construction sups:., or. The state defines "Homeowner" as, --Person(s)
who owns a parcel on which he/she resides or intends to be,a dne or tw1D famz�-_.
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 f egulations. The inspection process requires that the building department be called
to inspect work at various stages, which include foundation/footings(before baclfill).
sonotube holes (before your) a rough building inspection (before work is
concealed) insulation inspection(if required) and a final building insnection.: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 occupancv
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
I, understand the above.
Wom,e owner/resident's signature requesting exemption)
I will call to schedule all required building inspections necessary for the building permit
issued to me
Date ale, a
Address of work
location
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Crr 3 Ofll {t>rfl��ill�toli _
3.R r4 n L r t l D � --
DEP/1RT1.-fEIJ-T OP BUILDD\10 INSPPC?IOt.'s
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j 212 Main Street ' Munictpai Budd;nG
Northam-pton, Mass. 01000
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WOR10EIt'S Co INUENSA77ON MSU Z, I CE AI'FU�A�7�'
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%VIth a principal place of busines residence at: -- -
(ph(Dne') _50 5 q3
(sa�t/ci rJ/szatL/a p)
do hereby ce under Lic. ?ins and pcnalties ofperJuly, h�I
{ ( ) I am an employer providing the following'workcr's comocns?oo, cove Ige for Im
etnpioyees worlong on ties job:
(lanLr-a1+C Comram,) (Pclic-.?�>;�bcr) — ( ;piraaor.D2=)
O I am a sole propriecor, general conrracor or homeowner(ci:cie ore) and have hired
the consaciors listed below wbo hive the follows worker's conoen_t2tion pe!icies:
(_Namc Of Contmaof) (Insumnc: Cornoarly/-1106c (-E:plydU^n Date)
(Name of Coneaezor) (Ir ,u-azc Comoanti•/Folic-; Nu.tnc_r) Date)
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(Name of C0U=c16r) (Imsiu-anc Compareyipoke}• N;rsbcr) (i=xpimdoa Dale)
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(Name o!Contractor) (Lmntraact Comczny/Potiey Nunbr:r) Date).
(.G1G33_d:�scocal x�c�.if ace=u_-v to a�cutL•iaforniion pc'i to.11
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( I.am a sole-proprietor and have no one working for me.
` I aat..a home owner performing all the work myself.
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I NOTE:plea be.tr:7C ifi,•K SIC bemcwvcra Ktb cIcy p p�tD dz C '+ C=—e.�uo a rryair work oa.d..elL^�of
not Mora 0—t.s--o_•=tj is eels the bomcownc zc}ido ox ca chc p-octs6 zr--pu�tbe—, L-r ox C=r=Dy oecwad to be
azployes uade the-ui;rr--=P-•.,:oa Act(GLl57 n 1(5)�:ppU=LEoo by.6omco mcr rw-G _«p===y-id—LL-_
Iag1 r'- of en c•.ployor under du Wort Oe,C,o.pamiriea Ae[_
I—4-a—d db..2 a oopy of Lbi.ml.®rat m..y be foc�.ar ded t.o the C<Sx,ta,ca of lu?uFSici Accident-'OfG_of t=+r+ac•far tb.
novcasc v=Tic_lioo.nd ttLt f_iltac to&==,co%crabt trade section 25A of MGL 152=Icd to the i^{xaaica olcimiazl per+ c=
mast:._--xg oCi fine of trp to 51.300.00.ndf« o(up to Qa y-"•=d 6.i1 peuhia ie be form of i S..op wort CH,=and.
fim of s 100.00 i day Lpjta a co,_
For dcp.n�1 u.c xJy
Permit NumbeS
Signauire of Lic;=_rr- Crrrtiticc I F Lace 1
SECTION 8-CONSTRUCTION SERVICES �
8.1 Licensed Construction Supervisor: Not Applicable ❑
Name of License Holder:
License Number
Address Expiration Date
Signature Telephone
9 Re istereklome:l "roverreitbCoitractor: . Not Applicable ❑
Company Name Registration INum er ---
Address Expiration Date
Telephone
SECTION 10-WORKERS'COMPENSATION INSURANCE_AFF1DAYkT'(M.G.L..c.152,§25"C(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...... 0
. o>1>IYrQ » 1 M .0 `.
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.
Homeowner Signature�& ��.�%`
SECTION 5-DESCRIPTION OF PROPOSED WORKfcheck all applicable)
New House ❑ Addition ❑: Replacement Windows Alteration(s) Q Roofing
Or Doors D
Accessory Bldg. ❑ Demolition ❑ New Signs [0] Decks [C] Siding[O] Other[ ]
Brief Description of Proposed
Work: A4
Alteration of existing bedroom Yes No Adding new bedroom Yes NO
Attached Narrative Renovating unfinished basement Yes No
Plans Attached Roll -Sheet
6a.F�NIVew F`ouse�n��c "cCcF��ia�to�ex�stlrtc�hauslnct.�col�ptet�Eth��oFfaWirilg:
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. Masscheck 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 7a-OWNER AUTHORIZATION-TO BE COMPLETED WHEN
OWNERS AGENT OR'CONTRACTOR APPLIES FOR`BUILDING PERMIT
1 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 appiication are true and accurate,to the best of my knowledge
and belief.
Signed under the pains and penalties of perjury. '
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('A + -3)t)'VA 1'
Print Name
Signature foe Owner/Agent D to
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Section 4. ZONING All Informati6h Must Be Completed. Permit Can Be Denied Due To Incomplete Information
Existing Proposed Required by Zoning
G This column to be filled in by
Building Department
Lot Size 14
Frontage 1-7'
Setbacks Front
Rear
Building Height
Bldg.Square Footage
Open Space Footage %
(Lot area minus bldg&paved
#of Parking Spaces
(volurne,&Location)
A. Has a Special Perm it/Vuhunce/Findi ng ever been issued for/on the site?
i 0 DON7KNOVV YES 0 �
IF YES, dateissue&,
IF YES: Was the permit the Registry of Deeds?
NO K J DONTK0OVV 0 YES
IF YES: enter Bonk Page! and/or Document#' |
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D. Does the site contain a brook, body o[water orwetlands? NO v�� DONTKNOVV «~� YES �_�
IF YES, has a permit been or need to be obtained from the Conservation Commission?
'
Needs tobeobta[nmd �~� O�to�nmd �~� Date
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C. Du any signs exist on the proper�? 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 0 NO
IF YES, describe size, type and location:
E Will the construction activity disturb grading or filling)over 1 acre orisd part ofo common plan
that will disturb over 1acre? YES � ) NO
`�°
|F YES,then o Northampton Storm Water Management Permit from the DPW iorequired.
_
City of Nortf ampton ftqM
_
Building Department ° yP
212 Main Street SerivecSe fit
Room 100 erne yatla�tt} �� R ��
Northampton; MA 01060 �S�ts �Srcra}fan
-587-1272 pt3rle 413-587-1240 Fax 413 a v
APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTION 1 -SITE INFORMATION
1.1 Property Address: This
" sect, to be completed by office
94 - -
Zone ' � OuerlAV: (strict
Elfin 5f dIStrlGt CB District
SECTION 2-PROPERTY OWNERSHIPIAUTHORIZED AGENT
2.1 Owner of Record:
Na�LSE t) C=ent Mailing Ad / /� } T r;
�rr�-r�_wJw/��wwi(f((`"�"' �,. �G ��� �''h 'V��-�IT9�r,� �
�J Telephone `
Signature r `3
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
completed by ermit applicant
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
6. Total=(1 +2+3+4+5) Check Number
This Section For Official Use Only
Date
Building Permit Number. Issued:
Signature: r
Building Commissioner/Inspector of Buildings- Date
File#BP-2006-0784
APPLICANT/CONTACT PERSON DUVAL PAUL H
ADDRESS/PHONE P O BOX 956 NORTHAMPTON ()584-5743 ()
PROPERTY LOCATION 94 HAWLEY ST
MAP 32C PARCEL 234 001 ZONE URC
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Buildiniz Permit Filled out
Fee Paid
Typeof Construction: CONSTRUCT 36 X 18 INGROUND 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 FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INF 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 et Commission
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.
94 HAWLEY ST BP-2006-0784
GIs#: COMMONWEALTH OF MASSACHUSETTS
MaQBlock:32C-234 CITY OF NORTHAMPTON
Lot:-001
Permit: Building
Category: BUILDING PERMIT
Permit# BP-2006-0784
Project# JS-2006-1195
Est.Cost: $7500.00
Fee:$50.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: Homeowner as Contractor
Lot Size(sq. ft.): 32582.88 Owner: DUVAL PAUL H
Zoning.URC Applicant. DUVAL PAUL H
AT. 94 HAWLEY ST
Applicant Address: Phone: Insurance:
P O BOX 956 () 584-5743 ()
NORTHAMPTONMA01061-0956 ISSUED ON:211012006 0:00:00
TO PERFORM THE FOLLOWING WORK.-CONSTRUCT 36 X 18 INGROUND POOL
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: Date Paid: Amount:
Building 2/10/2006 0:00:00 $50.00871
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Building Commissioner-Anthony Patillo