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; / File No.0003277 Paae# 4
Building Sketch (Page - 1)
Borrower Client Mary Bel e
Property AddreSS 62 Sandy Hill Road
.CitV Northham ton COURtV Hampshire State MA Zip Code 01062-2630
Lender Allied Home Mortgage Capital Corporation
40.0'
E Lei o Bath
Kitchen
Bedroom
N N
Bedroom Garage
edroom Living Room
40.0'
Rooms not to scale
SkembbyApax rv^
Comments:
AREA CALCULATIONS SUMMARY LIVING AREA BREAKDOWN
Code DescHpt on Size Net Totals Breakdown Subtotals
GLA1 First Floor 960.00 960.00 First Floor
24.0 x 40.0 960.00
' MORTGAGE LOAN INSPECTION
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BOOK 1952 PAGE 278
PLAN BOOK 77 PAGE 99
4gt�Mpr 0007d���dd5iiii�����
of Xorthampton
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DEPARTMENT OF BUILDING INSPECTIONS
INSPECTOR '212 Main Street • Municipal Building
NortliamPton,MA 01060
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HOME OWNER EXEMPTION ACKNOWLEDGEMENT
The State of Massachusetts allows the homeowner the right under 780CMR 108.3.4 to
act as !,,is/her construction sups.-.,is:,or. The state defines "Homeowner" as, "Person(s)
who owns a parcel on which he/she resides or intends to be, a one or two fami -
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 oven 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
I, 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
Address of work
location
r
O¢-tttlJf p�O �.
ti
a ti (riff of �.TflrfllaIIip
A � E }iasai<chacclla' _
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DEPARTMENT OP BUILDrNG INSPECTION'S
212 Main Strcct • ATuwcipal Building
j Northampton, Mass. 01000
i
- NVOR)CL1Z'S CONLPENSA1703N GqSU7t.A1`ICF A l�fiD�AtiTlT
_A�_LL.L_
(li ccns�Jpermi floc)
with a principal place of bUSI-UeSSfrCSlde1]Ge at: --
i
(phone')
(su�t/ci ty/st=':a p)
do hereby certify, under the.pa_ins and penalties of peguuy, Ial
I ( ) I am an employer providing die followin-. -vorkcrjs colnocasZ:jo, cove age for lny
employees worlong on Lins job:
(Insw-� Conr�sl) (Polio; Numb r) (r;•pim or.D2tc)
I .
( vf I am a sole proprietor, general coaa-acor or homeowner (ci:cie one) and have hued
the coon-a tors listed below wbo have the following workes coLpep_tzdon pokiest
i (i+amt of Co-...,.ctor) (Inst!rant: Cornpan}il cue; ,tunbc:) (Y 4tra"20r. Date)
i
(Name of Contractor) (11LS'arancc Compam./polim• Nu-Mb-c-0 (xpiM6on Date)
(Nzme of Coamci :) (Lasuranc; Comp-=)-/Polk}• Nttmbc.r) (Expirstioa Daic)
f
(Namc of Conaacior) (Ia ufan� Comraay/Pobcy Numb°.r) (E%pir�aon Date).
(aa7ch_,66ioc=1 to atcu&taroc�on pczta.taaa.s to all
(") t am'a sore proprietor and have no one worh3ng for me.
( } I am.a home owner performing aU the work myself.
NOTE:plesc be aware tbx:v Je bemeow,=.ubo employ pc oaa to&D •^-, =coo rgaa,.-ark cz.d"MIE^z of
not mote tb--tbo >mra is V' ch the bomoowvcs rtsdcm or oa the p-oe.zw:b zpp�th=r n c r ax C=C-lUy cc=-d -Cd rn be
caVloy=untie the.•u�en2p=ziioo Act(GLtl52ss 1(5)},=ppliabon by a bcmaoaaa for c btu_a palm r=y eyed_=cc the
Ic A CL an cz?foynr under din wa,-k lc cooapom+lioa Act.
i
I uad--d lb-z copy of tbL6 mtcmaoa may bo for—,d.d to the Dcpartmcaa of Indwsid Ac Ad --e Ofr.00 of 1--a for tba
joove'.sc vc it•eaioo a_'td aL-L L-il=to seeztrc)covcT�undo'soczioa 23A of MOL 152 C=Ia-d to the i�xuaton of QimirLtl pcasltic
ooazi> or a fine orup to 51.300.00 andfor capri3oaxne=of cep to ooc yc3r eta ei%i]pcmt�n a tx forcer of a Stop Work Order n d a
f=of.11 D0.00 a day L 105%me
i _ _ f ... For i�.nm=•�vac onl7
PcrIlllt Nt1RltiCS
//Or �.jz�°_- Lot
Signature of Lio=iscJ- Pcm-duce e l
i
SECTION 8--CONSTRUCTION SERVICES +
8.1 Licensed Construction/Supervisor: ( / Not Applicable ❑
Name of License Holder: S� �-O
License Number
5� LA, Lke
Address Expiration Date
Si ature Telephone
9e ere peoveme so ra o Not Applicable ❑
----------------
- } �, 145-051
Company Name Registration Num a—fir------"--
Address Expiration Date
fl A,�`t Telephone
SECTION 10-WORKERS'COMPENSATION:INSURANCE`AFFIDAYfT(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 buildine 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.
AIso 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
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SECTION 5-DESCRIPTION OP PROPOSED WORK(check:all-applicabie)
New House ❑ Addition ❑ Replacement Windows Alteration(s) E] Roofing
Or Doors
Accessory Bldg. ❑ Demolition ❑ New Signs [O] Decks Siding[O] Other[d]
Brief Description of Proposed G `' ,�}. cr•°
Work:
Alteration of existing bedroom Yes No Adding new bedroom Yes No -
Attached Narrative Renovating unfinished basement Yes No
Plans Attached Roll -Sheet
sa if Nevis ousear N iomY a Ist n_ !, ousinqrxomp iau .ina:
<: --
a. Use of building:One Family Two Family Other
b. Number of rooms in each family unit: 5 Number of Bathrooms r
c. Is there a garage attached? Y t
d. Proposed Square footage of new construction. L-, t-# If Dimensions X
e. Number of stories? t
r
f. Method of heating? �}'" �'} � _ d ' ' Fireplaces or Woodstoves l J Number of each
g. Energy Conservation Compliance. Masscheck Energy Compliance form attached?
h. Type of construction /
L Is construction within 100 ft.of wetlands? Yes V No. Is construction within 100 yr. floodplain Yes No
_ t � "
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 "r Private well City water Supply
SECTION Ta-OWNERAUTHORIZATION-TO- COMPLETED WHEN
. I , -
OWNERS AGEN);ORGOJNTLRi4GTOR-APPLIES FOR BUILDING PERMIT
r`�✓� e [9 e �j Z �'a Ad y as Owner of the subject
property
hereby authorize
to act on my behalf,in all tters re tive to work authorized by this building permit application.
3 o�
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
Signature o er/Agent Date
Section 4. ZONING All Informatioh Must Be Completed.Permit Can Be Denied Due To Incomplete Information
Existing Proposed Required by Zoning
This column to be filled in by
—�-�--�-� Building Department
Lot Size
Frontage
Setbacks Front
Side_ L:=0 R: LIZ R:i ,Z I
Rear I �'
Building Heightif1 - - -
1
Bldg.Square Footage 2E 17<71 % Im lay;
Open Space Footage �`""�'� % ?
(Lot area minus bldg&paved �� i
parking)
#of Parking Spaces "1
Fill:
(volume'&Location
A. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO 0 DONT KNOW (er YES 0
IF YES, date issued:'
IF YES: Was the permit recorded at the Regis of Deeds?
NO 0 DONT KNOW YES
IF YES: enter Book Page' and/or Document#'—`
B. Does the site contain a brook, body of water or wetlands? NO 0 DONT KNOW 01" YES 0
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 0 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(clearing,grading,ex ation,or filling)over 1 acre or is it part of a common plan
that will disturb over 1 acre? YES 0 , NO
IF YES,then a Northampton Storm Water Management Permit from the DPW is required.
F
City of 0ari-Iptorn
��
Bulldinlj, partment- ;
292 M it 'Street JUN _
Ro 10
Northamp on; A 01060
phone 413-587-1840 F x 413-58
UILDIN
APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTION 1.-SITE INFORMATION
1.1 Property Address: This sect�Qn to l�e'corn�fieted by office
(}' ( I CI4 iNlap 7 :Lot Unit
C. A,Ive,a4l'Dii
2 T
4
EI�mSb DISL�lGt ��r r .!��; CB.�IStFICf o.
SECTION 2-PROPERTY OWNERSHIPIAUTHORIZED AGENT.
2.1 Owner of Record:
n
Name(Print) Current Mailing Addres..s---/
�i1 ' `1°t t�'si 41..c.+�• M1l�^t 4 r`.71 ��
' t Telephone
Signature 4 jam— (� t7
2.2 Authorized Agent:
+t is Y1
Name(Print) Current Mailing Address:
Signature Telephone
SECTION 3-ESTIMATED CDNSTRUCTION COSTS
Item - Estimated Cost(Dollars)to be Official Use Only
completed by ermit applicant
1. Building V (a)Building Permit Fee
UOJ. ov
2. Electrical ,(b)Estimated Total Cost of
Construction'from'6 ®�O'
3. Plumbing Building Permit Fee
4. Mechanical(HVAC)
5. Fire Protection
6. Total=(1 +2+3+4+5) Check Nurnber
This'Section For'O.fficiaLUse Only'
:.Date
Building Permit Number'!'
umber . Issued:
Signature: r
i
Building Commissioner/Inspectorof Buildings Date
File#BP-2005-1201
APPLICANT/CONTACT PERSON ANDREW T WALSH JR
ADDRESS/PHONE 2 SUMMER ST EASTHAMPTON (413)522-7795 Q
PROPERTY LOCATION 62 SANDY HILL RD
MAP 29 PARCEL 402 001 ZONE URA
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Buildinp,Permit Filled out
Fee Paid
Typeof Construction: CONSTRUCT 12 X 37 DECK&REPLACE WINDOW W/DOOR
New Construction
Non Structural interior renovations
Addition to Existine
Accessory Structure
Buildinp,Plans Included•
Owner/Statement or License 082029
3 sets of Plans/Plot Plan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
IN,EpfiMATION 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 Street Commission
2 00-
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.
62 SANDY HILL RD BP-2005-1201
GIs#: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 29-402 CITY OF NORTHAMPTON
Lot: -001
Perrnit: Building
Category_ BUILDING PERMIT
Permit# BP-2005-1201
Project# JS-2005-1621
Est. Cost: $8000.00
Fee: $50.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: ANDREW T WALSH JR 082029
Lot Size(sq. ft.): 22520.52 Owner: BELGE MARY E
Zoning: URA Applicant: ANDREW T WALSH JR_
AT: 62 SANDY HILL RD
Applicant Address: Phone: Insurance:
2 SUMMER ST (413) 522-7795 (�
EASTHAMPTONMA01027 ISSUED ON:6110105 0:00:00
TO PERFORM THE FOLLOWING WORK.-CONSTRUCT 12 X 37 DECK & REPLACE WINDOW
W/DOOR
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: H O Z ,!5 S
Rough: Rough: House# Foundation:
Driveway Final:
Final: Final:
Rough Frame:
Gas: Fire Department Fireplace/Chimney:
Rough: Gil: ins-!ation:
Final: Smoke: Final: 0 �0
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 6/10/05 0:00:00 $50.00
212 Main Street,Phone(413) 587-1240,Fax: (413)587-1272
Building Commissioner-Anthony Patillo