29-174 (2) 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.
BUILDING LOCATION ACCURACY IS NOT GUARANTEED
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-'0: SOURCE ONE MORTGAGE SERVICES CORP. &
CONNECTICUT ATTORNEYS TITLE INSURANCE COMPANY
TO THE BEST OF MY INFORMATION, KNOWLEDGE AND BELIEF
I HEREBY REPORT THAT I HAVE EXAMINED THE PREMISES AND BASED ON EXISTING
MONUMENTATION ALL VISIBLE 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 # 250167
—NOTE-
'— THIS PLAT FOR MORTGAGE LOAN PURPOSES ONLY
SURVEYOR: ���' '1 AND DOES NOT CONSTITUTE A PROPERTY SURVEY
OF AAA _MORTGAGE LOAN INSPECTION PLAT—
NORTHAMPTON, MASSACHUSETTS
RANDALL , PREPARED FOR
E JOHN F. COYLE
/35032 SCALE: 1 "=40' MAY 28 , 1999
t�hoo� HAROLD L. EATON AND ASSOCIATES, INC.
REGISTERED PROFESSIONAL LAND SURVEYORS
235 RUSSELL STREET — HADLEY — MASSACHUSETTS
Crib) of wort ljkimptall (1�
$ d �ilassacltusctts ja
DEPARTMENT OF BUILDING INSPECTIONS '
212 Main Street ! Municipal Building
INSPECTOR M S'.
Northampton, Mil 01060
DOME OWNER EXEMPTION ACKNOWLEDGEMENT
The State of Massachusetts allows the homeowner the right under 780CMR 108.3.4 to
act a.; i.i,(her construction sup i l;a sta:c c,efines ` liomeowner as, " Person(s)
who owns a parcel on which he/she resides or intends 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
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 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
W13> C ALC4fhxJ 4&4__ understand the above.
(Home owner /reside fi 's signature requesting exemption)
I will call to schedule all required building inspections necessary for the building permit
issued to me.
Date X1-14— 03
Address of work
location g/ )CdF F7eLJ _J
l=l� wte--1 ii4-Y 0/a G
OW
of N"orillallip!Lill
C'
T OF IIIUIIj)I,'�(;
212 Win SLreeL ' Ifunidjud Bud(Aq,,
Norbampton, AWR 01060
WORIICEIZ'Is CO',MPF,NSATIOIN IMUVANCF, AFFIDAVIT
,io
am
Con'-1p ly)
�c up�1,_., 1 I-a-I 1i Fi-icl o,-
( IPP.ic n i. T
(A compamomm NUMN: I& n VON,
(Namt� of 1 a1,-)
GNanc of connicor) Datc)
,1111 :ml C, ; I Uj)!11,_.",): foi-
nwxc own duce Unks m oval on lz::"qvnm r"00(W Oc on
czrplc,ycs un,'�T Ov,\or..i r:'� ".."(61,152•�l(5)),n[-, f
"ZWI of=ITWYa Ul),-'o %VC4lc L
I undo;stand Lill'a copy oflhu ctat—1-1-Y I-fa- i«1 to 01 fb,u,a
v 'f lctl�
-N,cz-R&c c.1 Icalion z":-A tll--t fLillur-c to covcla�—_ui,,iz 25 A cIMCK,152(-ar,ltad to 0)', � 11"
combling of I W,of up to S I ODj*O an vor mir",vlows of up to'm)vu nxic"vil VIllltics in tr f< to cf., 0,-'�and a
fir--0('.S I W.(X) 1'lAy 1,-2.I I I
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SECTION 8-CONSTRUCTION SERVICES
8.1 Licensed Construction Supervisor: Not Applicable ❑
Name of License Holder
License Number
Address Expiration Date
Signature Telephone
9ReQstered°HomeImprovement Contractor , „„r „{, ,r„ r ;,`r ..fix,`., a Not Applicable ❑
.sao qs/
Company Name Registration Number
ill EAST S I', t —A4-A o llo -e 11 3a 0 3
Address Expiration Date
Telephone y i s)g9y-,24t 4
SECTION 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...... ❑
rr* 4
11: Hom� �wnerrEempfion
The current exemption for"homeowners”was extended to include Owner-occupied DwellinIZs 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 buildiny- 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 an�State of Massachusetts General Laws Annotated.
Homeowner Signature----�� - -
SECTION-5=DESCRIPTION:OF_PROPOSED WORK(check all applicable)
New House ❑ Addition ❑ Replacement Windows Alteration(s) ❑ Roofing ❑
Or Doors ❑
Accessory Bldg. ❑ Demolition❑ New Signs [ ] Decks [ ) Siding[ ] Other J
Brief Description of Proposed Work: A >VG— aROUtUD
Alteration of existing bedroom Yes No Adding new bedroom Yes �"'�No
Attached Narrative❑ Renovating unfinished basement Yes t---No
Plans Attached Roll ❑ • Sheet❑
sa, If New house and,a addition'to'existing-housing; complb"te�.thebfolloWin :
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?
In. 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 7'a :OWNER;AUTHORIZATION -TO BE COMPLETED WHEN
OWNEkS'AGENT-0R CONTRACTOR APPLIES FOR BUILDING PERMIT
as Owner of the subject property
hereby authorize & PO LS to act on
my behal , in all matters relative o w rk authorized by this )uilding permit application.
ylG-o3 - ---
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.
'>,411115D A
Print Na
Signature of Owner/Agent Date
1
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 ..5r Acre S
Frontage 05, 10 f
Setbacks Front /S
Side L: R:_ L: R:
Rear
Building Height
Bldg. Square Footage %
Oa
Open Space Footage %
(Lot area minus bldg&paved 03; Arc4s
parking) _
#of Parking Spaces
Fill:
volume&Location
A. Has aSppeecial 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:
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Ali
City of Northampton Satus�ofPerm►t
R
Building Department Cur ,!'Wt D ve e.• _
212 Main Street Swer/Sepic ` aria
.1� Wa Room 100 terlWeli vats l � .
� �
Northampton, MA 01060 TwSetsot
phone 413.587-� 240 Fax 413-587-1272 Plo{/Site PlansY
c ;
APPLICATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTION 1 - SITE INFORMATION
This section to be completed by office, -
1.1 Prq eR rty Address:
Map Lot Unit
S I EER�I ELF �R
Zone tl w` Oyerla District
'�►-oRc,�ct AA 01oba y
Elm St. District_ CB District
SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
R�-rizr_-
Name Print) Curre NA.-ilhnr Address:
Telephonc
Signature
2_2 Authorized Agent:
----- ------------------------- — - --
Name(Print) Current Mailing Address:
i Signature Telephone
SECTION 3 - ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollars) to be Official Use Only
completed by ermit applicant
1. Building 41�6ti 6-0 (a) Building Permit Fee
2. Elegy-f ical (b) timated Total Cost of
_ .2 �• Construction from 6
3. Plumbing Building Permit Fee
4 Mechanics! (HVAC)
5. Fire Protection
6. Total = (1 + 2 + 3 + 4 + 5) y76TD •cro Check Number p� --
Th-s Section For Official Use Only
Building Permit Number: Date Issued:
Signature: -
Building Commissioner/Inspector of Buildings Date
r--
File T BP-200-3-0885
APPLICANT/CONTACT PERSON CALLAHAN DAVID A&BETH M
ADDRESS/PHONE 81 DEERFIELD DR (413) 584-8264 Q
PROPERTY LOCATION 81 DEERFIELD DR
MAP 29 PARCEL 174 001 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 _
T_ypeof Construction: INSTALL 2F 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 FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INF( 6MATION 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
111"Y"ZIJSI�1�6
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.
BP-2003-0885
GIS#: COMMONWEALTH OF MASSACHUSETTS
� I CITY OF NORTHAMPTON
Lot:-001
Permit: Building
Category: BUILDING PERMIT
Permit# BP-2003-0885
Project# JS-2003-1427
Est. Cost: $4700.00
Fee: $25.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Groff: Homeowner as Contractor
Lot Size(sa. ft.): 20778.12 Owner: CALLAHAN DAVID A&BETH M
Zoning URA Applicant: CALLAHAN DAVID A & BETH M
AT. 81 DEERFIELD DR
Applicant Address: Phone: Insurance:
81 DEERFIELD DR (413) 584-8264 (�
FLORENCEMA01062 ISSUED ON.4125103 0:00:00
TO PERFORM THE FOLLOWING WORK:INSTALL 21' ABOVE GROUND 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• Receipt No: Date Paid: Check No: Amount:
Building 4/25/03 0:00:00 145 $25.00
212 Main Street,Phone(413) 587-1240,Fax: (413)587-1272
Building Commissioner-Anthony Patillo