29-251 (12) Cj)F <\ Ll I q
SECTION 8-CONSTRUCTION SERMCE5
8.1 Licensed Construction Supervisor: Not Applicable
Name of License Holder:
License Nurnbef
Address Expicatlon Date
Signature Telephone
9 Realistered Horeie Inyj aaatneat Contiractw. Not Applicable
Company Name Regis.'tration Number
Address Galion Date
Telephone
SECTION 10-WORKERS'COMPENSATION INSURANCE,AFFIDAVIT(M.G.L.c.152,§25C(6))
Workers Compensation Insurance affidavit must be co 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....... 17 No.....r
111.�,�JAOMCQWWWEXMD 00
The current exemption for"homeowners"was extended to incr rde Owner-occupied Dwrlhnas of one(,t) or two(2)families
and to allow sueh ho neowner to engage an individual for bire v,4,;o does not possess a lip,provided that 0te,oar arts
as supervisor.CMR 780, Sixth Edition Section 108.3.5.f.
Definition of H ameowner:Person(s)who own a parcel of land on which helshe resides or intends to reside,on which there
is,or is intended to be,a one or two family duelling,attached or detached structures accessory to such use and/or farm
strictures.A Person who constructs more than one horw in a tiro-year ueried shall not he canAdered a hanwowner.
Such homeowner shall submit to the Building Official,on a form acceptable to the Buildbi8 Official,that h ei shaN be
responsible for alt such work performed under the buiidina 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 issue
Also be advised that with reference to Chapter 152(S'i?orkers'Compensation) and Chapter E 53(Liability of Employers to
Employees for injuries not resulting in Death)of the Massachusetts General Laws Annotated,you way be fiairfe for pemn(s)
you hire to perforni work for you under this permit..
The undersigned"homeownear -fies an assunas^s re-j"sibility for compliance with the Stadte Building Code,City of
Northampton(hdinsriees, d Local- Laws and Stage of Massachusetts General Laws Annotate&
Homeowner;Sigpatum K
Ell
i F
h
SECTION 5-DESCRIPTION OF PROPOSED WORK(check all ac pitiable
New House F-1 Addition cement Wows Alteration(s) Roorm
Or Doom LN6 I
Accessory Bldg. Demolition Now Signs [E3) Decks f6d"O" Ong[p] firer la
Brief ss ription of Proposed
rx 3%EiVIE 1A t , 'eolk� if s l t.
Alteration of existing bedroom Yes ✓ No Ong new groom Yes loo
Attached(Narrative Renovating unfinished basement Yes No
Plans Attached Roll -Sheet
i3r8t_If Now house mild ot eilRO!!t to ex"no homing. @[@'I re toi�cr Mn
a. Use of building:One Family Two Farniby r
b. Number of rooms in each family unit: Number of Bat toms
c. Is there a garage attached?
d. Proposed Square footage of new construction. Dimensions
e. Number of stories?
f. Method of heating? Fuepiaces 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 tloactptairr Yes No
j. Depth of basement or cellar floor below finished grade
k. Will building conform to the Building and Zoning regulations? Yes No.
L 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
I, I ✓ T / "J as CK%rAr of the sutiect
property
hereby a ze
to act ehalf,�n ftfitters relative to work authorized by this buifding'pe it appliqation.
?
sign re of er N I crae
AX �/`X'i r)V ► as OwnerfAuthorized
Agent hereby cia that the s is and information on the foregoing application are true and accurate,to the best of my Imomdedge
and belief.
Sig ed under the pains and penalfier� pejury.
i,-
P&Name
S re of es/A Date
Section 4. ZONING All Infotnation Must Be torWklvrl.Permit Can Be Denied Due To Promm fete Informathm
Existing Pnwsed Regssind by Z,ronng
This c au to be flbd in tr
Bzulding Depentmamt
Lot Size
Frontage
Setbacks Frost
Side L: R: L: R:
Rear
Building Heigbt
Bldg.Square Footage _ %
Open Space Footage °a
(Lot area minus bkr g&paved
arlin l
#of Parking Spaces
Fill:
voluxue&Lcx sExec)
A. Has a coat Permit/VariancefFinding ever been issued forfon the site?
NO 6DONT KNOW 0 YES Q
IF YES, date issued:'
IF YES: Wile permit recorded at the Registry of Deeds?
NO DONT KNOW 0 YES 0
IF YES: enter Book Page andfor Doccrnent#
B. Does the site contain a brook, body of orates or wettands? NO DO2IT KNOW 0 YES
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained 0 Obtained 0 , Hate Iced:
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 O )40
IF YES,describe size,type and location:
E. VILA the construction activity disturb(gearing,gradirq eg6avation,or filling)over i acre or is it part of a ownrnson plan
that will ditrb over i acre? YES 0 NO
IF YES,then a Northampton Storm Water Management Pem*trom the DPW is requimd.
Qity of Notttlampton Stews of
Building aepartmierd Curb Cuti6d"W aay
212 Main StreetA
Roo rn 100 WatsrlWd AvabbiMy
Northampton, NIA 010 Twin Set$of Sttiuctung l
phone 413-587-1240 Fax 413-587-1272 Pkws7ft Ps
Other Spre*
APPLICATION TO CONSTRUCT,ALTER,REPA9k RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTION 1-SITE INFORMATION
1.1 Property Address: This section to be compliated by office
map Lot —unit
Zone OverlayDimblict
SECTION 2-PROPERTY OWNERSHIPIAi1?HOR&MO AGENT
2.1 Owner of Record:
()JV&d 17f;tY Yn
ame ) Curver+t i'
i 4 h
Te>
s
2.2 A U
dent:
1141�o(jll y .�„' �� , .E�� IWA 0/l W-
a Pri Cu Mani V Address:.
S' nature Tee
SE 3-E CONSTRUCTION t:OST&
Item Estimated Cost(Dollars)to be t?ffidal Use Only
co tact nrrt #
I 8uildirtg (a)t3uildiing Permit Fee
2. Electrical (b)Estimated Total Cost of
Construction from 6
3. Pluming Building Permit Feed 60 L
4. Mechanical.(HVAC) S-0
5.Fire Protection
6. Total=(1 +2+3+4+5) Check Number 9 7 9 Z 1,10-116
This Section For Official Use Ord M.a%�"
Date Ste P w 0 F-t_
Building Permit Number: Issued:
Signature:
BuddkV CommissianwAnspector of SUH&W Date
JI•
File#BP-2006-1120
APPLICANT/CONTACT PERSON EASTMAN MISTY V&WAYNE H
ADDRESS/PHONE FLORENCE
PROPERTY LOCATION 61 OVERLOOK DR
MAP 29 PARCEL 251 001 ZONE URA
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
"Pildin2 Permit Filled out
ee Paid 106-00
Typeof Construction: Window and door replacement reno basement for storage
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
INFO�tMATION 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
166
Signature of Buil ing 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.
(1%!OVERLOOK DR
BP-2006-1120
GIs#: COMMONWEALTH OF MASSACHUSETTS
• g- s l CITY OF NORTHAMPTON
Lot: -001
Permit: Building
Category: BUILDING PERMIT
Permit# BP-2006-1120
Project# JS-2006-1652
Est. Cost: $6500.00
Fee: $150.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Groin: HOME OWNER EXEMPTION,
Lot Size(sq. ft.): 18120.96 Owner: EASTMAN MISTY V&WAYNE H
Zonine URA Applicant: EASTMAN MISTY V & WAYNE H
AT: 61 OVERLOOK DR
Applicant Address: Phone: Insurance:
FLORENCEMA01062 ISSUED ON:411912006 0:00:00
TO PERFORM THE FOLLOWING WORK.-Window and door replacement, reno basement for
storage
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 4/19/2006 0:00:00 $150.0096792
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Building Commissioner-Anthony Patillo