35-286 (10) • -NOTE-
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.
BUIL)ING LOCATION ACCURACY IS NOT GUARANTEED
13
U ,
4
6'S
TO: FLORENCE SAVINGS BANK &
FIRST AMERICAN 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-
le — THIS PLAT FOR MORTGAGE LOAN PURPOSES ONLY
SURVEYOR. `l AND DOES NOT CONSTITUTE A PROPERTY SURVEY
-MORTGAGE LOAN INSPECTION PLAT-
OF
NORTHAMPTON, MASSACHUSETTS
RANDALL , PREPARED FOR
E. JAMES & PATRICIA BOYLE
IZER y
#35032 SCALE: 1 "=50 ' DECEMBER 19 , 1997
<1 ' RS �a HAROLD L. EATON AND ASSOCIATES, INC.
REGISTERED PROFESSIONAL LAND SURVEYORS
235 RUSSELL STREET - HADLEY - MASSACHUSETTS
Gl itV of Nart4anvptart
Z =
� 6 �lassadpisttts
DEPARTMENT OF BUILDING INSPECTIONS
212 Main Street * Municipal Building
INSPECTOR
Northampton, MA 01060
r
HOME OWNER EXEMPTION ACKNOWLEDGEMENT
The State of Massachusetts allows the homeowner the right under 780CMR 108.3.4 to
act as iris/her construction sup:r, sor. The state defines "Homeowner" as, " Person(s)
who owns a parcel on which he/she resides or intends to be, a one or hvo 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 backfrll),
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
_f, 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
arillallip I Lill
Rl
-TARTMEINT-1- OF FUIMING INSPECTIONS
212 Main Street * Municipal huildill!"
Northampton, Mass- 01060
NVORKER'S CO- -PF N AIO N INSURANCE AM
�;,ith a principal place of business residence t: j
do licl chv 11s ail'] penalul'-"; of p('l 1111 v)
pl-o"'IdIM, the :!I),
eluplovccs ,vol!KIM, on U'll"; Job.
compally) D21c)
�,olc propllc*ol, t,Cll ral colltracto,-
the contractors kstccl beiov vT110 hav the ","oll:c-
(Nallic of ConC,-nc:c,) (Insul-alic- Date)
(N,�l I 01 C 1
of T:,'l,---! Patc)
Of(,o11!1-,1C,,CI) (Ilisill-alicc Co1lr,.17-1
have no oll,,-
NUIF.
<
A-(GI152,1 1(Y0,ei,,
I,pl ctztuc of an—qAovo under t!-o ,Yvkcl.
I
COVCXIF:C VCnfjC-:!IiCKI and tIL--t f--Ilurc to 25A of MC31.152 can Icid to tlx:
oo(ii-uting of a f1r,,of up to S 1,SL).00 oft"')to cn)- e l Civil iKfulticl m of n St-)
fnn o(S I 00.W I cily
SECTION 8-,CONSTRUCTION SERVICES
8.1 Licensed Construction Supervisor: Not Applicable ❑
Name of License Holder ---
License Number
Address Expiration Date
Signature Telephone
;9 R istere i I�bmefirriproverrient Contractor w,d.., „Vii„ ; „ . �f MPF Not Applicable ❑
Company Name Registration Number
Address Expiration Date
Telephone
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...... ❑
per E emNon
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 sliall 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 f� which this permit is issued.
Also be advised that with reference to Chapter 152 (Workers' Compensation) and Chapter 153 "I.lability of I mploycrs 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" certi ies 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 DESGRIPTIOWOF'PRO POSED WORK(checKal!applicable)
New House ❑ Addition ❑ Replacement Windows Alteration(s) ❑ Roofing ❑
Or Doors ❑
Accessory Bldg. I/ Demolition❑ New Signs [ ] Decks [ ] Siding [ ] Other [ ]
Brief Description of Proposed Work: AckcL --k 'C Y1 2- ;ke(@ Ile 1,11 ( 14AV
Alteration of existing bedroom Yes_� No Adding new bedroom Yes No
Attached Narrative❑ Renovating unfinished basement Yes No
Plans Attached Roll ❑ - Sheet❑
6 'AUNew` house~'and or addition`to existing Housing,.complete=the:fol'Id inir:
a. Use of building : One Family wo 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?
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
t--0,fe"r` 'T),)`'`CO-+'\_ _ as Owner of the subject property
hereby authorize - to ac; or.
my behalf, in all matters relative to work authorized by this, ;wilding permit application.
Signature of Owner Date
1, L_ CIO y1U Jn C0-V'y _ as Owner/Authorized Agent
hereby declare that the statements and information on the foregoing application are true and accurate, to the best of lily
knowledge and belief.
Sign eofunder the pains and penalties of perjury.
r'eM J v�C C LI - — -
Print me
r- - - ----- --- �112s 1 3 ---
Signature of Owner/Agent Date
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 °z a-` vt
Frontage ACC} -_e +
Setbacks Front 5 D fc }+ dew �-
Side L: /q o' R:_3y L: /�/,O R:_j
Rear
Building Height 1 t
Bldg. Square Footage ISO I %
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 X 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:___
A
City of Northampton S atus,'of R A r
Building Department CurbCutlDs ' �:
212 Main Street SeWerMeptte is c
Room 100 VVaer/WelfRval1 t.- r�
?? F ^ n Northampton, MA 01060 TWoiSets'ofStr
phone 413-587-1240 Fax 413-587-1272 Plot/Site Plan
OtFier Specify � � ' z
APPLICAT-IGN-TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
L__
SECTION 1 - SITE INFORMATION
This section to be comp) ted by office
1.1 Pro ert Address:
Map � Lot' Unit-----
Zone Overlay District
_
Elm St. District CB District
SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT
7
2.1 Owner of Record:
+ l a k. Ce; �w rt C
La L it
— --
Nanie(Print) t rrer' ^,,!I, i, Address.
-
Signature
2.2 Authorized Agent:
I Name(Print) — — r_n t Mailing Address:
Signal re �
SECTION 3- ESTIMATED CONSTRUCTION COSTS
-- -
Item Estimated Cost (Dollars) to b, Official Use Only
completed b�ermit anpl ;a i
5,,ikling Permit Fee
tirnated Total Cost of
cnst�uction from (6) _
3. PI!:mbir., Building Permit Fee
VA( )
Fire, Prot, tion _ � -
6_ Total (1 -2 + 3 + 4 + 5))� Z.., (�C?C� -- -- ---�_'ieck Number —-
This Section For Official Use Only -
Building Permit Number: Date Issued:.---_ — —
Signature: - -- -- -- --- --
Building Cornmissioner/Inspector of Buildings Date
File#BP-2003-0933
APPLICANT/CONTACT PERSON PETERSON BILL E&LAUREN E
ADDRESS/PHONE 34 SYLVAN LN
PROPERTY LOCATION 34 SYLVAN LN
MAP 35 PARCEL 286 001 ZONE SR
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Buildiniz Permit Filled out
Fee Paid
T_ypeof Construction: ERECT 10 X 12 SHED
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
INFOI dMATION PRESENTED:
pproved 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 Co ion
Q3
Signature of Building O icial 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.
34 SYLVAN LN BP-2003-0933
GIs#: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 35 -286 CITY OF NORTHAMPTON
Lot: -001
Permit: Building
Category: BUILDING PERMIT
Permit# BP-2003-0933
Project# JS-2003-1499
Est. Cost: $2600.00
Fee: $25.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Groin Homeowner as Contractor
Lot Size(sq. ft.): 52576.92 Owner., PETERSON BILL E&LAUREN E
Zoning: SR Applicant: PETERSON BILL E & LAUREN E
AT. 34 SYLVAN LN
Applicant Address: Phone: Insurance:
34 SYLVAN LN (413) 584-7009 ()
FLORENCEMA01062 ISSUED ON.5 15103 0:00:00
TO PERFORM THE FOLLOWING WORK.-ERECT 10 X 12 SHED
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 Sienature:
FeeType• Receipt No: Date Paid: Check No: Amount:
Building 5/5/03 0:00:00 1593 $25.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Building Commissioner-Anthony Patillo