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36-026 (2) � oo Y Qt y exiS 5c) !1 OC)�j cr XZ f 1.,N {( 1 X 6 �' 7- p 1 ni n � x I � I vy-\A • CIO r � a � 'ne� -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. BUILDING LOCATION ACCURACY IS NOT GUARANTEED --I �1 L 7F r F� a� TO: APPLIED MORTGAGE SERVICES CORPORATION & LAWYERS TITLE INSURANCE CORPORATION 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- SURVEYO +\R: F—• y THIS PLAT FOR MORTGAGE LOAN PURPOSES ONLY a AND DOES NOT CONSTITUTE A PROPERTY SURVEY OF Mq —MORTGAGE LOAN INSPECTION PLAT— NORTHAMPTON, MASSACHUSETTS RAN PREPARED FOR E. -' CHARLES PLANTE IZER w► 135032 SCALE: I "=30 ' OCTOBER 30 , 2003 HAROLD L. EATON AND ASSOCIATES, INC. suRV�� REGISTERED PROFESSIONAL LAND SURVEYORS 235 RUSSELL STREET — HADLEY — MASSACHUSETTS • -ti ¢'St1A7NP�. Gl if g of 'Nart4alltp#mt z $ 8 jlTilassac3tuseffs DEPARTMENT OF BUILDI7�G INSPECTIONS INSPECTOR '212 Main Street • Municipal Building Northampton, MA 01060 HOME OWNER EXEMPTION ACKNOWLEDGEMENT The State of Massachusetts allows the homeowner the right under 780CMR 108.3.4 to act as hds/her construction super-:*s sor. The state defines "Homeowner" as, " Person(s) who owns a parcel on which he/she resides or intends to be, a dine or-two fame y - 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 Build-mg department for-the City of Northampton wants-any persons)-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 fegulations. 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 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. (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 Crif-�3 of A E -EI:3aachnrctta' _ 4 DEPARTMEI-T OF ➢UIL00\10 INSPPCTtONS 212 Main Strcct DSunicipal Building Northampton, ATass. 01060 «'OIUCER'S CONITENSATION LNSURANCE ?.FIBA.��`IT pi ins.-�-1per-m�ci�> \kriLb a principal place of businessfresidence at: — - d� 06 1- (j —(6 DO� do hereby certify, under dic.paint ;nd penalties olperJury, hit j ( ) I am an employer providing the foilowing! • { . coverage nor my employees %vorl3ng on this job: �t aanij--n= Comm,) (Polio: Nu--,�bccr) (r:-pim or D2Lc) ( ) I am a sole propretor, general contractor or homeow-Der (c cie one) and have hired the consactgrs lined below wbo hive the foUoLVinQ worker's Ga Jep_,�aaon pokier j (Namc o; Co_!^cior) (In-umll ; C01:10aSI)•i-1106Ci bate) (1`Iamc of COnCmclor) (Ln-7Wanez Compaay/police; Numc:r) (irP+rtion Date) (Name of Conrraao,) (Insysanc: Company[Poticy Namlu) (F-xp r:aon Datc) 1 - (Name of Contraaar) (I=ran= Como azy[Policy Nun t zr) (Expiration Dale). (e1ISL1l 1S.'t-r0C=j 'vcv,ifa r+--••-ti-tn a�c'vc�iarora+3 oa pcvua:a6 to.11 j O I am-a sole proprietor and have no one woridng for me. ( ) I am,a home owner perfon=-c, all the work myself. i NOTE.pl==. be aorarc rb-0 wt]c bcoeovx:a w�bc employ Pcaex w dz rcpaa work cra.d.•cJl_`of 1 aot more thra tt�o qtr is wt-obL tb.bomoowac raid.«oa the Cra,=S zppurtea_=tbce,rt ooe gxlly oecd.-ni to be eirployes trade the.. c=p-",icn Aa(GL1152 1(5)x=ppU=6oa by n bommava fc a lac _(X PC-Mh rr_r cNidmoc the 1cIPI ccaau of as a=pioyer under do Works e,C c::P anon Ad I [uad---,d tba a oopy orthi.cascm..a may be r.,--id to tbo oc,,t arjn�4^ cd wy OSrroe ortm+r`oo°ror thw cove^zo^e reif esioa,ad qLa f iltat to senuc tovcrte^c und--soctioa 25 A of),IG L 152.a Ied to the i=P0%fioa of eimiaa1 pcailzic eo¢v mg of•Erne of up to S 1300.00 arWor impr6oa�Drop w Doc)r_r cad coil pe»Yio is tSc form of a Stop Work Ordc and fig ()(::I 00.M r d y cFrtiazt mG .. For - PcrMjI NUML--r - © �-- �-0G I. � __ Lots Si r,-tzturc of L c�scc/Pcrmitica Ce l s s SECTION 8-CONSTRUCTION,SERVICES J] 8.1 Licensed Construction Supervisor- Not Applicable ❑ Name of License Holder: �-r e P nZ a V �-" License NuPqlo z C) ( 2 L e �� v R c.,c e �.4 (P Addre Expiration DA Signature Telephone -t t =Reais�er¢d Ho`fne=lin ri�veinent.C'ontraEtac..� � Not Applicable ❑ --------- Company Name 1:d Registr tion Number RQ `C';l c tC ®r � Address �r Expiration Date © J Q 6 '4- Telephone SECTION 10-WORKERS'COMPENSATION INSURANCE.AFFIDAVIT"(MLG:L.c-,152,..§25C(6)J 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 it. Signed Affidavit Attached Yes....... No...... ❑ ft = ic 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 rime,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 a i SECTION:5—DESCRIPTION OF PROPOSED WORK(check'allt-applicable) New House ❑ Addition Replacement Windows Alteration(s) Roofing El Or Doors 1:1 Accessory Bldg. ❑ Demolition ❑ New Signs [0] Decks [❑ Siding[0] Other[O] Brief D ip i n f Proposed - Work: r UCH d 1 Alteration of existing bedroom Yes No Adding new bedroom Yes No v l Attached Narrative Renovating unfinished basement Yes !/No Plans Attached Roil -Sheet 6a t l�ewM sn Icon het h , of a. Use of building:One Family Two Family Other b. Number of rooms in each family unit: Number of Bathrooms NV c. Is there a garage attached? © / d. Proposed Square footage of new construction. ! Dimensions ` °�' (.7 e. Number of stories? I I s f. Method of heating? Fb FCC e [7 Of 141 Fireplaces or Woodstoves Number of each g. Energy Conservation Compliance. Masschecck Energy Compliance form attached? h. Type of construction V�. C j\GQ C ",A\xa 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? 4'--Yes No. I. Septic Tank City Sewer Private well City water Supply SECTION 7a.-OWNER AUTHORIZAL(ON""-TO"BE`COMP LET ED"WHEN: OWNERS AGENT OR CONTRACTOR APPLIES`FOR.Bf11LDING=PERMIT I,_ ��r htrl �� q n as Owner of the subject property hereby authorize S p h i1 ro I l�. to act on my behalf,in all matters relative to work authorized by this building permit application. Sign re of Owner Date I, as Owner/Authorized Agent hereby declare at the statements and information on the foregoing application are true and accurate,to the best of my knowledge and belief. e Signed under the pains and penalties of perjury. Print Name Signature of Owner/Agent Date Section 4. ZONING All Informatibn Must Be Completed. Permit Can Be Denied Due To Incomplete Information Existing Proposed Required by Zoning This column to be filled in by Building Deparanent Lot Size Frontage � `f SA Yh C_ •_ Setbacks Front �C Side L: R• L a a_ R: Rear 7, t ZO Building Height Bldg. Square Footage J– I Open Space Footage % -- � (Lot area minus bldg&paved o i parking) #of Parking Spaces — - Fill: 3� I volume*Location) A. Has a pe ' I Permit/Variance/Finding ever been issued for/on the site? NO DON'T KNOW 0 YES 0 IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO 0 DONT KNOW 0 YES 0 IF YES: enter Book Page; ! and/or Document# B. Does the site contain a brook, body of water or wetlands? NO NT KNOW 0 YES 0 IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained Q Obtained Date Issued: C. Do any signs exist on the property? YES l0 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: 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 i IF YES,then a Northampton Storm Water Management Permit from the DPW is required. s � !-` City of Nort ampton ��B wilding Department 'vraa � '212 Main Street dew 1 -- - CG5 Room 100 i North mpton; MA 01060 wog efso trr ti iR t,CGS phone 4�3-58 -1240 Fax 413-587-1272 PCtn ' ,Aflp'IbATIO2N TO"CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 -SITE"INFORMATION This'seetionao be compfete�by Qftice X 1.1 Property Address: D3 De c I f i ff I d b r i V NIY{� " I�t 2 t I�ru lr C / 3 IrYI Gk, C l zone O ve rlay Drsfnct ex St Disfnct C13 D�stnct ;- EI SECTION 2-PROPERTY OWNERSHIPIAUTHORIZED AGENT'." 2.1 Owner of Record: Name(Print) Current Ma n 'fling Addreps: � � I� Telephone Sign re 2.2 Authorized Agent: ldc RD 0 f--1 C) rzc l �-4�.:��-ic r1 r ,4 Name(Pi t) a 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 .J0 0 +- —^ (b}Estimated Total Cost of a © � Construction from 6` 3. Plumbing ' i. .—. Building,Permit Fee 4. Mechanical(HVAC) 5. Fire Protection 000 75 6. Total=0 +2+3+4+5) 0 C3� . Check Number � This$ectiorr For Official`Use Only Date Building Permit Number Issued: Signature: Building Commissioner/Inspector of Buildings- Date File#BP-2006-0357 , APPLICANT/CONTACT PERSON STEPHEN BROIDE ADDRESS/PHONE 820 FLORENCE RD FLORENCE (413)585-8000 PROPERTY LOCATION 28 DEERFIELD DR MAP 36 PARCEL 026 001 ZONE URA THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out poluu Fee Paid T_weof Construction: CONVERT 12 X 20 CARPORT TO KITCHEN New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included• Owner/Statement or License 3 sets of Plans/Plot Plan j F LLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON ATION PRESENTED: THE 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 S Commission zoas 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. 28 DEERFIELD DR r BP-2006-0357 GIs#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 36-026 CITY OF NORTHAMPTON Lot: -001 Permit: Building Category: BUILDING PERMIT Permit# BP-2006-0357 Project# JS-2006-0527 Est. Cost: $44000.00 Fee: $200.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: STEPHEN BROIDE Lot Size(sq. ft.): 13111.56 Owner: PLANTE CHARLES E Zoning Applicant. STEPHEN BROIDE AT. 28 DEERFIELD DR Applicant Address: Phone: Insurance: 820 FLORENCE RD (413) 585-8000 FLORENCEMA01062 ISSUED ON.1011312005 0:00:00 TO PERFORM THE FOLLOWING WORK.-CONVERT 12 X 20 CARPORT TO KITCHEN 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 10/13/2005 0:00:00 $200.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo