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-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
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TO: EASTHAMPTON SAVINGS BANK &
COMMONWEALTH LAND 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-
SURVEYOR: <': T%n' __ THIS PLAT FOR MORTGAGE LOAN PURPOSES ONLY
AND DOES NOT CONSTITUTE A PROPERTY SURVEY
of �S -MORTGAGE LOAN INSPECTION PLAT-
NORTHAMPTON, MASSACHUSETTS
RANDALL � PREPARED FOR
E. a MAX & DARLENE ZURAWSKI
U IZER to
!35032 SCALE: 1 "=40 ' DECEMBER 2 , 1997
s HAROLD L. EATON AND ASSOCIATES, INC.
REGISTERED PROFESSIONAL LAND SURVEYORS _
O¢'St1�+a1P?O
,,.Grzty of Warthanyton S,t e
z
` DEPARTMENT OF BUILDING INSPECTIONS /=
INSPECTOR 212 Main Street • Municipal Building >a
Northampton,MA 01060 S ,`
HOME OWNER EXEMPTION ACKNOWLEDGEMENT
The State of Massachusetts allows the homeowner the right under 780CMR 108.3.4 to
act as his/her construction supc::-v sor. T he state defines "Homeowner" as, "Person(s)
who owns a parcel on which he/she resides or intends to be, a one or tWo j�ami 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 wilding department for the City oTNorthampton wants-azry 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/footines(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, 4a` Y_ �1 1-V 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
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0-i Pf �\Tclrfljullipfott
it R f ��a�awrhasrtle' �_
w DEPAR T)vfEWT OP BUILDrI\,C INSPECTION'S -
212 Alain Strcct ' DSunicipal Building
Nort.hampton, Mass. 01060
WORIa—R'S COKPENSA770Tit MSURA-NCE ?. TTI)fit17'
(licsrnscxlper-mitfcc) --...--- --.
Vn b a principal place of busioessfresidence at: -
i (str��/ci tyfsza.ula p)
do hereby certify, under dic.pains and penalties of perjury:, har
j ( ) I :1n an employer providing the following w ori:cr's coinocasa:Jor. covem^c for In)
emplovees `,,orlong on tjus job:
l'
(Lsuranc Comm-) (Police: ?:u�lrr) -- (r:pirtior.Dom)
I "
( ) I atn a sole proprietor, general contractor or homeow-oer (ci c:e one) and have hired
the coauacctors used below wbo hzve the folio%wing workers camoen_taoon pckies:
j
(i+31lJC of Cont^cior) (In ur3nc-c cornpany/Polley NluzII--:) (xpirrau0n. n1lC)
j -
i (N:me of Conv-aclor) (insarzn Company/Pol.in, Nunc_r) (irpiraon Dait)
(Name of Coamcldr) Qasuranc-- Compamyfpolicy Namb_t1 (Expiration Darcy
i
(Name of Contractor) (Losuranc- Compaa}�1PoUcy Numb:r) (Expi anoa Dale). -
(aII�.<3 ..t-t.�oc�J cScC.f nom••-•.•ti.in m, ?u�inform=ioc P=%,jaj S to.11 meS-Ln:s� -..._.-
I
jI am 'a sole proprietor and have no one working for me.
I ( ) I am..a home owner performing all the%work myself.
NOTE:pi.be -tZ-3c hOcD= =-to ctaploy pc-,c=to&=>=j --,,, r,c=,—.roc a igaa work oo r of
not more th n t'soe t�fs is u-beb the bomomwc rtm&,or oo the pcun6 zppurtea._=them Lt o-x C==-.2y c,.6-cd to L-
caVloy :uac a the-=k&I Act(GUI 52-=1(5)).=.pptiabon by a homeoQaa fc_6c==or pcmn=y—idam tl:c
lc�sl nabu orsm asplaye und�rdio Wocl;dr compom�Lioa Act
� 1 ua6azs.aod tb,2 a of thin mtcm�ma b-focanvdsd to tbo Dry..rtmco¢
I O1�' Y of Induxr;cl McidcII�'OtLoe of[rsurwae for th.
oovaa�e rciScaioa rnd the L•irtac to s,==LoveTase tmdc jc, ioc 23.&of 1.10L 152 m tcd to the i=Pczi6-of cimiasr P=L'LWe
coazrsmg of a tint of up to S I y00.o0 a'Wo, of up to ooc ycr end civU pmaltio io tx form of a Stop Wok Orcrc aad=
j
fl=of S 100.00.day LFainn t>x
- For d�.rta�=�u,c only
j --� permit Numb=
✓CI ✓I S �,(, L01
itL�lurc of Li�scclperTStitict: e __ .J J
SECTION 8-CONSTRUCTION SERVICES r
8.1 Licensed Construction Supervisor: /� Not Applicable ❑/
Name of License Holder: T`q -P-
M- ,5 �J�6--J �� -7o
C J9/9 Y)J d, P0-A) ftA('1 I License Number
Ad ress d/C� Expiration Date
`113 �k Lj /
ignature Telephone
9. e ise': : mspo � Not Applicable ❑
Comoaannnv Name �^//� �f, I J� f Registrr/ation um er --
-2 C/J/�✓NaN I V /V� /�..' Z ,401014 0!(// �/
Address Expiration Date
§00, Cl / /�� G G'�J�"6' 't/ /YI -G� Telephone /fJ /
SECTION 4'0-WORKERS'COMPENSATION INSURANCE"AFFIDAVIT(M.GcL.c.152 4 25COY
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....... I& 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 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
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SECTION 5-DESCRIPTION OF PROPOSED W.ORK:(check all applicable1
New House ❑ Addition ❑:, Replacement Windows Alteration(s) Roofing �]
Or Doors 0
Accessory Bldg. Demolition ❑ New Signs [0] Decks [p Siding[0] Other[d]
Brief Description f Propyso r ��
Work: t/! / r
Alteration of existing bedroom Yes��No Adding new bedroom Yes _No
Attached Narrative Renovating unfinished basement Yes _ C___�,_No
Plans Attached Roll -Sheet
say 31�e �iaas� noac[c�c�>�`�O;��extst�ctc�YIioastng�cflmp�ete`fiae��fa t��><nq:
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. Masscheck Energy Compliance form attached?
h. Type of construction
L 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
OWNEF 'HORZTION-TO BE.COMPLETED,WHN SECTION 7a A
OWNERS AGENT OR'CON_,MCTOR-"APPLIES FORrBUILDING:PERMIT
715 as Owner of the subject
property
hereby authorize
to act on y behalf, in all matt elative to work authorized by this building permit application.
Signature f 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.
�rr-e/s 019vi3ay.�
Print Name
nature of Owner/Agent Date
1
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Section 4. ZONING All Information Must Be Completed. Permit Can Be Denied Due To Incomplete Information
Existing Proposed Required by Zoning
This column to be filled in by
7 . Building Department
Lot Size
Frontage
Setbacks Front s S 1 1
Side L:L R:` i L:i=�R: `
Rear l !
Building Height -
Bldg. Square Footage %
Open Space Footage r� % ; per
(Lot area minus bldg&paved
parking),
#of Parking Spaces
Fill:
volume I&Location)
A. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO DONT 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 I Page and/or Document# !
d v�
B. Does the site contain a brook, body of water or wetlands? NO DONT 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: j
1
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,excavation,or filling)over 1 acre or is it part of a common plan
that will disturb over 1 acre? YES n ,. NO
IF YES,then a Northampton Storm Water Management Permit from the DPW is required.
City of Northampton
Building Department
212 Main Street
Room 100
Northampton; MA 01060 ..
phone 413-587-1240 Fax 413-587-1272
APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTION 1 -SITE'INFORMATION
w f� � Th>ts section to be cot�apleted.by office
1.1�Property
�AV dd-rr�ess--: .
bZK5 \ A � �
nht
..,,, ` s k R7 s ., s
Elm S Distnc"" 22
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT,
2.1 Owner of Record:
Name(Prin p =a�'r�CJ
Telephone
Signature
2.2 Authorized Agent:
Name(Print) Current Mailing Address:
&.44 c// 2 9
06na Telephone 7_SECTION 3ES TIM ATED CONSTRUCTION COSTS
Item Estimated Cost(Dollars)to be Official Use Only
completed by ermit applicant
1. Building (a)Building Permit Fee
2. Electrical (b)Estimated Total Cost of
Construction from 6
3. Plumbing Building Permit Fee
4. Mechanical(HVAC)
5. Fire Protection
6. Total=(1 +2+3+4+5) Check Number
This'Section For Official'`Use Only
Date
Building Permit Number Issued:
Signature:
i
Buildings Commissioner/inspector of Buildings Date
File#BP-2006-0414
APPLICANT/CONTACT PERSON James Dawson
ADDRESS/PHONE P O BOX 121 CHESTERFIELD (413)296-4710 Q
PROPERTY LOCATION 303 BROOKSIDE CIR
MAP 36 PARCEL 131 001 ZONE URA
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Buildiniz Permit Filled out
Fee Paid O(ff 25
Typeof Construction: ERECT 10 X 16 SHED
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/Statement or License 002701
3 sets of Plans/Plot Plan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INFO.RMATION 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 Co on
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.
303 BROOKSIDE CIR BP-2006-0414
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map:Block:36- 131 CITY OF NORTHAMPTON
Lot: -001
Permit: Building
Category: BUILDING PERMIT
Permit# BP-2006-0414
Project# JS-2006-0604
Est. Cost: $1600.00
Fee: $25.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: James Dawson 002701
Lot Size(sq.ft.): 22041.36 Owner: TURATI ALAN J&LINDA RENKOWIC
Zoning:URA Applicant: James Dawson
AT. 303 BROOKSIDE CIR
Applicant Address: Phone: Insurance:
P O BOX 121 (413) 296-4710 ()
CHESTERFIELDMA01012 ISSUED ON:1013112005 0:00:00
TO PERFORM THE FOLLOWING WORK:ERECT 10 X 16 S ED
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 10/31/2005 0:00:00 $25.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Building Commissioner-Anthony Patillo