36-143 (2) c�
j
iLO
i
-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
i
i
s
pmt
ri
I
TO: EASTHAMPTON SAVINGS BANK &
COMMONWEALTH LAND TITLE INSURANCE COMPANY
TO THE BEST OF MY INFORMATION, KNOWLEDGE AND BELIEF i
I HEREBY REPORT THAT I HAVE EXAMINED THE PREMISES AND BASED ON DJSTING
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 # 250160
-NOTE--
SURVEYOR:�FAI"7-� -L THIS PLAT FOR MORTGAGE LOAN PURPOSES ONLY
-- AND DOES NOT CONSTITUTE A PROPERTY SURVEY
OF A%* -MORTGAGE LOAN IN�;PECTION PLAT-
NORTHAMPTON, MASSACHUSETTS
RANDA-L � PREPARED FOR
IZ. H SUSAN ROBINSON
035032 SCALE: 1 "=40' MAY 13 , 2002
SU HAROLD L. EATON AND ASSOCIATES, INC.
l,�NO Ry��
REGISTERED PROFESSIONAL LAND SURVEYORS
235 RUSSELL STREET - HADLEY - MASSACHUSETTS
Crz#fir of Norfila ptan
$ � j�assac{tusrtfe I� -
DEPARTMENT OF BUILDING INSPECTIONS
212 Main Street Mmnicipal Building
INSPECTOR e%.
Northamptoui, MA 01060
HOME OWNER EXEMPTION ACKNOWLEDGEMENT
The State of Massachusetts allows the homeowner the right under 780CMR 108.3.4 to
act as !Js/her construction sup,_: ,::;or. T ha stale defines "Homeowner" as, " Person(s)
who owns a parcel on which he/she resides or intends to be, a one or hvo fancily
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 buildiniz 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, understand the above.
(Home own /resident's signature requesting exemption)
I will call to schedule all required building inspections necessary for the building permit
issued to me.
Date ! 3�0 3
Address of work
location g t�oY--s+fie- 4 -r-4_t c.-
►'mot g
zhallI}lftill
212 Afaln Street AInniciIA Bw l irl:
Northamptan. 'class_ 01060
WORKI''lR'S (-;OMPENSATI_ON 1"NSUIZANCh; AFFIDAVIT
i
V,'iih �. 1)1 iilClt)3_ k?laCt' Oi �7L1Si17eSS�f?`;ic;CI1CL' 3t.
I ,ifa ;?'1 I1111!J�rC, (II OVA.. - the AdloP, n nv k&..
�'R]I)1(� C.a '�VUI?allies IJiI is 1 )7b.
1 Jil sole 1 IOi7awy, :rema 7 ;...,
1 C�(�C,J; '_I
th'c contT "'ml Red below o 113 _ [he QAOna VIM WS carwansaW Was:
(Nt. e P1 A:1un i,_.:) Answamc Qiu _ !Almlop ... ..;u Dale)
Mue of Connactoi) (Iluzlhnc� Coln. c� `uml��tl Date)
C.A "r:e:
NOTE F._plc-x he n;va e that
net^xYC ihnn L�.rcc tuatt Ir ui-:�:Ltx lyX:Y.7:�2?z rr_::-�ex at t-`"�.-;.�_:�;: :"crc: 1 t_`xrCC cc v t�crr_tal', c�•._:::i=::�:�i`'
1csi1 elatut of rn�:�>lo}'a under l::o WcY�«'a Co;vjxr,_,anon r'.�-L
I undcn2L�d tha_>cvey of Chia ctitct;a:f r.:ay lx fx,�-nr�ie,1 to tfn Il ;;txcv of Itxi.:a'r i:.J Ac.i�'nti of 'd for lfrc
oovc,-ngc vcific-atioa nad that feilttrc to t%t:.t:c covcrn�„utxicr zccticc 2',A f MC,1,15:can Iced to ttxi irn;x)sitia��_f"c=.:^•i:_1 pctultia
muting of a f:rr_of Up Cos I,SCK).00 et�i'v of up ton,}_,r,I civil;'7—I tic I i❑ of
fr>r o(Sl(�.C'0 a:L.y agzinA[rv:-
Fcc'S`tt�-tt�lu. --
� f Numtr�r
I cxm,l i;•�
2.; 03 -
_
SECTIONt -'CONSTRUCTION SERVICES
8.1 Licensed Construction Supervisor: Not Applicable ❑
Name of License Holder
License Number
Address Expirai ion Date
Signature Telephone
9 Resist"erect Homelmpr'ovement Contractor „� Not Applicable ❑
x y
Comp" 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...... ❑
fllil.x 4
"ome Owne E Mp", 1'on'
The current exemption for"homeowners"was extended to include Owner-occupied Dwellings of one(1) or two(2) farliiies
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-vear 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 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 AnnotateJ, 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 Genera, Laws Annotated.
Homeowner Signature __. c •c X3.0
r
Y
SECTION 5- DESCRIPTION OF PROPOSED WORK(check all applicable
New House El Addition El Replacement Windows [Alteration(s) El Roofing El
Or Doors ❑
Accessory Bldg. ❑ Dernolition❑ New Signs ] Decks ] Siding [ ] Other [ ]
-- - — -
Brief Description of Proposed Work: __[>,CjCA 4ec� rlQ
Alteration of existing bedroom Yes _ No Adding new bedroom Yes _ No
Attached Narrative U Renovating unfinished basement _ Yes _ _No
Plans Attached Roll U - Sheet U
6a. 1f'New-46dse1a"nd'6r'addition to existing housing, c6mplete the followinis_
a. Use of building : One Family_ Two Fac i I y--_- 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
Number of stories?
f. Method of heating? _ Fireplaces or Woodstoves - Number of each
g Energy Conservation Compliance. ^.,lascheck Energy Compliance form attached?_
h. Type of construction
Is construction within 100 ft. of wetlands? Yes -_- No. Is construction within 100 yr. floodplain ___---`,es __- Nc
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
-ASCU P.p� ,-q as Owner of the subject prepert;
-- --- - -
hereby authorize ---- - ---- to ?',1 o'
my behalf, in all matters relative to work authorized by `h -:r, rig p emit application.
Signature of Ow r Date
- _ as Owner/Authorized Agent
hereby declare that the statements and information on the foregoing application are true and Eccurate, to the best of nay
knowledge and belief.
Signed under the pains and penalties of perjury.
Print Name
Signature of Ow r/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
Frontage
Setbacks Front ��
Side L:Jy`?,(pR: ICD`7--91/ L:3
�-- —
L
Rear " �
Building Height 7 /
Bldg. Square Footage % 192;33
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 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 fo, the property ?YES
No
IF YES, describe size, type and location: _._ _
<,rf emus 0l
X14 P
City of Northam Eton Status of PermrtT
Building Department Curb Cut/Drrveway,Permtt�
212 Main Street �
t Sewer/Septrc Avarlabtllty - -
Room 100 WaterlWell A a Iailifi/3
Northampton, MA 01060 d
( Two Sets of St"ructura P,lans�
ph -)r e 413-587- 1240 f j,.x 4 1 3
- Plot/Site Rlans t {,
Other Specrfy: t_
fri L' R T, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
1 rr
F J MN 2 4 20003 Ilu)
ECTI TI N
CT-13t, BINfT N - - - - - -- - -.----- -- -
4 QIpE� This section to be completed by office
�>a f'C�C�lLSfGiP L-IfrC I Map ---- - Lot Unit --
Zone Overlay District
Elm St. District CB District
SECTION 2 PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
USA 1 -- -
� _ b��- s, o_�-1 - _- -_-- P U t:�?X- _�..�(o,�c�.S�l�?��t'cw►�0102'
222 Authorized Agent-:
t ,s:
I
SECTION 3_ESTIMATED CONSTRUCTION
CostP Dollar � - - - --- -`- —,--
� r COSTS-
Estimated ( official Use Only
completed a n7 + t
- bV I
Permit Fee
led Total Cost of
nstruction from (6)
Buildin; Permit Fee
7. � r i,rU l�,Cti0f1 I I
6 v'
Q - Number
This Section For Official Use Only
Building Permit Number: _ Date Issued:--_-_
Signature: _
Building Commissioner/Inspector of Buildings
File#BP-2003-1204
APPLICANT/CONTACT PERSON ROBINSON SUSAN M
ADDRESS/PHONE 308 BROOKSIDE CIR (413)582-6996 Q
PROPERTY LOCATION 308 BROOKSIDE CIR
MAP 36 PARCEL 143 001 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 vl�o 17
Typeof Construction: CONSTRUCT 16 X 12DECK TO ABOVE GROUND POOL
New Construction
Non Structural interior renovations
Addition to Existing
Accesso1y Structure
Building Plans Included•
Owner/Statement or License
3 sets of Plans/Plot Plan
THE OLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INF 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 PERL\IIT 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
Z.G 2 0 •>
Signature of Building Official at
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-2003-1204
Gzs#: COMMONWEALTH OF MASSACHUSETTS
CITY OF NORTHAMPTON
Lot: -001
Permit: Building
Category_ BUILDING PERMIT
Permit# BP-2003-1204
Project# JS-2003-1871
Est.Cost: $1500.00
Fee: $50.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
use Group: Homeowner as Contractor
Lot Size(sq. ft.): 1511 5.32 Owner: ROBINSON SUSAN M
Zoning URA Applicant. ROBINSON SUSAN M
AT.• 308 BROOKSIDE CIR
Applicant Address: Phone: Inshwance:
308 BROOKSIDE CIR (413) 582-6996 ()
FLORENCEMA01062 ISSUED ON.•6126103 0.00:00
TO PERFORM THE FOLLOWING WORK:CONSTRUCTI6 X 12DECK TO 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 OccupanU Signature:
FeeType: Receipt No: Date Paid: Check No: Amount:
Building 6/26/03 0:00:00 2009 $50.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Building Commissioner-Anthony Patillo