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I � � � z �� � r �� � � � N to � .� J h �6 , t a � r Sr �I � � 0 i 1 �� • . . _ _ � i •- . . ♦ � .' ... _ i i • • 1 • • � . • � i � ti r , w-�s r 3& r2-.31 `�}- J �.! i c.� I �� � !! o ��_ I V y:.:� ` 1 F rT� � / �. e � //�i ' � � � a � � v� i r----------- � I � �a tf �� i_ r'_ �.� + � I �� � � _ � � jx �� ' -� � .�. _ , 1 � � � r��n' � ar i,�� -�;i� � � s ,._ � � • /` \ r � \� �, atl a; � � �r� t3} � � �, �� � �� } � N � h ` � , � � �� u� � � 6 s �} ' 1� v, aj r �� � � a� � � � �► i I i c � I i � � i N � z P� � � ' � , 1 n � � � � � � � I � � � ! `� i �• �,�� $: �t � � � _ a CI s S � \ a (� � � `1 � t � t�1 � � � �� �1 ��} III h� tl� {��A�.1 ♦fi •. :.+; �`�,, 4 a. --NOTE-- t THIS PLAT IS COMPILED FROM DEEDS, PLANS' AND OTHER SOURCES AND IS NOT TO BE CONSTRUED AS AN ACCURATE SURVEY AND IS NOT TO BE RECORDED-"r,__ L, S ULi �.,� .1 L 9 fi M I os r TO: NORTHAMPTON CO-OPERATIVE BANK & FIRST AMERICAN TITLE INSURANCE COMPANY I HEREBY REPORT THAT I HAVE EXAMINED THE PREMISES AND BASED ON EXISTING MONUMENTATION ALL EASEMENTS, ENCROACHMENTS AND BUILDINGS ARE LOCATED ON THE GROUND AS SHOWN AND THAT THE BUILDINGS ARE ENTIRELY WITHIN THE LOT LINES, EXCEPT AS NOTED. I FURTHER REPORT THAT THE PROPERTY IS NOT LOCATED WITHIN A FLOOD PRONE AREA AS SHOWN ON FEDERAL FLOOD INSURANCE MAPS FOR COMMUNITY # 2 5 4 1 6 SURVEYOR: `' �' -J-� THIS PLAT FOR MORTGAGE LOAN PURPOSES ONLY AND DOES NOT CONSTITUTE A PROPERTY SURVEY ' -MORTGAGE LOAN INSPECTION PLAT- NORTHAMPTON, MASSACHUSETTS L mm PREPARED FOR +160u RUTH A. F OGG SCALE: 1 "=30 ' MAY 5 , 19c46 HAROLD L. EATON AND ASSOCIATES, INC. REGISTERED PROFESSIONAL LAND SURVEYORS �• -1" 235 RUSSELL STREET - HADLEY - MASSACHUSETTS �THA1tlP�. O O g� ti$ Crxt r of Xort4auiptan Z ,�lAS5ACh1I8ltt5 - sy DEPARTMENT OF BUILDING INSPECTIONS INSPECTOR 212 Main Street • Municipal Building 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 supi�-­,,ig 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 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 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 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 ortilaillpf Lill g 6 h�135Ac!l lit rtta ' m t>EPIRI'ME-NTT OF BUILDI?�G INSPECTIONS 212 MaLill Street ' Afunicipttl Building 2rTorthaml)toil, 7\Snss. OlOGO NNTORICER'S C0Mi TENSATION 1NSUIZANCE A FE-DAV].T �r -�i�11_ A__w__►.._-��---��r�__©2��-_,G�m�R�---1.e�rn�3�/Q- .- ----___ (lIC�P th a principal place, of busiress/residcnc�2 Ad- F`99FI F—i"D WA (strc°ticiti:,....c:�r�, d0 llcreo}' CC�ilI}�, lI:1C'cl C}1C' pa:•rlS i'.iit7 pCil<it7CS (�i pC'.I�l1I�r, (Ili?:. ( ) I m -Ln employe, providing the iollovvinr '.vorkcr=s cornpcns t-1on covera�c for Iny enlplovees Working on t}iis job: (La,-a c—z Conpam') (P e-c;Nu—nbcr) ---- (.C.}-t!irltion Date) ! j I a-c-i a sole proprietor, g=enera hon.ccl,;v e: c"cle one) and .;avc 'Hired the cont cIors listed beiow i'i]0 i? c� the •T'OrkPI'-S GJi J°P_ Or1 `0!JC.cS: (Name Of ConL-nCtor) (Zn_L J1 CC Lv^ll"D- GllC NLLLIlbcr) Datc) (Name of Contrlaor) (i 1s r„r:c° Coy arI`vPe!ic; Nurlbcr) D2.te) (Name Of Coaum lor) - (Name of Cont nCtcr) — (Ins ancti CoTilr .y Polio Numtr�) (..".[Ll G'1;..d'lIJC<:1I S:.�Ct::'•^�'�-�3^:.:���_.:...'. :-.:: - _� __ l 1 <LT] I1 UlC 1)rUl?r1C Ji 2.II 1 ilI?''3 110 QI1'v .•'UI" ;_ii t0 ii1�. Il,, ;.11 iL iii';Smolt. NOTE:please be awzrc Ltsr.::Jc h r;co lrra ,-c c.: pIc Ir. ,_�v ::::r� _:ancc a:._n m cr:;r;,it ..-.... •cl!s not rncee th-n thrno unite in t"i�c'a'dx rc:.:.::z a-oc; ca:ployC�3 uti cr llr tvc,?'.ci x cc z-=: ica't-C,(G i.1 S2 .I(S)' vt:lic:Scr,by❑ho;aro«rr`:or lcsal natuc of rn cmployx under t::o Wor4 Cx'z t oti,o .lion!.cc I undo--to d di,S-cony of th:..aafc::.s_S cuy be fc,—v<Iod to tlr[YtnrL rsi:of]rwiu.rtl_t Acci& y(:ili c+o of'•':%'+r 7_a for dl covcr-&&c va-ifictioc and th.t G.lure to 2 S A of:;GL^152 can(c d to the inip:-s tiara c fisting of a fu)--of up to S 1,SMCO n;T&'X ir.:arur tti:!of::p to cr.-)-Zr s:.1 civil per sltiu in do Sohn of n S!c-, lino of S;IQO.QQ a dsy igi-in:l rn.. .- n Cos dr;;uuncatal u>•c urly Ycrrnit Numfr.s __- L J i nature of i.ict n• ^ -_.._.r } w a; S�CTON 8 CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder : W; I/1 /,4 A4 04 mo1,-E 1.A r-A C V-E L V,-,, OCR- License Number lay 6:1ZFF,fJE Ft-b 2d 941.213 Address Expiration Date F C9Ft'r L- , 01,4 0 13 y� Si ture Telephone R'eter°`e �t"one m"ter ue ontracto:: Not Applicable ❑ L'I E L c)avi tiFR Company Name Registration Number 7-,�Y �&gLOF,-,FIQ /?.p 6.5'dN Address Expiration Date L 7 D M,4 Ot Jzld. Telephone/3))7,3,8; SECTION 10 1M1IORKERS',COMPENSATION 11 S RANCE-AFFIDAVIT(M G16 c 2-52, §;25C' 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 o he building permit. Signed Affidavit Attached Yes....... 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"home owmer" 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 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. OF-Homeowner Signature �s *? SEC7?lOt�S DE5GRIP-4TAON�OFfPROPOSEM ORK(check all apalica�le) . wry+�a�s�a-.�unme�rwvasvrazue.wa�->a ,. ,z t - - New House ❑ Addition 3i Replacement Windows Alteration(s) ❑ Roofing ❑ Or Doors ❑ Accessory Bldg. Demolition❑ New Signs [ ] Decks [ ] Siding[ Other [ ) Brief Description of Proposed Work: vlr0.�, t S Alteration of existing bedroom Yes No Adding new bedroofi Yes o Attached Narrative 0 Renovating unfinished basement Yes No Plans Attached Roll 0 • Sheet I/ 6a�1.fi f e°douse W ddi.116W,.fo-existing;-housing -camp°bete theµfollow�n a. Use of building : One Family V Two Family Other b. Number of rooms in each family unit: Number of Bathrooms 1 c. Is there a garage attached?— Ck(101 V1 cj � �U�-�- 0 ® E_X LS -An V1,J d. Proposed Square footage of new construction. bimensions + e. Number of stories? Qk dj-'- f. Method of heating? Fireplaces or Woodstoves Number of each g. Energy Conservation Compliance. Kr/ 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 `ITO BE COMPLETED WHEN OWNEkS"AGENT ORCONTRACTOR APPLIES FOR BUILDING PERMIT as Owner of the subject property hereby authorize M c, -s E to ac,. on my behalf, in all matters relative to work authorized by this building permit application. (��6acr (:>t- '-4 Signature of 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. Print Name ignature 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 j Building Department Lot Size Z'31 c � / � 2 P Frontage Setbacks Front ? 1 A 3 Side L:,.30' R: L: "� R: ,14� " Rear a 011 , Building Height y q Bldg.Square Footage bo `( �'?; 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 V DON'T KNOW YES IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO DONT KNOW YES IF YES: enter Book Page and/or Document# 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: D. Are there any proposed changes to or additions of signs intended for the property ?YES— No IF YES, describe size, type and location: City of Northampton Building Department � � ; 212 Main Street Room 100 Northampton, MA 01060 phone 413-587-1240 Fax 413-�C272 APPLICATION TO CONSTRUCT,ALTER,REPAIR OVATE O LING L SEP 2 9 2c04 f SECTION i-SITE INFORMATION DES?Df Ict�on be compl� l b office 1.1 Property Address: Inc-, `Map Lat Un>t Zone' °°¢ Over{ay,;Dustncti Elm Sts DIstrI ct ,CB District SECTION 2-`PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: Name(Print) Current Mailin Address: Telephone- Signature 2.2 Authorized Agent: Name(Print) Current Mailing Address: Signature Telephone SECTION 3 :ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed b ermit applicant 1. Building (DO {a)Building Permit Fee I P3,2. Electrical (b)Estimated Total Cost of Construction from 6` 3. Plumbing m^ Building Permit Fee 4. Mechanical (HVAC) 5. Fire Protection 6. Total = (1 + 2 + 3 +4 + 5) Check Number This Section For OffidaLUse Only Building Permit Number: Date issued: Signature: Building Commissioner/Inspector of Buildings Date File#BP-2005-0370 APPLICANT/CONTACT PERSON Lamore Lumber Co ADDRESS/PHONE 724 GREENFIELD RD DEERFIELD (413)773-8388 PROPERTY LOCATION 1136 BURTS PIT RD MAP 36 PARCEL 157 001 ZONE SR THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out Fee Paid JrU T_ypeof Construction: CONSTRUCT 16 X 20 CARPORT& 10 X 12 SHED New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included• - Owner/Statement or License 076123 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INF ATION 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 Str ommission 1� 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. 1136 BURTS PIT RD BP-2005-0370 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block:36 157 CITY OF NORTHAMPTON Lot:-001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: BUILDING PERMIT Permit# BP-2005-0370 Project# JS-2005-0490 Est.Cost: $18000.00 Fee: $50.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: Lamore Lumber Co 076123 Lot Size(sa. ft.): 13024.44 Owner: FOGG RUTH Zoning:iR Applicant: Lamore Lumber Co AT. 1136 BURTS PIT RD Applicant Address: Phone: Insurance: 724 GREENFIELD RD (413) 773-8388 Workers Compensation DEERFIELDMA01342 ISSUED ON.1015104 0:00:00 TO PERFORM THE FOLLOWING WORK.-CONSTRUCT 16 X 20 CARPORT & 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 Shmature: _ FeeType• Receipt No: Date Paid: Check No: Amount: Building 10/5/04 0:00:00 5168 $50.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo 1136 BURTS PIT RD BP-2005-0370 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 36- 157 CITY OF NORTHAMPTON Lot:-001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category BUILDING PERMIT Permit# BP-2005-0370 Proiect# JS-2005-0490 Est.Cost: $18000.00 Fee: $50.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: Lamore Lumber Co 076123 Lot Size(sq. ft.): 13024.44 Owner: FOGG RUTH Zonine: SR Applicant: Lamore Lumber Co nr-rP AA plicant Address: Phone: Insurance: 724 GREENFIELD RD (413) 773-8388 Workers Compensation DEERFIELDMA01342 ISSUED ON.1015104 0:00:00 TO PERFORM THE FOLLOWING WORK.-CONSTRUCT 16 X 20 CARPORT & 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: _ �, ;,• O,l. In ulat:on: Final: Smoke: Final: 0(-(- j-y,0 6- THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATION,S� Certificate of Occu a nC >! Si nature: FeeType• Receipt No: Date Paid: Check No: Amount: Building 10/5/04 0:00:00 5168 $50.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo