36-181 (2) FROM ,: .� NN DECHESSER CPBD PHONE NO. 1 413 569 0612 Oct. 16 2000 03: 14PM P6
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THIS PLAT NOT FOR RECORDING PURPOSES I� �
10
NOV 1 5m
!APT OF BUIU,ING IF��FI TlnP >
Plan Book 88 Page 60 - - - ° ~ ~---
Lot #3
"I
# Ill
0 0
Ln Ln
I
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/vv
Dunphy Drive
To: The Baybank &
The Chicago Title Insurance Co.
iEREBY REPORT THAT I HAVE EXAMINED THE PREMISES, AND BASED ON EXISTING MONUMENTATION,ALL EASEMENTS, ENCROACHMENTS
10 BUILDINGS ARE LOCATED ON THE GROUND AS SHOWN AND THAT THE BUILDINGS ARE ENTIRELY WITHIN THE LOT LINES. I FURTHER
-PORT THAT THE PROPERTY IS NOT LOCATED IN A FLOOD PRONE AREA AS SHOWN ON FEDERAL INSURANCE MAPS FOR COMMUNITY
JMBER 25 0 1 6 0#
ATED: June 22 , ;1995
NOTE
"' THIS PLAT FOR MORTGAGE LOAN PURPOSES ONLY AND DOES
JRVEl'OR: ` L,�Zo NOT CONSTITUTE A PROPERTY SURVEY.
MORTGAGE LOAN INSPECTION PLAT
I" OF Northampton, Massachusetts
R1cyARD Prepared For
Angela Mansolillo
LAF3ARGE,SR —°
#34605 � Scale: 1 "=30 '
Richard J. L,aBarqu, Sr., Registered Professional Land Surveyor
110 King Streat, Northampton, Massachusetts 01060
�KttAM pT
O O
-
� d �lasaacEiusttia'
DEPARTMENT OF BUILDING INSPECTIONS
212 Main Street ' Municipal Building '
Northampton, Mass. 01060
WORKER'S COMPENSATION INSURANCE AFFIDAVIT
with a principal place of business/residence at:
9-7 (phone#)` �z-
(stmet1city/sta 1&zi p)
do hereby certify, under the pains and penalties of pegury, that:
( ) I am an employer providing the following worker's compensation coverage for my
employees working on this job:
(Inc=ce Company) (Policy Number) (Expiration Date) s<s<<
( ) I am a sole proprietor, general contractor or homeowner (circle one) and have hired
the contractors listed below who have the following worker's compensation policies:
(Name of Contractor) (Insi=cc Comparry/Policy Number) (Expiration Date)
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(Name of Contractor) (Insurances Com,any/Policy Number) (Expiration Date)
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(attach additional sheet ifne enxryto include infvrrnatioa pauining to all ooctrndors)
I am a sole proprietor and have no one working for me.
( ) I am a home owner performing all the work myself.
NOTE:please be aware that wbilo homcow who employ perzons to do maiatetaance,O=tuetion or repair work on a dwelling of
not moc a than throe units is which the homeowner raids or on the groutyds appuacawt thereto arc not generally ooandered to be
employers under the tvoni,a comp=sation Ad(GL152,ts 1(5)),application by a homeowner flu a lice=or permit may evidence the
legal stahna of an employer under the Worker's Compomation Act
I understand that a copy of this statement may be foswoxded to tbo Depnrtaxnt of Indzrslrid A=dcrts'Offioe of 10%Jrsn0e for the
coverer vaifiattion and that failure to secure coverage undcx section 25 A of MGL 152 can lead to the imposition of criminal pcnakics
consisting of a$ne of up to S1,500.00 and/or irupriso of up to one year and civil pctaltia in the form of a stop Work order and a
fine of 5100.00 a day ttse.
For '' Daly
Permit Number
11 rEi' Map# ___Lot#
Signature of Licensedpermittee e
` .
~
�
SECTION,8-CONSTRUCTION SERVICES
8.1 Licensed Construction Supervisor: Not Applicable 0
Name of License Holder V1 License Number
164 0 :310-7/C 7-
Addres3 Expiration Date
Signature Telephone
Company Name R4- Registration Number
Address 8-7 Q16LLA Expiration Date Gh ?
Telephone
SECTION 10-WORKERS' COMPENSATION INSURANCE AFFIDAVIT(M.G.L.ic. 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.
The current exemption for^hooeovmnem''was extended 0oinclude (l) or two(2)families
and to allow such homeowner to engage an individual for hire who does not possess ulicense,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 Deriod 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 buildine 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 '� Chapter^ ' Compensation)
Employees for injuries uotreoubingmDeudh)of��Massachusetts G cnorulLowaAuuo\ated,you may be liable forpemon(m)
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
SECTION'S DESCRIPTION OF PROPOSED WORK(che-ck all applicable)
New House ❑ Addition Replacement Windows Alteration(s) ❑ Roofing ❑
Or Doors ❑
Accessory Bldg. ❑ Demolition❑ gns [ Decks [ ] Siding[ ] Other[ ]
Brief Description of Proposed Work: r F Z�
r
Alteration of existing bedroom Yes No Adding new bedroom Yes No
Attached Narrative❑ Renovating unfinished basement Yes No
Plans Attached Roll ❑ - Sheet
a. Use of building : One Family)— Two Family _Other
b. Number of rooms in each family unit: i Number of Bathrooms Z-
c. Is there a garage attached? LVI-11�. �L�Ct PL--
d. Proposed Square footage of new construction. 07-- Dimensions Z )k
e. Number of stories?
f. Method of heating? F 4 W Fireplaces or Woodstoves�a Number of each
g. Energy Conservation Compliance. Mascheck Energy Compliance form attached?
h. Type of construction C4_)-f
i. Is construction within 100 ft. of wetlands? Yes _No. Is construction within 100 yr. floodplain Yes x No
j. Depth of basement or cellar floor below finished grade wa 1i L 0V
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
OWNER AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
as Owner of the subject property
hereby a horize to act on
my behalf, in all matters relative to work authorized by this building permit application.
Signature of Owner Date
0 C'u, 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 rd, penalties of perjury.
v� M C
Print Name
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 LS ec -- 3
a�
Frontage
Setbacks Front �
Side L:�S-R: W L:_4W,, R: Zf-'-,) C::?, p
Rear c
Building Height Z 2 'ZZ% (35-,
Bldg.Square Footage ?CV % 110c) 0
Open Space Footage %
(Lot area minus bldg&paved 2j y So C(O ' `l ?O
parking)
Z �
#of Parking Spaces
Fill:
volume&Location
A. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO 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 y
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.
s
of Northampton
ing Department .
2 Main Street
NOV 152= Room loo fig,
No a pton, MA 01060
ti 8 -1240 Fax 413-587.1272
rPT OF Sult.
APPLICATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTION 1-SITE INFORMATION
y This ser»'#ion to f e Ieted of 4
1.1 Property Address: O �`
Map 'Eot nit
Zone ' OvertayDlCstric
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
Nam (Print) Current Mailing Add ress:
07!;Q
Telephone
Sig re
2.2 Authoriz Agent: f
M CJ&:�n P-7
L
Name(Print) Current Mailing Address:
9,4 — 335
Signature Telephone
SECTION 3- ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollars)to be Official Use Only
m leted by ermit applicant
1. Building (a)Building Permit Fee
coo , CJ o
2. Electrical (b)Estimated Total Cost of
5r5(l(3 co Construction from 6
3. Plumbing Building Permit Fee
4. Mechanical (HVAC)
5. Fire Protection
6. Total =(1 + 2 + 3 +4 + 5) co ,Q(9 Checlt Number U '~
This Section For Official Use Only
Building Permit Number: d Date Issued:
Signature:
Building Commissioner/inspector of Buildings Date
File#BP-2001-0503
APPLICANT/CONTACT PERSON Paul McCutcheon
ADDRESS/PHONE 87 Chestnut St (413)584-3352
PROPERTY LOCATION 111 DUNPHY DR
MAP 36 PARCEL 181 ZONE SR
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Buildinp,Permit Filled out
Fee Paid l
LMeof Construction: REPLACE EXISTING DECK W/12 X 16 4 SEASON SUNROOM
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included•
Owner/Statement or License 062544
3 sets of Plans/Plot Plan
THE LOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION:
Approved as presented/based on information presented.
Denied as presented:
Special Permit and/or Site Plan Required under: §
PLANNING BOARD ZONING BOARD
Received&Recorded at Registry of Deeds Proof Enclosed
Finding Required under: § —w/ZONING BOARD OF APPEALS
Received&Recorded at Registry of Deeds Proof Enclosed
Variance Required under: § —w/ZONING BOARD OF APPEALS
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 Commissi Permit from CB Architecture Committee
Signature of Building O al 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.
BP-2001-0503
COMMONWEALTH OF MASSACHUSETTS
Nla, lock: 36- 181 CITY OF NORTHAMPTON
Lot: -001
Permit: Building
Category:Deck Addition BUILDING PERMIT
Permit# BP-2001-0503
Proiect# JS-2001-0861
Est.Cost:$8500.00
Fee: $50.00 PERMISSION IS HEREBY GRANTED TO
Const.Class: Contractor: License:
Use Group: Paul McCutcheon 062544
Lot Size(sg.ft.): 14984.64 Owner: MANSOLILLO ANGELA
zoning: SR Applicant: Paul Mc_C_utch_ e_on_
AT: 111 DUNPHY DR
Applicant Address: Phone: Insurance:
87 Chestnut St (413) 584-3352
FLORENCEMA01062 ISSUED ON:11/17/00 0:00:00
TO PERFORM THE FOLLOWING WORK.-REPLACE EXISTING C=C K W/1 2 X 16 4
SEASON SUNROOM
POST THIS CARD SO IT IS VISIBLE FROM THE STREET
Inspector of Plumbing Inspector of Wiring D.P.W. Inspector of Buildings
Underground: Service: �� Meter:
Footings:
Rough: Rough: ('� '� House# Foundation:
Final: Final:
jlti'w
Rough Frame: �Y r~C � .,14` ' ' ,r
Gas Fire Department Fireplace/Chimney:
Rough: Oil: Insulation: >
Final: Smoke: Final: �3
THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF
ANY OF ITS RULES AND REGULATIONS.
Certificate of Occu anc si nature: -
Fee Type: Receipt No: Date Paid: Check No:. f Amount:
Building 11/17/00 0:00:00 4691 $50.00 '
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Building Commissioner-Anthony Patillo
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