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25A-140 (3) N � Z • 0 0 * 0 m rn c * Dg cn o G) o > > XC) D 0 � 97-0 - -- -- - 0-m- z rn Z _ 0 -n0 � O -o I -i to rnrn rn � � IG) C: < D rn z I 01- z O = I rn (� m = vx � rn cn O 0 I � z rn v i i l 95.0' I - - ,\ I I I \ I I I ! T I 91.0 I 95.0' 1 i N I W ( I I F �!, �� 93,.0 M _ - -- ---- - - - - - - - - - - -_— y---� rn \ pROPER�`N= z KATHLEEN LUGOSCH, ARCHITECT BETSY FEICK RESIDENCE --- �^ PROPOSED SITE PLAN 15 HAWKES VIEW ROAD,AMHERST,MA.01002 NORTHAMPTON, MA. Phone 413-548-9877 z LL96-86S-£Tb auoyd dW 'NOld WVHlbO N 3 M ZOOIO'VW'1S2i3HWV'OVO'd M3IA S3HMVH ST Sn313 aNd SNVld ON 1J3-IH:)'lt/ H:)so!)nl N33lHlt>1 3:)N34IS321 )1313 AS139 NOI VAON3b 30VdVE) <^ 0 o= OOO 'n f-Q8 ZF W°-W 0 900 3� U O w Z rL z -Z woz lAJ X Z W Z Z Wo° ,Maq (n (A au Zia 0z5m ��° C7 Z �0Z V 1 w?O (n ri F--- -------- I I © I I W uj — rn I o LL zu i I o_ LU 00 I I a --- w I----------------� I a a e .. z—— - I I o,a To I� II � � --� W LJ a I W -- LLLLJJJJ I , I � a I l L--J T— — — Q ILI I a 3w 3w U 0 oc J J K � 11 __. -------_- ------ ------ -_.y 3 J O a m i o ul 0� M X = ID Q L auj OZ Q Q O 0 Z UX M N L w0 0 X Q U- v ° U 0 V3: 0 I Ln Z z n ti n ri w ° tea' O >1 O F O O Z= O I Q f C2 -FEF 0 I o 111111IN111111IT Z O 0 0 0 ® O t "a Grits of Xort4a itpton z z $ � �Iassachusctfs ; wi DEPARTMENT OF BUILDING INSPECTIONS INSPECTOR 212 Main Street 0 Municilzl 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 his/her construction sups�•,, sor. The state defines"Homeowner" as, "•Persoh(s). who owns a parcel on which he/she resides or intends to be, a one or two fanuly 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 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 regulations. The inspection process requires that the building department be called to inspect work at various stages, which include foundation/footings(before backfll), sonotube-holes (before your), a rough building inspection (before work is concealed), insulation inspection (if required) anda 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 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 $ Crzft�r zYf 1art 11alliptoII 6 �assachnsrtts' m DEPfiRTMEN7 OF EUILDO\'G INSPECTI02q5 212 Main Street ' Municipal building Northampton, Mass. 01060 WOR.II�E'R'S CO1I T ENSATZON INSURANCE A:+ , ANriT Nvith a principal place: of busiress/residencc t: hone =,'__�` 1a • ��a — tt7 do hereby cer-4;. and--i- the pans and pc:n2itiC:; of n(-'gury, :.11at O I am an employer providing the follovvilic •: 01"ker's cornpcns2t3on coverage For my elllplov=3 Nvor-Eng on Leis job: G=J any Company) (Pe_ic:Number) (EXl=i7-6bn Date) _ I a.c1 sole r oriet eneral c-on�c`o; c,: hoinefl«ve (cLrcle one) and have hired the cootr ctors fisted below -,7,.-ho Mila the OLl ':v:% a t°Vc Corri er st c�lipen�:�:Gt ^j:;ci es: 4 -4e o -4 e-P (Name of Contractor) (IIls"ul�mncc Corr.^an-r,'Polic Numbs DSte f J� J l��3^i f ) t` ) May(- i "txvy_ moo, i �'.1� 7 1'Gl Z �o (Name of Contractor) (J'asurarcc Co--� �N./Policy Nuznt, t) (Expimdo:l Date) c , off©� �5 ' � t s _-- _11 _- (Nam of Contractor) _ (IDst-nct Ct�i; a li'olic; i�utvber) ^.x--;-zix0,Late) (Name of Contractor) (IDsutance Comp -y;Policy Numbs) (Exi3i::a6or,Date) t of Lll�t-`.L�IJCC.II S_-Ct:f:a:�.^t.^::A t�-_:'::.ic:::::K:7:L•:C4 .._....:..a:f:..eli O:f:"_:�L:+� I 'ilITl <. SOlL' 1)I-CJ1)I?t:�Ur Illta il�tVC t?O 011 ".'Jr�liT` for IT?e. � {, X 2111 a hoI?le 0"'In— ii C!?C`ITllIi !1 'J;Oi:: iii'rS 11. NO"ft.:p{ u Lx atva;c Liu: '%t'o c plcf;r r :o c: aancc w.:� Cr not bete th_u ao)co uni!i ir.trf d: he!�-i •.iv-rr: or a; _:.� ?v�rt r_rt thcCn arc n t --ployc3 51 2 ! Sl!. " ic:;I:y a hocnm N-4f for a L•c-=u c< �x X.. Itsxt status of an omptoyw uad r ttic Wcviccls qy re ration Act I undcztand dia4 a copy of this,rtata:�=auy t o fawnnied to 110 f?t utzrn of I u riJ Accidma'CiGoe of I:z:.' t>x for tfx covcragt+zrif�tioa and that f iltue to:xs:m�tr_,ro tu•,3;;<"if�2SA oC?.{GL 152 can lut w tt>c imy�oxitioa o.`c�:.ia.l pctsL':a comisiing of a fur of up to S f SCO.00 ar'fY i^}ri r.z er1 of::�to cr.:y,1 e:.i civil ptnaltia in��fcx n or'.'Sic,,';Jerk Ora;.=and a fism oCSl00.Qt)a day a�:.in:1 m� i i '' Fcr d�uuxnrs!u,c fxily l Permit s Ntimtx a __. ---- — r.=•; gn tturc of I.ic ` T ! rte•_..;_ :e^lnt:tlr; 8 1 Licensed Construction Supervisor: Not Appli cab��l++e ❑ Name of License Holder : � � (0 .'T o License Number Address . r Expiration Date fr �y Yp T -y} Plignature Telephone en: °on3 o Not Applicable 0 6� y Company Name 0 Regisstt-ration Number ` � c 1AAA' v¢ �"� it Address Expiration Dafe Telephone 1,13 £ '° Ol 00 ' ANCgErAFFIDAYIT{MGL c 1452, §2506)) 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 e building permit. Signed Affidavit Attached Yes....... No...... ❑. J. { 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 welling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more`than one home,iri a two-year period shall not be considered a homeowner. Such"homeowner"shall submit to the Buildings ffic*l;on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed unde� ie building permit. As acting Construction Supervisor your presence o he job site will be required from time to time,during and upon completion of the work fa,which this is issued. Also be advised that with reference Chapter 152(Worker' 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 forcompliance with the State Building Code,City of Northampton Ordinances, State and Local Zoning Laws and State of Massachusetts General Laws Annotated. Homeowner-Signature 5 Q � - ROP SED�iI�RK she f�. �.;. ._ New House ❑ Addition ❑ Replacement Windows Alteration(s) Roofing 43 Or Doors ❑ Accessory Bldg. Demolition*/*' New Signs [ j Decks [ J Siding[ J Other [ J Brief Description gf Proposed Work: er^dI t 'ey, 3 v x 0N-\ rs�,vA e> Alteration of existing bedroom Yes--0(0-No Adding new bedroom Yes A Q3 No Attached Narrative 0 Renovating unfinished basement Yes No Plans Attached Roll 0 • Sheet r' trxr o 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. Mascheck 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 L 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 �.� a # RfZ�&IOAI -TAO 8E CQMP�L0�7�Dr�(H�E: - CTOR�PPL ES FOR 05MIM1NG P as Owner of the subject property hereby aut orize C�CSek, — to act on my beh i all matters relativ work au orized by this building permit application. Jr- d Sign re of ner Date I as Owner/ nor zed A hereby dec are that the stat ments and information on the foregoing application are true and accurate, to es of my knowledge and belief. Signed under the pains and penalties of perjury. Print Name f ! Q g 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 J Building Deparftnent Lot Size ✓ l .� Frontage 0-0 Setbacks Front �.- i Side L: yo R:_114 L: R al,,� Rear Building Height l ` } Bldg.Square Footage �E % Open Space Footage / e % S1�r" b ; (Lot area minds bldg&paved G l� -J arldn _ zf3"�"L #of Parking Spaces Fill: (volume'&Location) A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO_NJ G 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 _J 0 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-LZ 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 413-587-1272 APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE� C rAMILY DWELLING s s I JUN - 9 2004 -SEC OFt 1 Q I SITsE IN -ice 1.1 Property Address: cel RL ° SEC ?12 3?t€OPEit� iKNERSHR .f RZE7iA 2.1 Owner of Record: Name(P' Current Mailing Address: i na re Telephone 2.2 Authorized Agent- t f(pL� + it Name(Print) Current Mailing Address: ° Signatu `' Telephone �€GTION�3 ESTIMA�'ED.001VSTRt7�G'�ION'C©STS - , Item Estimated Cost(Dollars)to be ti (modal bg Only, Com leted b ermit applicant 1. Building A ,eq 7 2. Electrical A5-60 rJ—�© fib Esfima t ed Tatar Cost of ,.,C Instn cEaoAif om 3. Plumbing Bulidm Permtt> ee. 4. Mechanical (HVAC) 5. Fire Protection 6. Total =(I +2+3+4+ 5) Chee^Ic Number ThVs,Seciii on-,For 0fFGatklTse Orin, Building Permit Number.; Date Issued• Signature: Building Commissioner/Inspector of Buildings Date G 53CJ-/S(� OlObo b�-�2AN (TER Nt I►� I ry 4. J -' J UN — 9 2004 P rTGi� Czlz�c J S ; WYTON,W 01050 bk- N5 SraL� r/ TC A H 45 � �- Ka 0-F --o ----- — o I -0 SAN I File#BP-2004-1249 APPLICANT/CONTACT PERSON RYAN REGAN-LADD ADDRESS/PHONE P O BOX 59 SHUTESBURY (413)259-1149 j PROPERTY LOCATION 34 BATES ST MAP 25A PARCEL 140,001 ZONE URB THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ZONING FORM FILLED OUT ENCLOSED REQUIRED DATE Fee Paid Building Permit Filled out Fee Paid Typeof Construction: DEMO&REISLACE EXISTING DET GARAGE(20 X 229") New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/Statement or License 060508 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFORMATION P1eSENTED: Approved VAdditional 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: § g, ? XA-A SiF Finding JZ 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 mmission 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.