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03-008 (8) N V MAHI )W RD EADOW RD �7 ) ECTION FOR OFFICIAL USE ONLY: :MIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE X 24 DETACHED GARAGE __AC Building Plans Included: Owner/Statement or License 3 sets of Plans/Plot Plan TH OLLOWING 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 Commission Permit from CB Architecture Committee 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. `IMPORTANT MESSAGE FOR / A.M. DATE ,.--� TIME P.M. OF do PHONE .AREA CODE NUMBER +. EXTENSION • FAX • MOBILE AREA CODE NUMBER ` TIME TO CALL TaEoH{7NEt7 A AN W,A,tln-M sfii yau. RErURNF-0 YQLfR CALL ;TT;*lnbN MESSAGE SIGNED FORM 30025 MADE IN u.s.A, --e X 2- S loll A/0 A-5 NOV 1 5 2000 b ti L t� 14,o —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. Nov 5 2000 : j FPT OF StM 11M c? nrfti , i �1 rX f S T7t W G- 6a U 0 TO: FLORENCE SAVINGS BANK . ,& _ FIRST AMERICAN TITLE INSURANCE COMPANY 1 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. 1. FURTHER REPORT THAT THE PROPERTY IS NOT LOCATED WITHIN A FLOOD PRONE AREA AS SHOWN ON FEDERAL FLOOD INSURANCE MAPS FOR COMMUNITY # 167 SURVEYOR: �' �- '� NOTE— THIS PLAT FOR MORTGAGEE LOAN PURPOSES ONLY AND DOES NOT CONSTITUTE A PROPERTY SURVEY y OF —MORTGAGE LOAN INSPECTION PLAT- �'r P MDALI NORTHAMPTON, MASSACHUSETTS E IZER PREPARED FOR ;33032 JOHN J. & VIOLA M. BATRANO Es S �pt� SCALE : I "=200 ' SEPTEMBER 27 , 1994 Y11 HAROLD L. EATON AND ASSOCIATES, INC. REGISTERED PROFESSIONAL LAND SURVEYORS '_o_ —L 235 RUSSELL STREET — HADLEY — MASSACHUSETTS f o4'��MpTO at Of Nart4allytoll �lIl4RChttSf115 m DEPARTMENT OF BUILDING INSPECTIONS 212 Main Street ' Municipal Building ' Northampton, Mass. 010 60 WORKER'S COMPENSATION INSURANCE AFFIDAVIT V, ��if ( rows (licenserJpeTmittee} with a principal place of business/residence at: �L-o,.y- �rl, ✓ °"1 1 C,0 (�—S /i'I (phone#) Lf i 3 ✓ (street/city/statPlzip) do hereby certify, under the pains and penalties of perjury, that: ( ) I am an employer providing the following worker's compensation coverage for my employees working on this job- (Insurance Company) (Policy Number) (Expiration Date) O 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) (Insurance Company/Policy Number) (Expiration Date) (Name of Contractor) (Insurance Company/Policy Number) (Expiration Date) (Name of Contractor) (Insurance Comparry/Policy Number) (Expiration Date) (Name of Contractor) (Insurance Company/Policy Number) (Expiration Date) (atta r additioml sfice ifneccssuy to include information pertaining to ell ooatma ors) O I am a sole proprietor and have no one working for me. ?Kt I am a home owner performing all the work myself. NOTE:please be aware that while homcowvcrs who employ pawns to do mxjatc=ne, �nuiion or repair work on a dwelling of not Mom than three units%a which the homeowner resides oC oo the grounds appartcmni lhetrW are not gaxrnky ooandcred to be employers under the wm+ctt compensation Act(GL152,-1(5))�,application by a homcow=for a license or permit may evidence the legal etatua of an employer undothe Wodcees ConVonaation Act. I understand ffiA a copy of this ctatetneat may be fotwcutied to tho Depa,t of I.&"rid Aoadw&Offioo of In%mlaco for the coverage verification and that failure to secure oovrrago under soctioa 25A of MOL 152 can lad to tba imposition of Crimi l Penalties 000siumg of a fine of up to S1,500.00 andloC imprisoamcat of up to one year and civil pamiltics in the form of at Stop Work Ord-and a fum 01 5100.00 a day again l tax. For&p-t='W use only Permit Number Map;# Lot# .rte- Signature of License&Permittee Date �C�t C�rlQiuA NSTRII, I` Sliifiq $ 1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder License Number Address Expiration Date Signature Telephone ffl AN Not Applicable ❑ Company Name Registration Number Address Expiration Date Telephone SECTI©N1tJ VgRKEI±aUMh1�SATlf?N l!1U1AlVC�pfF1l�AY,IT,(M.G�L c,152,Tj 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. igned 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"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 buildins 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. Homeowner Signature New House ❑ Addition ❑ Replacement Windows Alteration(s) ❑ Roofing 0 Or Doors ❑ Accessory Bldg. Demolition❑ New Signs [ ] Decks [ ] Siding[ ] Other[ ] Brief Description of Proposed Work: Alteration of existing bedroom Yes No Adding new bedroom Yes No / Attached Narrative❑ Renovating unfinished basement Yes y No Plans Attached Roll ❑ - Sheet❑ 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? 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 SEcto N 7a OWN' N, TQ33 QIVIIOL TED WHEN WNviNs A907 QR Ct�D►R APNN�INS >~NNNMDING PERMIT as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application. 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. I—Signed under the pains and penalties of perjury. 17'7 F1-H— Print Name l//i /o v Signature of Owner/Agent Date r Y 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 ;q Z 00 f' Side L:/00f R: G/00 L: 16V R: C,/Cd� Rear f e>a 49 Building Height Bldg.Square Footage % 2.2V 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 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 _Z 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 for the property?YES_ No IF YES, describe size, type and location: r M 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 SECT10$ STE IN170OR IA'FIOk" t 1.1 Property Address: b * /U el 060 SECTlON2 PRaPR7Y OiI�iERSH1Pkl3RIZEQ AGENT 2.1 Owner of Record: V' $vv.4 ill 7'/tov,. r !Or Name(Print) Current Mailing Address_. Telephone Signature 2.2 Authorized Agent: Name(Print) Current Mailing Address: Signature Telephone TIC1N' ESTIMATD#�ON$' ll MOM , Item Estimated Cost(Dollars)to be Officll.tJs Orly, completed by ermit applicant Building 2 �� (a):BuitdIng Perrn� 00: r 2. Electrical (b) s . ted Tdtal 00t,Of Cdhitructiori frworn . 3. Plumbing Bulldirrg Perm>It Feet 4. Mechanical (HVAC) 5. Fire Protection 6. Total =(1 +2 + 3 +4 + 5) ,,Check N�mber Th s:Sectio"Mo ir Officlak Us0"' l B rrtdlrig=Perrrrrt'Number to lssu[6d ,*1k l _ Signature "l urldlrgCrrrnrrr� lcrr erll ,.. i File#BP-2001-0450 APPLICANT/CONTACT PERSON SWAN V MAHI ADDRESS/PHONE 471 COLES MEADOW RD (413)586-8117 O PROPERTY LOCATION 471 COLES MEADOW RD MAP 03 PARCEL 008 ZONE RR THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out Fee Paid Typeof Construction: ONSTRUCT ATTACHED 14 X 18 SHED/GARAGE New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/Statement or License 3 sets of Plans/Plot Plan 2 TH OLLOWING 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 Commis ' Permit from CB Architecture Committee Signature of Building OfficiaK 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. 471 COLES MEADOW RD BP-2001-0450 G1S#: COMMONWEALTH OF MASSACHUSETTS ''Map:Block:03-008 CITY OF NORTHAMPTON Lot:-001 Permit: Building Category:GARAGE BUILDING PERMIT Permit# BP-2001-0450 Project# JS-2001-0767 Est.Cost: Fee: $25.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor., License: Use Group: Lot Size(sa.ft.): 522720.00 Owner: SWAN V MAHI Zoning:RR Applicant: SWAN V MAH 1 AT. 471 COLES MEADOW RD Applicant Address: Phone: Insurance: 471 COLES MEADOW RD (413) 586-8117 O NORTHAMPTONMA01060 ISSUED ON.11/17/00 0:00:00 TO PERFORM THE FOLLOWING WORK.-CONSTRUCT ATTACHED 14 X 18 SHED/GARAGE 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: 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: Fee Type: Receipt No: Date Paid: Check No: Amount: "Building 11/17/00 0:00:00 1113 $25.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo