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17C-117 04,`29/2@ D 2 15:'221 41-258612440 RJ BLANk PAG'-:- 01 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. ZA t N A'R 0 ""11\02 TO. SPRI NG FrELD c; FIRST AMFIRICAN TITLE INSURANCE COMPANY I HEREBY REPORT THAT I HAVE EXAMINED THE PREMISES AND RASED 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 N07T--'D. I FURTHER REPORT THAT THE PROPERTY IS NOT LOCATED YATHIN A FLOOD PRONE AREA AS SHOWN ON FEDERAL FLOOD INSURANCE MAPS FOR COMMUNITY -NOTE- 'E SURVEYOR: THIS PLAT FOR MORTGAGE LOAN PURPOSES ONLY ANiJ J� DOES NOT CONSTITUTE A PROPERTY SURVEY -MORTGAGE LOAN INSPEC-PON PLAT- PMDALL NORTHAMPTON, MASSACHUSETTS L PREPARED FOR tZER %JI #35M RONALD J. & FIDELA S .J. BLANK is SCALE- 1 "=40 ' FEBRUARY 27, 1992 HAROLD L. EATON AND ASSOCIATES, INC- - 6� REGISTERED PROFESSIONAL LAND SURVEYORS 3-51 RUSSELL STREET - HADLEY - MASSACHUSETT'. �r6' l Kr +v r w i .f _ d . aw YF"rW� ;4A y _ '$ Grit of 'Wart allipterr -----_" � � �attxc�{nxctta '° DEPARTMENT OF .BUILDWa INSPECTIONS 212 Main Street ' Municipal Building ' Northampton, ?lass. 01060 `4YORREWS COMPENSAUTON INSURANCE AFFIDA.VU Q �1 '_ {licerlste/pemsitt�} with a principal place of business/residence at: _11 hane#) 3 . 2SJ�3 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 gob: ce Company) (folic;Number) n Date) ( ) lain 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) Company/Policy Numb-=)� (Expiration Date) (Name of Contractor) --(Insa ance Compairy/PoUcil Number) (Expiration Date) (Name of Contractor) (Insurance Compalxy/POLicy Number) (Expiradon Bate) (Name of Contactor) (Iwarance Company/Policy Number) (Expiration Date) (ansdt AM 606 al shod traeomary to inaludo MR%M atioo paeu=ug to all=**d+o") ( } I am a sole proprietor and have no one working for me. t } I am a home owner performing all the work myself. NOTE'pleau be aware tint whim hcmoown=who employ paw=to da m=tc==c,acmaracdon or tgxa r work ea a d%%Umg of not more than three w2 is is which the hoakeowaer resides Of oa the WOUXXis mpartensd thersta are oot geaaaily 000sidt=1 to be employas ttndcs the wotkeft oampats4aa Act(GLI52,ss 1(5)),appticabrl,a,by a homooww fm a Haase oc penult tray-id--the 14tpl atatua of as employvc aadw the Wakeet Coaopaaaatioa AaL I—detttxad that a ewpy ofthis statemaat tray be focwax%W to tha Devarom A of I*&L-Aial AmWalt a otters of Ia>ursoao for the covmgc vtcMcadw and that failure to secure co%vmp undw sacdm 21A cf MOL I52 an lad to the uVoidom of criminal penalties eoa%Lvtittg,af:fine of up La t1,300.00 aadlor .of up to one yar aai civil peatwcs is the foe=of a Stop Work order and a ' f=of S100.00 a,day*plat ton. F*V %L-onty .. Relit Number 5 1S I13�` MV# T,ot# LiocascelPeanittx I 8.1 licensed Construction Su eIp ryisor: Not Applicable ❑ � Name of License iWAu License Number Address Expiration bate Signature Telephone Not Applicable ❑ Company Name Registration Number �Akicdd 2, Address U --� Exp±ration ®ate iTelephone2j� 1r TbN0 WgREtS'.CtM0ENSTtON [�1N� gii°� x2, 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...... ❑ 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 12erson who constructs more than one home in a two-year period shalt 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 tithe,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 persons) 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 r F V- u* New House a Addition Replacement Windows Alteration(s) 0 Roofing 0 Or Doors ❑ Accessory Bldg. ❑ Demolition❑ New Signs [ J Decks X Siding Other 1 ] Brief Description of Proposed Work: i Sower, Alteration of existing bedroom Yes x No . ew bedroom_ y Yes x No Attached Narrative 0 Renovating unfinished basement Yes X No Plans Attached Roll 0-SheetX 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. e. Number of stories? i f_ Method of heating? Fireplaces or Woodstoves v Number of each g. Energy Conservation Compliance. Mascheck Energy Compliance form attached? h. Type of construction I 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? r_ Yes No . 1. Septic Tank City Sewer Private well City water Supply +Q FT O xA ?Ltd Q Willi t � as Owner of the subject property hereby authorize h���f a��%� /`1 C`�. � �,(�rr � _ to act on my behalf, in all matters relative to work authorized by this building permit application. Si nature of Owner _ Date - — � 1, as Owner/Authorized Agent hereby Jeclare that the s atements and information on the foregoing application are true and accurate, to the best of my knowledge and belief. Signed under the pains and penaltie of perjury. �2� r 1aAJ Prin Name Signature of Owner/Agent Date Section 4. ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE DENTED DUE TO LACK OF INFORMATION m^ Existing Proposed Required by Zoning This column to be filled in by Building Department Lot Size `3 l 7 317/ 7 Frontage I ' t` !� Setbacks Front Side I,:-1-0 R: € L: G""_R: 35- : 3 S Rear t'q-a l O Building Height 26 1 i 9 «" Bldg. Square Footage Open Space Footage % C/ (Lot area minus bldg&paved parking) #of Parking Spaces [Fill: olume&Location A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO DON'T KNOW l\ _ 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:`�a 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 ng Department Main Street i,Room 100 o ° ha pton, MA 01060 APR p0 � r ne413 87. 240 Fax 413.587.1272 AP'PLIWt6N40` , ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING M SEc3'j t 1 f -E IN 1 1 1"ON,; 00 / 7 1,1 Property Address: fie ` pW i SECTION :'PiRTITQN/1 . .RSHiP/glf�f�1ARIZIR� AN7 21 Owner of Record: NCfl 7GA I C1 kASL-) Name(Print Current . Mailing Addres Signature 12 horized_g nom' r�-rz�i�c mbau 1` __ _i -ZI i i c )U)t lc Name(Print) Current Mailing Address:: Signature Telephone iti s Item Estimated Cost (Dollars)to be Off�lal �e'Q ' completed by perrnit applicant 1. Building ✓ off-Q D Q , 2. Electrical tja ±3wkz �4f , " 1 3. PlumbingJkrm1e,, M 4. Mechanical (HVAC) 5. Fire Protection �x 6. Total =0 + 2+ 3 +4 + 5) � F ui 6 - .�f wsC Y .i. ': .'` �YRSI `Sr O'i�t' r,l�` :».: -,•.'i ..r' �...,.airrs`u..sc,�..;�:c+x..rR,.. 4Y` .iL BultlingPermr tra�C DAte Gsu =� a. S+gr`ia"ture tnl . Btildinge Eomlttis 5jonerJinspector of 8u0dings pew T � File#BP-2002-0939 APPLICANT/CONTACT PERSON GERALD ARCHAMBEAULT ADDRESS/PHONE 171 WEST ST (413)247-5903 PROPERTY LOCATION 27 SHEFFIELD LANE MAP 17C PARCEL 117 001 ZONE URB THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Buildiniz Permit Filled out Fee Paid — Tvpeof Construction: CONSTRUCT 122 SQ FT 3 SEASON PORCH&260 SQ FT DECK New Construction Non Structural interior renovations Addition to Existing_ Accessory Structure Building Plans Included: Owner/Statement or License 010788 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON 1NF,QAMATION 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 Street Commission 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. BP-2002.0939 GIS#: COMMONWEALTH OF MASSACHUSETTS ' ''# I -4V CITY OF NORTHAMPTON Lot: -001 Permit: B U i I d n g Category: BUILDING PERMIT Permit# BP-2002-0939 Project# JS-2002-1523 Est. Cost: $22000.00 Fee: $50.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: GERALD ARCHAMBEAULT 010788 Lot Size(sa.ft.): 3171 1.68 Owner: BLANK RONALD J&FIDELA S J zonin :URB Applicant: GERALD ARCHAMBEAULT AT. 27 SHEFFIELD LANE Applicant Address: Phone: Insurance: 171 WEST ST (413) 247-5903 Workers Compensation W HATFIELDMA01088 ISSUED ON:516102 0:00:00 TO PERFORM THE FOLLOWING WORK.-CONSTRUCT 122 SQ FT 3 SEASON PORCH & 260 SQ FT DECK 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 Signature: Fee Type: Receipt No: Date Paid: Check No: Amount: Building 5/6/02 0:00:00 2395 $50.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo 27 SHEFFIELD LANE BP-2002-0939 GIs#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 17C- 117 CITY OF NORTHAMPTON Lot: -001 Permit: Building Category: BUILDING PERMIT Permit# BP-2002-0939 Project# JS-2002-1523 Est_i'n;,! $22000.00 Fee: PERMISSION IS HEREBY GRANTED TO: Coast:. r7;s,: Contractor: License: Use Group:— GERALD ARCHAMBEAULT 010788 Lot Size(sq.ft.): 3171 1.68 Owner: BLANK RONALD J&FIDELA S J Zoning URB Applicant: GERALD ARCHAMBEAULT AT. 27 SHEFFIELD LANE Applicant Address: Phone: Insurance: 171 WEST ST (413) 247-5903 Workers Compensation W HATFIELDMA01088 ISSUED ON:516102 0:00:00 TO PERFORM THE FOLLOWING WORK.-CONSTRUCT 122 SQ FT 3 SEASON PORCH & 260 SQ FT DECK POST THIS CARD SO IT IS VISIBLE FROM THE STREET Inspector of Plumbing Inspector of Wiring D.P.W. Building Inspector Underground: Service: Meter: ,t Footings: Rough: Rough:ul3/�d�. f! ouse# Foundation: 0,0 t-C S d Driveway Final: L -(5). © 9 Final: Final: G 1�%