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17A-098 (4) s _ u n IT . a r ,r�r O x$x IG cM u ,-3 floe- P7'ZX 0 PiGe BQOA --- - r.4' C�NC Pi6r2 .46I SOW > qeA zp�r 2� I oil folWD ATWK� 1 4,x1 � ot� N Dv�s J�m s�.� Lf--- tt 1/2-18 �7q�S ON 1!=./ I F �T� 11 —NU It. 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. BUILDING LOCATION ACCURACY IS NOT GUARANTEED oo I _ 0 � ,} N - -� /S7 She. � .�¢► �s.oy TO: FLORENCE SAVINGS BANK & LAWYERS TITLE INSURANCE CORPORATION TO THE BEST OF MY INFORMATION, KNOWLEDGE AND BELIEF I HEREBY REPORT THAT I HAVE EXAMINED THE PREMISES AND BASED ON EXISTING MONUMENTATION ALL VISIBLE 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 # 250167 _ —NOTE— SURVEYOR: �• -�- THIS PLAT FOR MORTGAGE LOAN PURPOSES ONLY - - AND DOES NOT CONSTITUTE A PROPERTY SURVEY _MORTGAGE LOAN INSPEC11 IN PLAT- NORTHAMPTON, MASSACHUSETTS RAND&L PREPARED FOR �,�,E�.pp �' THOMAS F. HOGAN rm N #35032 SCALE: 1 "=30 ' JANUARY - 11 , 1999 <( S Rq HAROLD L. EATON AND ASSOCIATES, INC. REGISTERED PROFESSIONAL LAND SURVEYORS 235 RUSSELL STREET — HADLEY — MASSACHUSETTS HOME OWNER EXEMPTION ACKNOWLEDGEMENT The State of Massachusetts allows the homeowner the right under 780CMR 108.3.4 to act as his/her construction supervisor. The 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 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 occupancv 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 pQrrnits 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 7­ Co.nn.o�t»�eaitlq o�_Vassac zusetts —� "`""""""" i�eJaYt.Me:Zt OI IFZfitlstPLal_�CCi>�eliZS QTof Il.vesti,a inns 600 TVashiji ton St;•eet Boston, MA 02111 411174'.mass.g 0v1dia «'orI:ers' Compensation Insurance Affidavit: Builders,!Contractors;Electricians,'Pl:imbers Ar,nlicant Information Please Print Legibly N=e Business,"Orzani-ation Incividual;i: Address: Citv/State21p: A/b4Z Phone#: � •/ Are you an employer' Check the appropriate box: Type of project(required): �. I am a general contractor and I i.❑ I am a employer with ❑ 6. []New construction employees (full and/or part-time).* have hired the sub-contractors �.10 I am a sole proprietor or partner- listed on the attached sheet. %. ❑ Remodeling ship and have no employees These sub-contractors have g. ❑Demolition working for me in any capacity. employees and have workers' 9. ❑Building addition [No workers' comp. insurance comp. insurance.- �. We are a corporation and its 10_❑Electrical repairs or additions required.] ❑ rP 3.❑ I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself. o workers' comp. right of exemption per_VGL r 1 ❑Roos repairs insurance required.] ; c_ 12, §1(4), and we have no er employees. [No workers' 13. O th ' E- comp. insurance required.] ;V Any applicant that checks box TI must also Sil out the section below showing their workers'compensation policy inform ion. Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit.a new affidavit indicating such. �Cont:actors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have emplovees,they must provide their workers'corm.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Compar_y Nzme: Policy#or Self-ins. Lic.#: Expiration Date: Job S ire Address,V 6(?A /1 6J Cirv/State,Zi,,J/' eloCZ Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 1-52 can lead to the imposition of criminal penalties of a fine up to S 1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to S250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DLA for insurance coverage verification. I do hereby cerrifv under the pains and penalties of perjury that the information provided above is true and correct. nature: / Date: Phone#: Of use only. Do not write in this area, to be completed by city or town ofjcciaL City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3. City,Town Clerk 4.Electrical Inspector -4.Plumbing Inspecwr 6. Other ii Contact Person: Phone SECTION 8 -CONSTRUCTION SERVICES 8.1 Licensed Construction Suoer/isor: Not Applicable ❑ Name of License Holder* &.9,1— i (�L O- /d�/' License N�Cummber/GJ? r J G %���J G G ow G / A Address Expiration l5ate Signa�re Telephone 9:Registered Home Improvement—Contractor r , _ Not Applicable ❑ ,Pa9���xrc�, oa4379 Comoanv Name Registration Number a A� iR401*- ff. �7�G,�c� mow. cue cd Address Expirati n Dat J ( Tefephoney�.�'f SECTION 10-WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M°.G.L.c. 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. Signed Affidavit Attached Yes....... [!I' No...... ❑ 11 =Home.ow,ner.k"Nem0 iQn 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-vear 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 building Dermit. 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 c- -'ON DESCRIPTION OF PROPOSEO WORK(check all aaolicable) l New House F7 Addition ❑ Replacement WiDdows Alteration(s) E-1 Roofing Ej Or Doors Accessory Bldg. ❑ Demolition ❑ New Signs [0] Decks [ � Siding[C1 Other[Dl Brief Description of Pr000sed ! Work:' KA/� .5t?&UjC. ..Sr e✓C �,t/�1✓CL--� tmyw .S da s//dz wi i --aw" /J u/J�le�ZQ�i�b+r� Alteration of existing bedroom Yes No Adding new bedroom Yes No Attached Narrative Renovating unfinished basement Yes No45w,(y Plans Attached Roll -Sheet Ga.If New house and or addition to existing housing,complete the fot[owina: �X 9 a. Use of building : One Family L- / Two Family Other ���y b. Number of rooms in each family unit: .p Number of Bathrooms c. Is there a garage attached? !vim' g d. Proposed Square footage of new construction. Dimensions e. Number of stories? I f. Method of heating? GA3 Fireplaces or Woodstoves_ A/O Number of each g. Energy Conservation Compliance. "4, Masscheck. Energy Compliance form attached? h. Type of construction Axe I. Is construction within 100 ft. of wetlands? Yes 4/' No. Is construction within 100 yr. flocdplain 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 L. Private well City water Supply SECTION 7a'-OWNER AUTHORIZATION-TO,BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT as Owner of the subject property t hereby authorize 6 to act on m ehalf, in all m ers lative to work authorized by this building permit application. Signatu e of Owner Date • WAef. PCAr n't , as Owner/Authorized Agent her by declare that the tatements and information on the foregoing ap lication are true an accurate, to the best of my knowiedge and belief. Signed under th pairs and penal- of perjury. ---—+ Feint Name G •ldC/f Signature of Owner/Agent °t Sectior 4. 'ZONING i AU information Must Be Completed. Permit Can Be Denied Due Tc Incomplete Information Existing Proposed Required by Zoning I This column to be E lied in by Building Department Lot Size Frontaze Setbacks Front Side L: .... _ R L _, R ' Rear µ Z') Building Height Bldg. Square Footage -.. % Open Space Footage . % I - (Lot area minus bldg&paved Darkine) of Parkinz Spaces Fill: (volume&Location) - — - - A. Has a Special ermit/Variance/Finding ever been issued for/on the site? NO DONT KNOW 0 YES 0 IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO 0 DONT KNOW 0 YES 0 _. IF YES_ enter Bork ; Page and/or Document#! B. Does the site contain a brook, body of water or wetlands? NO DONT KNOW 0 YES IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained 0 Obtained 0 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: E. Will the construction activity distum(clearing, grading,excavation, or filling)over 1 acre or is it part of a common plan that will disturt over 1 acre? YES NO !F YES, they a Northampton Storm Water anM agemenf Permit from the DPW is required. Department use only dity of Nori:,afllptor Status of Permit: R,JHding Depar men Cum Cut/Driveway Permit t .212 Main Si—=et Sewer/Se�nticAvailability I JUN � � 2008 Room 100 WaterWell Availability !-�Cfi}la pton, Mr. 01060 Two Sets of Structural Plans 1#4ei%C413-58/1240 Fax 413-587-1272 Plot/Site Plans 111060 Others Sped p...,fy APPLICATION TO CONSTRUCT,ALTER,REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 -SITE INFORMATION 1.1 Property Address: This section to be completed by office Map Lot Unit Zone Overlay District Elm 5t District CS District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: op ,� •�d✓�ey ,T� Name(P t) Current Mailing Address: 4-1/.3 . Telephone Signature 2.2 Authorized Agent: Name,( '`'t) Current Mailing Address: Signature Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item I Estimated Cost(Dollars)to be Official Use Only completed by perrnit applicant 1- Building (a),.Building Permit Fee 2. Electrical (b)Estimated Total Cost of Construction from (6) 3. Plumbing Building Permit Fee 4. Mechanical(HVAC) 5. Fire Protection 1 6. Total= (1 +2+3+4+5) 5040,pf> Check Number i This Section For Official Use Only Date Building Permit Number Issued: Signature: Building;Commissioner/lrspec or o ui aings Cate File#BP-2008-1133 APPLICANT/CONTACT PERSON O'CONNELL PATRICIA A ADDRESS/PHONE 33 GRANDVIEW ST FLORENCE (413)584-0713 Q PROPERTY LOCATION 33 GRANDVIEW ST MAP 17A PARCEL 098 001 ZONE URA 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: REPLACE STONE SIDE ENTRANCE W/6 X 9 WOOD ENTRY New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/Statement or License 3 sets of Plans/Plot Plan THE F LOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INJFQRMATION 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 Permit DPW Storm Water Management Demolition Delay /e< 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-2008-1133 GIs#: COMMONWEALTH OF MASSACHUSETTS 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-2008-1133 Project# JS-2008-001667 Est.Cost: $5000.00 Fee: $50.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Groh: Homeowner as Contractor Lot Size(sq.ft.): 9365.40 Owner: O'CONNELL PATRICIA A Zoning:URA Applicant: O'CONNELL PATRICIA A AT. 33 GRANDVIEW ST Applicant Address: Phone: Insurance: 33 GRANDVIEW ST (413) 584-0713 O FLORENCEMA01062 ISSUED ON.612012008 0:00:00 TO PERFORM THE FOLLOWING WORK.-REPLACE STONE SIDE ENTRANCE W/6 X 9 WOOD ENTRY 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: FeeType• Date Paid: Amount: Building 6/20/2008 0:00:00 $50.003746 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo �a `, ` ,h �� � � �` '� � � � � � f � ,�,� �� ��d � � � � � � � � HOME OWNER EXEMPTION ACKNOWLEDGEMENT The State of Massachusetts allows the homeowner the right under 780CMR 108.3.4 to act as his/her construction supervisor. The 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 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). sonbtube 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 occupancv 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 L 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 _ The Commottwex, i of Massacruserrs Depar rmen of 1ndatst,ia1.4cciderts Q'-ce oflrvestiaario=ts 600 YYashington Sz-eet Boston, -4Ia 03I11 www.mass.j ovldia �i'orliers' Compensation Insurance �flauatiit: Builders;'Contractors,Tlectricians;Pi iir.bers ADalicant inforriation PIease Print Legibly Na-Me (Business/Organizariorv'Individual): �a �/f/�� �•L�►,��►� (/ Ada-ess. M 1 ° //!/0 //�S7L, Cit`,'State/Zip: Q Phone ��,3 --a 3 Are you an employer'Check the appropriate box: Type of project c (required): 4. I am a general contractor and I i.❑ I am a employer with 6. ❑New construction employees (full and/or part-time).* have hired the sub-contractors I am a sole proprietor or parer- listed on the attached sheet. 7. partner- listed n Re ^odei'r° I shlr and have no employees These sub-contractors have ! 3. rj Detnefirion employees and have workers' wortin= for me in any capacity. 9. ❑Building addition (No workers' comp. insurance comp. insurance.: required.] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their I LE Plumbing repairs or additions myself. [N o workers' comp. ri ght of exemption per MGL 12.❑Roof repairs insurance required.] ' c. 152, §1(4),and we have no employees. [No workers' 13.❑ Other comp. insurance required.] 'Any applicant that checks box#1 must aiso 5,11 out the section below showing their workers'compensatior policy information. Homeowners who subs ur this affidavit indicating thev are doing ail work and then hire outside contractors must submit a new affidavit indicating such. }Contractors that check this box must attached at additional sheet showing the name of the sub-contactors and state w`nether or not those entities have employes. If the sub-contractors have employes,they must provide their workers'comp.policy number. I am an employer that isproviding workers'compensation insurance for my employees. Below is thepolicy and job site information. Insurance Company dame: Policy=i or Self-ins.Lic.T: Expiration Date: Job Site Address: City/State,'Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25?_of IIGL c. 152 can lead to the imposition of criminal penalties of a tine up to S1.500.00 a:�d'cr one-yea:impriscnent, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to 5250.00 a day a2aiist the violator. Be advised that a copy oft1 is statement may be forwarded to the Office of Iavestigarions of the DL,' forinsuraace coverage verification. I do hereby certify tnder the pains andpenaltie ofperjury that the in�ormation provided above is true and correct Si?nature: r1114 Date: Phone 5-2 C � D",Ticial Ilse onlr•. Do not write in this area, to be completed by city or town of ciaL Cit}'or Town: Permit/License r Issuing Authority(circle one): I1.Board of Healrh 2.Building Department 3. City/Town Clerk 1.Electrical Inspector 5.Plumbin_Inspector 6. Other Contact Person: Phone SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Suoerrscr: Not Applicable �❑ Name of License Holder: rye. T. , I p License Number 4acress Expiration Date( l�l/a/`((tiLiv ally b,e09 ;ianature Telephone 1.Registered Home Improvement ontiactor Not Applicable ❑ ,omoanv Name Regist— ratio�Number ddress Expiration Date Telephone ECTION 10-WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G L.c.152,.§25G(&) 'crkers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result the denial of the issuance of the building permit. cried 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.CNIR 780. Stith Edition Section 1033.5.1. 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-vear period shall not be considered a homeowner. Such"homeowner"shall submit to the Building Ofn–cial,on a form acceptable to the Building Official,that he/she shall be responsible for all such world 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 net 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. T'ne 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 ISECTION b-DESCRIPTION OF PROPOSED WORK(check all armlicabie) I New I✓ouse Addition Replacement windows Alteration(s) � :� Rooting Or Doors r IAccessory Bldg. !_: Demolition ED New Signs [0] Decks [0-00, Siding [pi Other[G]- Brief Description of Proposed/ �. Work: 4��a Alteration of existing bedroom Yes No Adding new bedroom Yes No Attached Narrative Renovating unfinished basement Yes No Plans Attached Roil -Sheet Sa If New'hod s2 and:or addiiio 'Ao exis Lino,housmc.comotete€hd,`ffottoinrina: a. Use of building: One Family Two Family Other b. Number of rooms in each amity 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 c. Energy Conservation Compliance. Masschecic .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. Wiil building conform to the Building and Zoning reguiaticrs? Yes No. I. Septic Tank City Sewer Private well City water Supply SECTION 7a-OWNER AUTHORIZATION.;: BE GOMP€:ETEDFWHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR ELIltDINC PERMIT 1 g l/ as Owner of the subject prcper y .�c>v hereby authorize `S' to act on my beh" in ail maters relative to'work authorized by this ilding permit application. ISignature of Owner Date 9�i l as Owner/Authcrzed r".gent hereby declare that the s atemems and information on the foregoing application are true and accurate, to flit' best of my knowledge and belief. i Signed under the pairs and penalties of perjury. f _i � ��cnature cf�wrer,Fcert -ai< I i Section 4. ZONING I All Information Must Be Completed. Permit Can Be Denied Due To Incomplete Information Existing Proposed Required by Zoning This column to be filled it,by Building Department 'z .......- Lot Size ........ ------- [Front aze ....... Setbacks . Front Side R:,- L: Rear Building Height ........... Bldg. Square Footage % Open Space Footage (Lot area minus bldg&pav ed ...... cariciniz-) #ofParkine Spaces Fill: (volume&Location) A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO DON7 KNOW 0 YES 0 IF YES, date issued:- IF YES: Was the permit recorded at the Registry of Deeds? NO 0 DONT KNOW 0 YES 0 IF YES: enter Book Pace and/or Document# B. Does the site contain a brook, body of water or wetlands? NO � DON7 KNOW 0 YES 0 IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained 0 Obtained 0 Date Issued: C. Dc 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 0 NO �- IF YES, describe size, type and location E. Will the construction activity disturb(clearing,grading, excavation, or filling)over 1 acre or is it part of common pian that will disturb over I acre? YES NO 0 IF YES,then a Northampton Storm Water Mamna­gemeft-Petmit from the DPW is required, Department use-only City of Northampton Stags of Perm,it_ Building Department Curbr Cut/Dnueway Permit'' if � ' 'i+ l`' 212 Main Street SerwerfSePticAvailability Room 100 tlVaterlWellAvailability. PA le Lhampton, Mr. 01 060 Two Sets.of Structural Plans JUN 2 5 Pe 41 -587-1240 Fax 413-587-1272 Plot(Site Plans Other Specify j0-L STRU T,ALTER,REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 -SITE INFORMATION This section to be completed by office 1.1 Property Address: Map Lot Unit Zone Overlay District Elni St District __________ — CB District _7 SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGciV T 2.1 Owner o ecord: Name(P nt) Current Mailing Address: `f J�"C 14 Telephone Signature 2.2 Authorized Agent: / Name(Print) Current Mailing Address: f y Signatu6 Telephone SECTION 3-!ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by permit applicant 1. Building (a)Building Permit Fee IjCJC� 2. Electrical ' (b) Estimated Total Cost of ©O�� Construction.from(6') 3. Plumbing I �,Building Permit Fee y i 4. Mechanical(HVAC) 5. Fire Protection 6. Total=(1 +2+3+4+5) Check Number This Section For Official'Use Only Date Building Permit Number. Issued: Signature: Budding;Commissioner/Inspector o u� mgs Gate 33 GRANDVIEW ST BP-2008-1133 GIs#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 17A-098 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL e.142A) Category: BUILDING PERMIT Permit# BP-2008-1133 Project# JS-2008-001667 Est. Cost: $5000.00 Fee: $50.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: Homeowner as Contractor Lot Size(sq.ft.): 9365.40 Owner: O'CONNELL PATRICIA A Zoning URA Applicant: O'CONNELL PATRICIA A AT. 33 GRANDVIEW ST Apniic:ant Address: t�aone: 'husurance., 33 GRANDVIEWd ST (413) 584-0713 O FLORENCEMA01062 ISSUED ON:612012008 0:00:00 TO PERFORM THE FOLLOWING WORK.-REPLACE STONE SIDE ENTRANCE W/6 X 9 WOOD ENTRY 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: 6(.5 Rough: Rough: House# Foundation: Driveway Final: Final: Final: Rough Frame: Gas: Fire Department Fireplace/Chimney: Rough: Oil: Insulation: Final: Smoke: Final: d ( -7- THIS PERMIT MAY BE REVOKED BY THF. ITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATI N Ate- .�• -vex. sa Certificate of Occupancy Signature: Feel e: Date ><d: Amount: Building 6/20/2008 0:00:00 $50.003746 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo 33 GRANDVIEW ST BP-2008-1133 GIs#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 17A-098 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL e.142A) Category: BUILDING PERMIT Permit# BP-2008-1133 Project# JS-2008-001667 Est. Cost: $5000.00 Fee: $50.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: GERARLD P LANDRY 038629 Lot Size(sq. ft.): 9365.40 Owner: O'CONNELL PATRICIA A mni-r.-_o:URA - Applicant: O'CONNELL PATRICIA A -- - ---- AT 33 v.=cr;i4UVI--VV S-1 Applicant Address: Phone: Insurance: 33 GRANDVIEW ST (413) 584-0713 O FLORENCEMA01062 ISSUED ON.612012008 0:00:00 TO PERFORM THE FOLLOWING WORK.-REPLACE STONE SIDE ENTRANCE W/6 X 9 WOOD ENTRY 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: S_r.::e: THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Certificate of Occupancy Signature: Feel e: Date Pni Amount: Building 6/20/2008 0:00:00 $50.003746 212 Main Street,Phone(413) 587-1240,Fax: (413)587-1272 Building Connnissioner-Anthony Patillo