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17A-197 T999LO :" I VW Ujo -3 - 2U I J .JoMpOOM ;) �ip ! I � UO I - MM A% * L L 6 9 - £ Z £ ( £ T � ) - 9 8 0 0 - L 0 0 TO VW ' uA% 0 1 -1 1101 9 xo q - 0 ' d (f ",4�it r�° I ' II 41-11 rvl t7 a::5r -7 -7 VU-EjJ0.A&FGGAt aWF!.19U0j -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. BUILDING LOCATION ACCURACY IS NOT GUARANTEED I . t � —C�o�� �9Zo ':'•mac._: `,.\L � ,E & TITLE INSURNACE COMPANY —NOTE- 4FORMATION, KNOWLEDGE AND BELIEF THIS PLAT FOR MORTGAGE LOAN PURPC I HAVE EXAMINED THE PREMISES AND BASED ON EXISTING AND DOES NOT CONSTITUTE A PROPER" SIBLE EASEMENTS, ENCROACHMENTS AND BUILDINGS ARE LOCATED ON �t� of Mas N AND THAT THE BUILDINGS ARE ENTIRELY WITHIN THE LOT LINES, boy —MORTGAGE LOAN INSPECTION Pl URTHER REPORT THAT THE PROPERTY IS NOT LOCATED WITHIN a RANDALL AS SHOWN ON FEDERAL FLOOD INSURANCE MAPS FOR E. � NORTHAMPTON, HUSET IZER y PREPAREED D OR F FOR 7 /35032 BRETT R. & LAURIE NORMAND ly I of Wart4amptan Y Y �I aSSRCtt 1IS[tt5 " s s DEPARTMENT OF BUILDING INSPECTIONS INSPECTOR 212 Main Street • Municipal 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, " 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 any 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 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 o�tytnx 0 J ��- { C1,zft,J Of ,XTJ17tI ZIIIr}lfntt !1 6 �1�i SSAC111t6CtlS llEPy�t2Thi£l.�r of rzurLDr?�G INSPECTIONS 212 Main Street ' Municipal Building Northampton, Mass. 01060 WORICT,R'S C0i1'1TENISATZ0N I7r'SURANCE A FIDA'rIT v"Ith a principal place of busiresslre:sideuce t: ,310 Or.- SG'�2 in> -1, 2 � ✓k+_ J (phone �03.3d - ------.....----- - --------------- - —- - + GZC I{ X77xc/�, X4,1 !?✓U© }" iSirc:Ucit .,,...,:7!t,) __..___.� d0 11CI'CJ}' CCIilI)', L:7:1 1 t11C hi:ii]$ I?iid pen-1L ni pCfJllr�I ( ) I am an employer- providing the lollovvint '.:orr_cr`s compensation coverage for my eltlployees working, on t?tis job: (In-gL=CC Corapam') V (Po-ii c:Nui be r) Date) j I am a sole proprietor, y=encral c-3D tr-2c_cr c- hc-rreowoer (c cle one) and have nirttd the contractors listed beiov `o]i :-,g ,jorkers co pen�a on oi;c es: (Name of C Col m-, Pot.icl Nu3nLYr) x;:ra' cr.Date) (Name of Conti ctor) -- (7.ltsar,_rc Comb ._vPe!ic,' Numb,-r; (l xp ratios Date) (Name of Contractor) — jrl c aI1C (_;�i r_�.i!�OI;C. NUJi]IYIr) - '.S r:i7:.. Date) - (Name of Contactor) - - (IaTurallc- Coln*, _yfPolicv Numb;--r) (Hxri-:tic Date) (r.Itadl_.d-_'iticril z::,ct i- ;:�;r _ - •; ( I iLll c'. pole plU1?C1f C )i c'..11 ilaV for iil NO-IF:plc-ac LC au-stc Ls:. not axre th_a throe uuita jr,%%J_-c'I he lam ti- .1tr-rca:,�=ot-CC cmployc3 uc1"ss Lr_ cr Gccu ni:r. a ct p.-r heal ctatur of an amployor unu, tho Wcul;cri C-o- wr-✓Ilion AcL i I undc--itx d thai a copy of 0i:.craters_'evy bo faw:v Ii J to tbo U-Sw tn-4 of lri i,ri-1 Ax6&=:f Off-j o of is r«-a for U- oovq-y&c vcri cztioa and th_t fa.iltue to ro:.�s:cnti uz•.�;.:cc�.ie;:25A of MG1,152 cin Ir._d to the inr sitia�o;r,-�ir_.I pet:aL'_cs comisti.-Ig of a fur-of up to S I.S00.Oo-nt 'Cy i^: ri z :_of::p to cr, }- r.:-.I civil rxaultica in yc k In nC n Ste,`;Jeri:Onl tr.d a fry of SI00.00 i day cgain:l m:. . I F,,&,ut—e-1 ur•c v,ly 'i - Ycrmit rIutntx:r ___.__ j t is ,),� SI„nature of i.icz; ;eJI'°.rmi;v:�� --r,:=-.,- S�CTON 8 YCONSTRUCTION SERVICES 8.1 Licensed Constructions/ Supervisor/: Not Applicable ❑ Name of License Holder : 131&.< L)ele x 1-4 License Number Address Expiration Date /, � Y13. ..3a--1 d'9JlL9 Signature Telephone �Re"g�ste` e"' me =mpro�rementID ntracto Not Applicable ❑ Company Name Registration Number Address Expiration Date Telephone .SEGTION 1D '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....... No...... ❑ YIPS 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 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 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 �SECT�Ofu�i�D S R PTON OF PROPOSED WORK check.all a' licaI a�x� 3,. „�.�r... ,._` rusa�-tea s-.w;+sw-�- rs:.o�,a x....., .r,•*YU.n,�. v x,. .- ,rl; =saa&', «3. New House ❑ Addition ❑ Replacement Windows Alteration(s)� Roofing ❑ 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 0 Renovating unfinished basement Yes No Plans Attached Roll 0 - Sheet 0 a, fiew'�hou d:ORaddition�`toexistingh uo sung ffffl e�fhefollo— 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 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 SECT1Ohk WNERJ1UTy0R(ZATION TO BE'COMPLETED 'WHEN OWNfRSAGE 7O�2C0NTRACTOR APPLIES FOR BUILDING PERMIT; : as Owner of the subject property hereby authorize 1 k `�\ e_- to act on my behalf, in all matters relative to work au orized by t0is building permit ap iicati n. Signature of Owner D to 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 and penalties of perjury. Print N e 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 Frontage Setbacks Front Side L: R: L: R: Rear Building Height Bldg.Square Footage % 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 X 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 K 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 IF YES, describe size, type and location: i. Y�ANorthampton i140 Department 212 Main Street MAR 0 2Q04 hR Room 100 Northampton, MA 01060 i _ . .phone 413-587-1240 Fax 413-587-1272 APPLICATION TO CONSTRUCT,ALTER, REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 -SITE INFORMATION �' �, �� ` �TTx�sect�ot�to be compiete3 Eby oi�c� 1.1 Prouerty Address: In NA l..��� f. vTIIC �B�IStrICt�* SECTION 21-PROPERTY-OWNERSHIP/AUTHORIZED-AGENT 2.1 Owner of Record: 2L . Co vn-Knxvi!�-bvL Mi, Nam Print) Current Mailing Address: ��, Telephone r /' 1 Signature (� 2.2 Authorized Agent: / �} Name(Print) Current Mailing Address: _3 . 3a 3 J�9 Signature It Telephone SECTION 3-ESTIMATED CONSTRUCTION:COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by ermit appli cant 1. Building d (a)';Building Permit.Fee 2. Electrical fib© p b (b)Estimated Total Cost of Construction from 6_" 3. Plumbing °p p Building Permit`Pee 4. Mechanical(HVAC) 5. Fire Protection 6. Total = (1 +2 +3+4+5) Z. �o Check dumber This Section For Official Use°Onl Building Permit Number: v Date Issued: Signature: Building Commissioner/Inspector of Buildings Date File#BP-2004-0930 APPLICANT/CONTACT PERSON BILL LONGRIDGE ADDRESS/PHONE P O BOX 88 BELCHERTOWN (413)323-8977 Q PROPERTY LOCATION 149 NORTH MAPLE ST MAP 17A PARCEL 197 001 ZONE URB 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: REMODEL INTERIOR WALLS New Construction DA01✓L11 Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/Statement or License 076661 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFQRMATION 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 V r 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. 149 NORTH MAPLE ST BP-2004-0930 GIS#: COMMONWEALTH OF MASSACHUSETTS ME:Block: 17A- 197 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-2004-0930 Project# JS-2004-1382 Est. Cost: $2500.00 Fee: $50.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: BILL LONGRIDGE 076661 Lot Size(sq. ft.): 9104.04 Owner: NORMANDEAU BRETT& Zonin :URB Applicant: BILL LONGRIDGE r. 1.49 n1OnT:4 N1Ap F 4'f Applicant Address: Phone: Insurance: P O BOX 88 (413) 323-8977 0 BELCH ERTOWN MAO 1007 ISSUED ON:412104 0:00:00 TO PERFORM THE FOLLOWING WORK.-DEMO INTERIOR WALLS, REMOVE BEDRM & REMODEL BATH 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: h: r_ House# Foundation: Y Driveway Final: Final: —0­0 Final: 1 Rough Frame& Gas: Fire Department Fireplace/Chimney: Rough: - 02 -��Z_S;' ..-"iu:a:ian: a Final:Qj��-' G`P moke: Final:OK g —l7 0�� THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Certificate of Occu anc 22 Si nature: FeeType: Receipt No: Date Paid: Check No: Amount: Building 4/2/004 0:00:00 414 $50.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo