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24D-327 (2) -THIS PLAT NOT FOR RECORDING PURPOSES- r FILL DISTANCES BY DEED wage � �0��Oa 82•�, 3p2 Y�G� BOOK 2�16 t Slp � w 96 . 4 ' STATE STREET TO: THE SHAWMUT BANK OF BOSTON & THE FIRST AMERICAN TITLE INSURANCE COMPANY. I HEREBY REPORT THAT I HAVE EXA?,MINED 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. I FURTHER REPORT THAT THE PROPERTY IS NOT LOCATED IN A. FLOOD PRONE AREA AS SHOWN ON FEDERAL INSURANCE :?A PS tvii %OlullvlvNITY NUMBER 250167 , DATED• May.- g . 1987 S UR V EYOR��-•`� -NOTE- THIS PLAT FOR MORTGAGE LOAN PURPOSES ONLY AND DOES NOT CONSTITUTE A PROPIMTY SURVEY -MORTGAGE LOAN INSPECTION PLAT- EA ION NORTHAMPTON, MASSACHUSETTS 111 No.23611 PREPARED FOR ''f�►�T4� ��`•' DANIEL & LYNDA MARGOLIS SCALE: 1 "=40 ' MAY 9, 1987 HAROLD L. EATON' PROFESSIONAL LAND SURVEYOR 9 SU'IJlP DRIITE - I{ADLEY - ?1aS_SACHIISETTS a�t1 q?s e) 062 -1 cj 2 b (o f r. 1g cp ro i e e 96 . 41 STAVE STREET `HE SHAWMUT BANK OF BOSTON & 'HE FIRST AMERICAN TITLE INSURANCE COMPANY .-, BY REPORT THAT I HAVE EX A141I H F0 THE PR EMS. , NTATION ALL EASMENTS , ENCROACH-MENTS AN . ROUND AS SHOWN AND THAT THE BUTLBI NGS AR I FURTHER REPORT THAT THE PROPERTY IS � AS SHORN ON FEDERAL ? SR jl i i�A On SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: �^ Not Applicable ❑ Name of License Holder: QT ,1 I Arm K C, License Number t tIJC� l J AddreL Expiration Dat Signature Telephone 9.Rea istered Home Improvement Contractor: Not Applicable ❑ 2,� r72-{Z tej�Ur V--V L 17 2 7 0 1 (P Company Name Registration Number Address Expiration Da te Telephone SECTION 10-WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c.162,§26C(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...... ❑ F}W P✓L = 11. - Home Owner Exemption 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 buildine 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 SECTION 5-DESCRIPTION OF PROPOSED WORK(066k all applicable) New House ❑ Addition Replacement Windows Alteration(s) E] Roofing E] Or Doors 0 Accessory Bldg. ❑ Demolition ❑ New Signs [❑] Decks [M Siding [❑] Other[❑] Brief Description of Proposed _ t Work: " i L ,t Alteration of existing bedroom Yes No Adding new bedroom Yes No Attached Narrative Renovating unfinished basement Yes _No Plans Attached Roll -Sheet sag if New house and or additioD to existing housing. complete the following: 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? �J b ff/ r3 e ^� f r d. Proposed Square footage of new construction. l� Dimensions e. Number of stories? +2 f. Method of heating? 0 1 ` /kUy Vs Fireplaces or Woodstoves _Number of each g. Energy Conservation Compliance, Masscheck Energy Compliance form attached? L, h. Type of construction w2Jkrkc'� i. Is construction within 100 ft. of wetlands? Yes No. Is construction within 100 yr. floodplain YeV_1<1 No j. Depth of basement or cellar floor below finished grade 4 4_y va cp k. Will building conform to the Building and Z ing regulations? Yes No . I. Septic Tank City Sewer 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 �j hereby authorize 1�'��' *,V—'N L-tract on my b alf II matters r t(ve to work authorized by this building permit application. 72 ` JJAt L'ature 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. Signed under the pains and penalties of perjury. Print Name �j© Q- 7j Signal re of Owner/Agent Date Section 4. ZONING All Information Must Be Completed. Permit Can Be Denied Due To Incomplete Information Existing Proposed Required by Zoning This column to be filled in by Building Department Lot Size � Z �5 Frontage Setbacks Front Side L: Z R: l b L:.ZS R: b Rear 7-5, Building Height �j o> '3c 1 Bldg.Square Footage 1 rj ,c 2? % t( 1 4 � Open Space Footage % f (Lot area minus bldg&paved 3 j R parking) #of Parking Spaces Fill: volume&Location -- A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO IR DON'T 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 IF YES: enter Book Page, and/or Document# B. Does the site contain a brook, body of water or wetlands? NO DON'T KNOW 0 YES i 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 0 NO IF YES, describe size, type and location: E. Will the construction activity disturb(clearing,grading,a avation, or filling)over 1 acre or is it part of a common plan that will disturb over 1 acre? YES NO IF YES,then a Northampton Storm Water Management Permit from the DPW is required. Ueartmn<1se only I` ity of Northampton sfett�s'afPermt �. uilding Department curb C,,u 1, rtvew6y Permit APR 2 8 2015 212 Main Street �rlSSptioAvallaiiy Room 100 W 6wWell40ilaWli`t` &Gas InspeCARM hampton, MA.01060 Tlwo Sets of rll Plans on. M 6 587-1240 Fax 413-587-1272 Plowdo Plans'. 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 2-( � :� Map Lot Unit Vti Zone Overlay District c t U,6 Elm St District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: Name(Rri , �— Curr nt Mailing Address: L�( � 3 �L, 12-12-17 1 ephone Signature 2.2 Authorized Anent: p , R !?,fg�C—Name(Pi Current Current Mailing Address: Signature Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by ermit applicant 1. Building �� (a)Building Permit Fee 2. Electrical yS (b)Estimated Total Cost of Construction from 6 3. Plumbing ( � Building Permit Fee 4. Mechanical(HVAC) 5. Fire Protection CL 6. Total=(1 +2+3+4+5) Sb Check Number This Section For Official Use Only Building ermit Number: Date` g Issued: . Signature: Building Commissioner/Inspector of Buildings Date File#BP-2015-1028 APPLICANT/CONTACT PERSON ROBERT WALKER ADDRESS/PHONE 36 Service Center NORTHAMPTON01060(413)584-1224 PROPERTY LOCATION 264 STATE ST MAP 24D PARCEL 327 001 ZONE URC(100)/ 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: CONSTRUCT 12 X 18 BEDROOM/BATH ADDITION New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included• Owner/Statement or License 034783 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFORMATION 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 Dem lay Signature of Buildin 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. 264 STATE ST BP-2015-1028 GIs#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 24D-327 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: ADDITION BUILDING PERMIT Permit# BP-2015-1028 Project# JS-2015-001962 Est. Cost: $40550.00 Fee: $108.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: ROBERT WALKER 034783 Lot Size(sq. ft.): 8363.52 Owner: MARGOLIS DANIEL&LYNDA Zoning: URC(100)/ Applicant: ROBERT WALKER AT. 264 STATE ST Applicant Address: Phone: Insurance: 36 Service Center (413) 584-1224 Workers Compensation NORTHAMPTON MAO 1060 ISSUED ON.5 1112015 0:00:00 TO PERFORM THE FOLLOWING WORK.CONSTRUCT 12 X 18 BEDROOM/BATH ADDITION 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 Siznature: FeeType: Date Paid: Amount: Building 5/1/2015 0:00:00 $108.00 212 Main Street, Phone(413)587-1240, Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner