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17C-204 (4) MORTGAGE LOAN INSPECTION J r 0 k � I r3 � I i z std 1 < C,, 'N- I 201 h} I 4�8 I hereby report that the premises shown on this plan is not located within a Flood Hazard Area as shown on Department of H.U.D. Federal Insurance Administration Maps, Community Number 250167-0001A Identificatio ate rit 3 1978 By: TO THE BAYBANK FIRST EASTHAMPTONN N.A. OWNER FINCK, RICHARD W. FWD THE FIRST AMERICAN TITLE INS . CO.— LOCATION' 61 MAIN STREET To the best of my knowledge, informa-� - -LoRENCE , MASS. 01060 tion have and belief, I hereby report that I ALMER HUNTLEY Sk ASSOCIATES INC. have examined the premises `•and that this � inspection plat shows the improvement or SURVEYORS•ENSINEERS•PLAMMiS improvements as located on `,the premises de- 125 PLEASANT STREET P.O. BOX 568 scribed, that the improvement or improve- NORTNAMPTON, MASSACHUSETTS 01060 ments are entirely within lot lines, and that there are no encroachments upon the SCALE, premises described by the improvement or et / improvements of any adjoining premises, except as indicated. I further report that .Q ooucusw. DATE, there are no easements of record affecting 3K nioMrsori the tract shown hereon, except as noted. No. 28088 Z)Z�, P�sTE� JOB NO._ / tsi MIS PLAT IS.FOR -IDENTMATION PURPOSES .ONLY AND DOES NOT CONSTITUTE A MWERTY SLRM ' RECEIPT DO NOT KEER T OR YOUR RECORDS PAYMENT 9243291187 050624 010402 * 100 * SERIAL NUMBER YEAR,MONTH,DAY POST OFFICE U.S.DOLLARS AND CENTS PAY TO f! `�- CHECKWRITER III Ili 1 1 1 ft! i'.,1'I�III (III. 39f IMPRINT AREA '�� j�li'I Illfllllill��'tlf �11I11111�I1i F .i�i l:. ADDRESS FROM ADDRES 1C/oA, COD NO.OR USED FOR ``r- {��.. azic This receipt is your guarantee for a refund of your money order if it is lost or 4"iftf i yy-Iri irrf�6to 1 ma _*ed at an I e f y�fee.\A stolen,provided you fill in the Pay To and From information on the money order replacement will not be issued until 60 days a e�ohey'La in the space provided.No claim for improper payment permitted 2 years after purchase date,provided the money order has not been paid. payment.If your money order is lost or stolen,present this receipt and file a claim for a refund at your Post Office. 1J C-C7 W n�W C-31177) __4V3 O V[! -� CD CD Cr O—UJO n, CD-00�r-r--s tna3 o CD���QJ ��—�•�co m CD Ica .+ w 0 O CD CD azQ CD m n CD= Cn c rnm CO O S-.•.+ z_+�cis� r+� zu,Cn 03 C-3 -< W r~-1- 1+CD CD-- �zu J 6a O CD to-i Z \'LSD�(• C N (D ._ri••G O in (D CD W CoOBE CD M o moo- °zcri 1M1 En OD-D3 sm ru L7 CA -- OO�OO �IW iE-CA Or -- a-•-_0 1 _ C- N NGSIC �O 00--1-1 (D•CA CSD—DO --4CDC:,' .•-F Ar -4 CD WNW DOr' rr'' O C0 CD .j 'Z 3-4W m F■ O f -1 —1 4 do +� CD 70 -N.io ��' °mom nl rrtCt]3 O OO O in tD _CD �0. 3 3 W O -4-J �! �. CD A n . r ..Lrzt-p of Xart4anrpf v t Z �1HS58Cl�liSttt4 ^ - DEPARTMENT OF BUILDI]\G INSPECTIONS INSPECTOR '212 Main Street • Municirkil Building '-o y Northampton,MA 01060 ,r HOME OWNER EXEMPTION ACKNOWLEDGEMENT The State of Massachusetts allows the homeowner the right under 780CMR 108.3.4 to act as h.is/her construction sup„:visor. The state defines"Homeowner” as, " Person(s) who owns a parcel on which he/she resides or intends to be, a one or two fami _ 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 backfrll), 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. --(H- - 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 r F=o Crif3 ofl�n� tl}i3111�3ft)11 _- _ a35 x n ctte — 4.. DEPARTMEN7 OP BUILD0\1C INSPPCTIOt,S I 212 Main Street Nfunicipal Building Northampton, Afass. OIOGO I W 0IU< EIZ'S CON�PENSATTON MSURA.NCE A1,I'D�AVIT' ( (Iican Pcrmitttx) %VI b a principal place of businessfresidence at: -- -- O� 0 !C? ('t ercp / ©PI?ec-•k tvl/lr(phonc') ��SS ' FOO 0 � (srr�t/city/s�atL�zi p) do hereby certif);, under the.pi'-ins and penalties of perjury, haI ( ) I am an employer providing the following o, covcrvgc for my employees worUng on tilis job: 1 (Irsunme~COO=-M') (Pelic:?','U ter) (E:-pirstior,D2i--) I ( am a sole proprietor, general c-ootmaor or homeowner (cir cie one) aDd 112ve hired the Conigactors listed below wbo have the following worker's camoen_sadon policies: i (,Namc Of Co„_^czOr) On urznc; Coinpan)'/hobs v (-H:-) auon.Ditc) (Name of Couuzctor) Gns-aranc: ComoaayrPoljc \umcrr) Daie) (Name of Coturdeto,-) (Insurance Com /PoU N:>mber) (Expirnllon Date) I - (i`'amc of Contractor) (Lrisuran Comt:aay/POUCY Numb:r) (E�pintion Darr). (Haab dditocsl rSca,ifncxz.y to ndvd iafocn.�oo pctaiaiag w.1I i 1 I am a sole pr-opfietor and bave no one worldng for me. ( ) I am,a home owner performing all the work myself. NOTE:plese be cwwc tsi,-U-,bomo -,,,n..-bo ccaploy pcsoos to do c,-..=oo c repair work ca.d.xIE.,4 of Mot morn th_n L oc=ru is%%inch Fbc bomoo ia-rtada oc oa the Qouor6 cppuricnern tbern LT oot Cc=-_Uy oo=.d=vd to be aivloye3 1, the­rkcr's c=2p *on Act(GU4 52s 1(3)1;*U=6m by n bomw--=fer c Gc _or permit n_y-113 c tbe Ic-pI cLal of en c=ployx odder dad WorkC e,Compomayioa Aa,_ [.:adcrtaod tha a Dopy of thu mtcmma ov y be foc-,u d.d to the pcpenmca¢or Iad+r,;cl n�dc Off oe of Lr -rot th. oova abc vaif c=ioa,std ttu L itta a to soauc)covcTage uadC saezioa 23A of 1 toL 15'2 c=led to the impcx'aioa of a-im;a Peailxicn coa'LVLaag of a fiat or up to S 1,500.00 andror 6mpri3oomcd of up to Doc y.,cod 6,-U Prn.!•ua in the form of a Slap Wort;Ord-and a ffrn a(s 100.00 a&y apiast me F«d,,-=—u, Drily Pcimit Numb--T 6 v s 1.•fap» got" >R si tart of a Efe SECTION 8-;CONSTRUCTION'SERVICES If 8.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder:- Ste~k-e-"� 0 ( le- © -2�9 'i� o p _a. License N tuber 1 f� Fl R C C C �/� t6 (D Ad s Expirati n Date Signature Telephone PP Not Applicable ❑ ta"�ils erg�'omer`iiara�reraer�.l�ontra Company Name Registration Num er Address Expiration Date Telephone SECTION 10-WORKERS'COMPENSATION INSURANCE`AFFIDAV#T`(WG.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...... ❑ 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 r r SECTION 5-DESCRIPTIONOF=PROPOSED WORK(check-all-applicable) New House Addition []:- Replacement Windows Alteration(s) Roofing Or Doors D Accessory Bldg. ❑ Demolition ® New Signs [0] Decks [jam, Siding[0] Other[o] Brief Description of Proposed Q Work: '(��N►aV - Alteration of existing bedroom Yes No Adding new bedroom Yes No Attached Narrative Renovating unfinished basement Yes ^ No Plans Attached Roll -Sheet g s$ e c �ceIS ylth �nc:ar # � n vu ccsc 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?_A1-0— d. Proposed Square footage of new construction. Dimensions e. Number of stories? �A'- ,(/ f. Method of heating? E'er S Fireplaces or Woodstoves ," 0 Number of each g. Energy Conservation Compliance. Masscheck Energy Compliance form attached? h. Type of construction \A/D A L 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? X Yes No. I. Septic Tank City Sewer Private well City water Supply SECTION Ta-OWNER AUTHORIZATION TOLBE,COMPLETED;WHE,k OWNERS,AGENTORCONTRAGTOR'APPLIES'FOR BUILDING PERMIT" I, LJ)W V �d a+ t.#t f►> as Owner of the subject property hereby authorize to act on y behalf, in all matters relative ttt work authorized by this building permit application. L Signature of Owner Date LA w z-i`o c..4- � l c� r-f�L-f- J' 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 7me'! Signature of Owner/Agent Date 1 Section 4. ZONING All Informatibh 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 ©V Lot Size Frontage Setbacks Front , ; -.0-k- pr F Side L 11 R:' �p L:' -_ F-t -f— — Z� Rear �Y Building Height Bldg.Square Footage —( % -- 3 t Open Space Footage r� % �- (Lot area minus bldg&paved azkin #of Parking Spaces Fill: i (volume,&Location A. Has a Specia ermit/Variance/Finding ever been issued for/on the site? NO DONT KNOW 0 YES IF YES, date issued:! IF YES: Was the permit recorded at the Registry of Deeds? NO 0 DONT KNOW I YES IF YES: enter Book j Page' ' and/or Document# B. Does the site contain a brook, body of water or wetlands? NO Or---DONT KNOW 0 YES Q 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 0 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 disturb(clearing,grading, ca lon,or filling)over 1 acre or is it part of a common plan that will disturb over 1 acre? YES I NO IF YES,then a Northampton Storm Water Management Permit from the DPW is required. 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 SECTION 1 -SITE.INFORMATION Th"s sectlnn to be coroQteted bar office 1.1 Property Address: �/ Ywx ga F,�i A-��'1�•(�- /� Y �PS�QAe� �CI3.D,IstrIM SECTION 2-PROPERTY OWNERSHIPIAUTHORIZED AGENT 2.1 Owner of Record: o R:1 P+r4 t-1 "P x-18 Name(P' ) �} Curreal Mailin Address: Yc ,✓ ^— Telephone Signature 2.2 Authorized Agent: Name(Print) Current Mailing Address: Signature Telephone SECTION 3-ESTIMATED'CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Offiicial Use Only completed by ermit applicant 1. Building `D Q (a,)Building Permit Fee rl 2. Electrical J ,(b)Estimated Total Cost of` V Construction from 6 3. Plumbing Building Permit Fee- 4. Mechanical(HVAC) 5.Fire Protection 6. Total=(1 +2+3+4+5) Check Number This Section For Official Use`Onl :Date.. Building Permit Number: Issued: Signature: ' i Building Commissioner/Inspector of Buildings Date File#BP-2005-1307 APPLICANT/CONTACT PERSON STEPHEN BROIDE ADDRESS/PHONE 820 FLORENCE RD FLORENCE (413)585-8000 PROPERTY LOCATION 61 MAIN ST MAP 17C PARCEL 204 001 ZONE GB THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Buildiniz Permit Filled out Fee Paid Typeof Construction: REBUILD PORCH New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/Statement or License 039880 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFO ATION PRESENTED: pproved 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 C 'ssion L Z+pa 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. 61 MAIN ST BP-2005-1307 GIS#: COMMONWEALTH OF MASSACHUSETTS MW:Block: 17C-204 CITY OF NORTHAMPTON Lot: -001 Permit: Building Category: BUILDING PERMIT Permit# BP-2005-1307 Project# IS-2005-1754 Est. Cost: $5000.00 Fee: $50.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: STEPHEN BROIDE 039880 Lot Size(sq. ft.): 5837.04 Owner: WHALEN LAWRENCE P Zoning: GB Applicant: STEPHEN BROIDE AT. 61 MAIN ST Applicant Address: Phone: Insurance: 820 FLORENCE RD (413) 585-8000 0:00 FLORENCEMA01062 ISSUED ON.6128105 :00 TO PERFORM THE FOLLOWING WORK.-REBUILD PORCH 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 6/28/05 0:00:00 $50.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo BP-2005-1307 61 MAIN ST GIs#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 17C-204 CITY OF NORTHAMPTON Lot: -001 Permit Building Category: BUILDING PERMIT Permit# BP-2005-1307 Protect# JS-2005-1754 Est. Cost: $5000.00 Fee: $50.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: STEPHEN BROIDE 039880 Lot Size sc.ft.): 5837.04 Owner: WHALEN LAWRENCE P _;_�„_,.,,: ,1< Annlica»t_S_.TEPHEN_BRCIIDE Al: 61 MAIN ST Applicant Address: Phone: Insurance: 820 FLORENCE RD (413) 585-8000 FLORENCEMA01062 ISSUED ON.6128105 0:00:00 TO PERFORM THE FOLLOWING WORK.-REBUILD PORCH POST THIS CARD SO IT IS VISIBLE FROM THE STREET Inspector of Pluinb:ng Inspector of Wiring D.P.W. Building Inspector Underground: Service: Meter: Footings: Foundation: 7 2- � 4 Rough: Rough: House# - 6, _0 s Driveway Final: Final: Final: Rough Frame: Gas: Fire De artment Fireplace/Chimney: Rough: Oil: Insulation: Final: Sintike: Final: ehr THIS PERMIT MAY BE !NHE CIT OF NORTHAMPTON UPON VIOLATIO OF ANY OF ITS RULES AND S. e Of Occu an Si nature: — Certificate p c FeeType• 4, Date Paid: Amount: Building 6/28/05 0:00:00 $50.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo