24C-064 (3) , BR A 1151 % BP-2003-1230
Gis#: _ COMMONWEALTH OF MASSACHUSETTS
r k:24C-two CITY OF NORTHAMPTON
Lot:-001
Permit: Building
Category, BUILDING PERMIT
Permit# BP-2003-1230
Preiecr# 3S-2003-1902
Est.Cost:$12180.00
Fee:$55.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
use G mi James Locke 001992
Lot Sizef sq.ft.): 17031.96 Owner: CASEY MARK A&MARY ELLEN
Zoning:URB Applicant: James Locke
AT: 88 MASSASOIT ST
Applicant Address: Phone: Insurance:
26 South Street (413) 268-9323 Workers
Compensation
WILLIAMSBURGMA01096-9726 ISSUED ON:7/1/03 0:00:00
TO PERFORM THE FOLLOWING WORK FRAME & FINISH 3' X 8' CANTILEVERED BUMP-
OUT TO TV ROOM
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: Receipt No: Date Paid: Check No: Amount:
Building 711103 0:00:00 12307 $55.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Building Commissioner-Anthony Patillo
File#BP-2003-1230
APPLICANT/CONTACT PERSON James Locke
ADDRESS/PHONE 26 South Street (413)268-9323
PROPERTY LOCATION 88 MASSASOIT ST
MAP 24C PARCEL 064 001 ZONE URB
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out n3O�
Fee Paid i 4 SW5ST
Typeof Construction: FRAME&FINISH 3'X 8'CANTILEVERED BUMP-OUT TO TV ROOM
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/Statement or License 001992
3 sets of Plans/Plot Plan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INF(NFMATION 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 Pemtits 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
Comygt'ssion f
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.
r� 2 Department use only
ID of Northampton Cpf Pd
ing Department Curb
Cut/Dnvewveway Permit
AN 3 0 2003 1 Main Street Sewer/Septic Availability
-Dom 100 WaterM/ell Availability
,t tC,q^,��`,s�ppR o ortha pion, MA 01060 Two Sets of Structural Plans:
DEN ai gp r,C. 00.4413- 1240 Fax 413-587-1272 Plot/Site Plans
Other Specify
APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTION 1 -SITE INFORMATION
1.1 Property Address'
T9his section� � to be coomplet d by office
(FE m'�S.9�mT s/ Map d,-�, ,—/Lot (Y Unit
N1� q(r PTD Zone _'4'1t '� Overlay District
Elm St.District CB District
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
M, k -f-M N -utN &mitt/ 88 Mt-55,45 y7 51--
Name(Pr1int)/11 ' �� ////T7' /qqJ�'' / Current Mailing Address: -�'/ 7 C/73 3
/� `� l�rK /�/�.( Telephone �r f
Signature /
2.2 Authorized Agent:
JA tES Lo-OK rc 24 Sade-( gr; & JU' 4-iviS3b
Name(Print) , Current Mailing Address:
Ju �— 268 - 9323
Signature Telephone
SECTION 3-ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollars)to be Official Use Only
completed by permit applicant
1. Building / / 0 3 O (a)Building Permit Fee
1 Electrical (b)Estimated Total Cost of
�' Construction from(6)
3. Plumbing /56 � ift/BC ) Building Permit Fee
4. Mechanical(HVAC) a q 071 ,RS
5. Fire Protection OO
6. Total=(1 +2+3 +4+5) / L/1 80 Check Number ��pTj� '__
This Section For Official Use Only
Building Permit Number: Date
Issued:
Signature:
Building Commissioner/Inspector of Buildings 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
,,,� �p �/? ���� Building Department
Lot Size Y3 au t'e ack'1
Setbacks �/
Setbacks Front
Side 1.:/ /4 R: 2-f" L:/!12: 24
Rear /1PJ,- P
Building Height 01A)t
t >_
Bldg Square Footage % 2-1/
Open Space Footage l
(Lot area minus bldg&paved N BCliikitlCmk-
parking)
k of Parkine Spaces 117
Fill: N d Nom(
(volume&Location)
A. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO DONT 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 N
I3. Does the site contain a brook, body of water or wetlands? NO 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:
SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable)
New House 0 Addition 0 Replacement Windows Alteration(s) 8Roofing ❑
Or Doors 0
Accessory Bldg. 0 Demolition❑ New Signs I ] Decks [ ] Siding I ] Other I I
Brief Description of Proposed
Work. FRA-me Y- P/N/se/ 3' x 8' CANTtg,v626t7 gomt-0V7 7a 7Y,Cot-,ti
Alteration of existing bedroom Yes V No Adding new bedroom Yes No
Attached Narrative Renovating unfinished basement Yes ✓ No
Plans Attached Roll -Sheet
6a. If New house and or addition to existing housing, complete the following.
a. Use of building One Family kr Two Family Other
b. Number of rooms in each family unit. /0 Number of Bathrooms
c. Is there a garage attached? NO V
d. Proposed Square footage of new construction. a Dimensions 3 x g
e. Number of stories?
f Method of heating? 6111 A-l2 '
. Fireplaces or Woodstoves e--k- �7 . Number of each /
SMAbt.
g. Energy Conservation Compliance. Al/A twain DA' Mascheck Energy Compliance form attached?
h. Type of construction INMO FR/int.
i. Is construction within 100 ftof wetlands? Yes ✓ No Is construction within 100 yr. floodplain Yes ✓ No
j. Depth of basement or cellar floor below finished grade N/A. — ND HE-VA/ON!/D%/ - 649Tasktie 0N6'V
k. Will building conform to the Building and Zoning regulations? 1, Yes No.
I. Septic Tank City Sewer 1.,,,.--- Private well City water Supply 1,1
SECTION 7a-OWNER AUTHORIZATION-TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
A I . siy //''/Aa-y4LLId CFFS£-( , as Owner of the subject
property
hereby authorize J,FN ss / ^ _ y/ 6-6>., CeA) 4- te---IDC-t —
-
to act on my be elf, all m rs relativ to workauthon> d building permit application.
Sig azure of wne � Date �t3-1�
I, __ /I0`I-1 t- #____- , as Owner/Authorized
-gent r- eby declare that the statements and information on the foregoing application are true and accurate, to the best of my knowledge
s •elief
Signed under/th�1e�' we
pains� and penalties
``of//perjury
.
Jfr
Print Name /,•
VT/rzi_' 6/ice—A3
Signature of 0 /Agent Date
SECTION 8-CONSTRUCTION SERVICES
8.1 Licensed Construction Supervisor:�sre.�� Not Applicable q❑
Name of License Holder'. 4j41i 6 w(iF�a-- to//9Z
�/� License Number y
J i/ 5f lul�Cl �Su /2 . S- o3
Address Expiration Date
l • Vi . 268-93z>
Sign/re Telephone
9.Registered Home Improvement Contractor: Not Applicable ❑
S-t 'co—EEE N J /—Ur4 L lot tV 7
Company Name Registration Number
zi, .Se 0 s, WE-44 4-(l u el- 6 -/z - o y
Address Expiration Date
Telephone 2,6e- T n 313
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 build permit.
Signed Affidavit Attached Yes f% No ❑
11. — Home Owner Exemption
The current exemption for`homeowners"was extended to include Ow -oceu ied Dwellin P s of one(I) or two(2) families
and to allow such homeowner to engage an individual for hire wh .res not possess a license,provided that the owner acts
as su ervisor.CMR 780 Sixth Edition Section 108.3.5.
Definition of Homeowner:Person(s)who own a parte • land on which he/she resides or intends to reside,on which there
is.or is intended to he.a one or two family dwellin. .ttached or detached structures accessory to such use and/or farm
structures. A I erson who constructs more th• • one home in a two- ear I eriod shall not be considered a homeowner.
Such"homeowner"shall submit to the Buil.'ng Official,on a form acceptable to the Building Official that he/she shall be
res onsible for all such work ierfor i d under the buildin• ermit.
As acting Construction Su•erviso our presence on the job site will be required from time to time,during and upon
completion of the work fon whi his permit is issued.
Also be advised that with rc` ence to Chapter 152(Workers' Compensation) and Chapter 153 (Liability of Employers to
Employees for injuries n. resulting in Death)of the Massachusetts General Laws Annotated,you may be liable for person(s)
you hire to performs rk for you under this permit.
The undersigned omeowner•'certifies and assumes responsibility for compliance with the State Building Code,City of
Northampton t rdinances,State and Local Zoning Laws and State of Massachusetts General Laws Annotated.
Homeowner Signature
Patted #5
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-NOTE-
TMS PLAT 7S COMPILED FROM DEEDS. PLANS AND OTHER
• SOURCES AND I5 NOT TO BE CONSTRUED AS AN ACCURATE
SURVEY AND IS NOT TO BE RECORDED.
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TO: FLORENCE SAVINGS BANK &
TICOR TITLE INSURANCE COMPANY -
I HEREBY REPORT THAT I HAVE EXAMINED 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 VATNIN THE LOT LINES,
EXCEPT AS NOTED. [ FURTHER REPORT THAT THE PROPERTY IS NOT LOCAitU MEIN
A FLOOD PRONE AREA AS SHOWN ON FEDERAL FLOOD INSURANCE MAPS FOR
COMMUNITYY�R�"�_�� { � 2�5016
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SURVEYOR: R1,14`IrF�£'�f»� -NOTE-
.e ' THIS PLAT FOR MORTGAGE LOAN PURPOSES ONLY
AND DOES NOT CONSTLTUTE A PROPERTY SURVEY
.'"µa -MORTGAGE LOAN INSPECTION PLAT-
gm. . AN,ORti. NORTHAMPTON, MASSACHUSETTS
PREPARED PER
• fYJ1s2
MARK A, & MARY ELLEN CASEY
SCALE: 1"=30' AUGUST 21 , 1995
• ' � HAROLD L EATON AND ASSOCIATES, INC.
.^� REGISTERED PROFESSIONAL LAND SURVEYORS
'F,QA�q-�^•4- �1�1 235 RUSSELL STREET - HADLEEY - MASSACHUSETTS
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