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W5.3 7- 5520 FAX (4155 Tli{$ CERTIFICATE IS ISSUED AS A MA 1 1 MK Ur mrw,,•..,
nck & >'erras Insurance Agency, Inc. ONLY ANDVONFERSYR,91181rITS %R U.THE CERTIFICATE
CAmpuS Lane HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVE,MGE AFF • - . -,' BY THE POL H • W.
r;sthanlpton, MA 01027
INSURERS AFFORDING COVERAGE NAIC #
JRir n u ure MISUR to NM Insurance Cowan 14788
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Huntington, MA 01050 INSUs RC: ..� EMI
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fME POLICIES OF INSURANCE LISTED BELOW NAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATE NOTW 9TAN
INY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT wiTTH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR
MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, ExCLUSIONS AND CONDITIONS OF SUCH t i
POLICIES. AGGREGATE LIMCfS BNOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
,g,..:4.!„ TYPE OF INEuRANCE POLICY NUMBER
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OBSCRIPTION OF OPERATIONS! LOCATIONS / VEN1CLE51 OCCLUSIONS MOND 9Y ENOORSEM$MT I9PECIAL PROMMANS
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SHOULD ANY OF THE ABOVE DESCROSED POLICIES BE CANCELLED BEEORBTHE
EXPARATIDN BATE T BNBOF THE ISSUING INSURER WILL ENDEAR TO MAIL J
10 DANE WRITTEN NOTICE TO THE CERTIFICATE HOLOLR NAMED TO THE LEFT,
MO FAILURE TO MAIL SUCH NOTICE SHALL noose NO OBLIGATION OR LIABILITY
City of Northampton OF ANY IOW UPON THE MUM, Its OR BrPR66ENrAT1Vis.
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"'.. The Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Investigations
600 Washington Street
•
Boston, MA 02111
www.mass.gov /dia
Workers' Compensation Insurance Affidavit: Builders/ Contractors /Electricians/PIumbers
Applicant Information Please Print Legibly
Name ( Business /Organization/Individual): _
Address:
City /State /Zip: Phone #:
Are you an employer? Check the appropriate box: Type of project (required):
1. El I am a employer with 4. ❑ I am a general contractor and I
employees (full and/or part- time).* have hired the sub - contractors 6. ❑New construction
2. I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling
ship and have no employees These sub - contractors have g. ❑ Demolition
working for me in any capacity. employees and have workers' 9. ❑ Building addition
[No workers' comp. insurance comp. insurance.$
required.] 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions
officers have exercised their 11.7 Plumbing repairs or additions
3. ❑ I am a homeowner doing all work
myself. [No workers' comp. right of exemption per MGL 12.0 Roof repairs
insurance required.] t c. 152, § 1(4), and we have no
employees. [No workers' 13. ❑ Other
comp. insurance required.]
*Any applicant that checks box #1 must also fill out the section below showing their workers' compensation policy information.
T Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such.
Contractors 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 employees, they must provide their workers' comp. policy number.
I am an employer that is providing workers' compensation insurance for my employees. Below is the policy and job site
information.
Insurance Company Name:
Policy # or Self-ins. Lic. #: 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 25A of MGL c. 152 can lead to the imposition of criminal penalties of a
fine up to $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 $250.00 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 certify under the pains and penalties of perjury that the information provided above is true and correct.
Signature: Dutc.
Phone #:
Official use only. Do not write in this area, to be completed by city or town official
City or Town: Permit/License #
Issuing Authority (circle one):
1. Board of Health 2. Building Department 3. City /Town Clerk 4. Electrical Inspector 5. Plumbing Inspector
6. Other
Contact Person: Phone #:
r •
Version1.7 Commercial Building Permit May 15, 2000
SECTION 10- STRUCTURAL PEER REVIEW (780SSCMR 110.11)
Independent Structural Engineering Structural Peer Review Required Yes 0 No 0
SECTION 11 - OWNER AUTHORIZATION -'TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
l e i e r n V_" vc• , as Owner of the subject property
hereby authorize Row. +••tl.+r- -� _ �, .. to
act on my behalf, in all matters relative to work authorized by this building permit application.
t: 4 a
Signature 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 painsand penalties of perjury
Print Name ....._.._.
Signature of Owner /Agent Date
SECTION 12 - CONSTRUCTION SERVICES
10.1 Licensed Construction Supervisor: Not Applicable ❑
License Number
Address Expiration Date
11
Signature Telephone
SECTION 13 -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 - genial of- the .issuance- ofThe- building- perrnif. - -__ - --
Signed Affidavit Attached Yes No 0
4:
Version1.7 Commercial Building Permit May 15, 2000
SECTION 4- CONSTRUCTION SERVICES FOR PROJECTS LESS THAN 35,000
CUBIC FEET OF ENCLOSED SPACE
Interior Alterations ❑ Existing Wall Signs ❑ Demolition ❑ Repairs ❑ Additions ❑ Accessory Building ❑
Exterior Alteration ❑ Existing Ground Sign ❑ ,New Signs ❑ Roofing ❑ Change of Use ❑ Other Q
Brief Description Enter a brief description here. t� r-
Of Proposed Work: C 0,- a , c .i7 TG Juc
SECTION 5 - USE GROUP AND CONSTRUCTION TYPE
USE GROUP (Check as applicable) CONSTRUCTION TYPE
A Assembly ❑ A -1 ❑ A -2 ❑ A -3 ❑ 1A 1 ❑
A-4 ❑ A -5 0 1 B ❑
B Business ❑ 2A ❑
E Educational ❑ 2B I ❑
F Factory ❑ F -1 0 F -2 ❑ 2C ❑
H High Hazard ❑ 3A ❑
1 Institutional ❑ 1 -1 ❑ 1 -2 ❑ 1 -3 ❑ 3g ❑
M Mercantile ❑ 4 ❑
R Residential ❑ R -1 ❑ R -2 ❑ R -3 ❑ 5A ❑
s Storage ❑ S-1 ❑ S-2 ❑ 5B ❑
U Utility ❑ Specify:
M Mixed Use ❑ Specify
S Special Use ❑ Specify:
COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATIONS, ADDITIONS AND /OR CHANGE IN USE
Existing Use Group: __..._.. __ Proposed Use Group. ;,_._,._..
Existing Hazard Index 780 CMR 34): ,.,.,...._._....._.__„ ._..._ . ____..._W Proposed Hazard Index 780 CMR 34): ....... ........_ ....___ _. ....._.'
SECTION 6 BUILDING HEIGHT AND AREA
BUILDING AREA EXISTING PROPOSED NEW CONSTRUCTION OFFICE USE ONLY
Floor Area per Floor (sf)
1
_ st ,.
__ ._
2..d ........_. 2 nd
3rd 3 r d
4
4 th
Total Area (sf) Total Proposed New Construction (
Total Height (ft)
Total Height ft /0 42 "
7. Water Supply (M.G.L. c. 40, § 54) 7.1 Flood Zone Information: 7.3 Sewage Disposal System:
Public o Private ❑ Zone Outside Flood Zone❑ Municipal ❑ On site disposal system
s iL7L
Versionl.7 Commercial Building Permit May 15, 2000
Department use oriy
City of Northampton Status of Permit
Building Department Curb Cut:/Drtveway Permit
212 Main Street Sewer /Septic Availability
Room 100 Water/Well Availability
Northampton, MA 01060 Two Sets of Structural; Plans
phone 413- 587 -1240 Fax 413 - 587 -1272 Pfat/Site Plans
Other Specify
APPLICATION TO CONSTRUCT, REPAIR, RENOVATE, CHANGE THE USE OR OCCUPANCY OF, OR DEMOLISH ANY BUILDING
OTHER THAN A ONE OR TWO FAMILY DWELLING
SECTION 1 - SITE INFORMATION
1.1 Property Address: This section to be completed by office
5- 0 ' e-f 1 oo 12— Map Lot Unit
F 10,-r,iM Zone Overlay District
a .._M adW.. .,.q Elm St District CB District
SECTION 2 - PROPERTY OWNERSHIP /AUTHORIZED AGENT
2.1 Owner of Record:
Name (Print) Current Mailing Address:
Signature Telephone
2.2 Authorized Agent:
Name (Print) Current Mailing Address
Signature Telephone
SECTION 3 - ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost (Dollars) to be Official Use Only
completed by permit applicant
1. Building / 1 ,` (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
6. Total = (1 + 2 + 3 + 4 + 5) 1/, f () Check Number
This Section For-Official Use Only
Building Permit Number Date ■
Issued
Signature.
Building Commissioner /Inspector of Buildings Date
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 pi c s_ze es that the building artment 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
- - - - -- -- puts in - con}unction,to_ the _bitildingpermitissued,_ 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
1, 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.
Address of work
location
The Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Investigations •
600 Washington Street
: � Boston, MA 02111
www.massg ov /dia
MEP - Workers' Compensation Insurance Affidavit: Builders / Contractors /Electricians/Piumbers
Applicant Information Please Print LegibIv
Name ( B•siness /Organization/Individual): 4eQ ,V\ � .�+ LA (`e
Address: r) (cQ e. -
City /State/Zip: Phone. #:
Are you an employer?-Check the appropriate box: Type of project (required):
1.0 I am a employer with 4. I am a general contractor and I
6. ❑ New construction
employees (fail and/or part- time).* have hired the sub - contractors
2. I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling
ship and have no employees These sub - contractors have. 8. ❑ Demolition
working for me in any capacity. employees and have workers' •
g Y P tY- 9 Q Building addition
[No workers' comp. insurance comp. insurance_.
required.] 5. 0 We are a corporation and its
10.0 Electrical repairs or additions
3. LJ I - am a- Iiorneowner_de g -all -work - - -- - _ _ e cexs ve Exercisedtheir —1-1. Q Plumbing repairs or additions
myself. [No workers' comp. right of exemption per MGL 12.0 Roof repairs
insurance required.] t c. 152, § 1(4), and we have no - if
employees. [No workers' 13.E4 Other J U A
comp. insurance required.]
J U
*Any applicant that checks box #1 must also fill out the section below showing their workers' compensation policy information_
t Homeowners who submit this affidavit : indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such.
:Contractors that check this box must arrarhed an additional sheet showing the name of the sub - contractors and state whether or not those entities have
employees. If the sub-contractors have employees, they must provide their workers' comp. policy number.
Iam an employer that is providing workers' compensation insurance for my employees. Below is the policy and job site
information.
Insurance Company Name:
Policy # or Self-ins. Lic. #: Expiration Date:
kb 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 25A of MGL c. 152 can lead to the imposition of criminal penalties of a
fine up to $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 $250.00 a day against the violator. 15e advised that a copy of this statement may be forwarded to the Office of
Investizations of the DIA for insurance coverage verification.
I do hereby certify under the its and penalties of perjury that the information provided above is. tr e_and_cnrrect.
tore: , 4wJ Date: e
Phone #:
Official icial use only: Do not write in this area, to be coinpfeted by city or town of ciaL
City or Town: Permit/License #—
Issuing Authority (circle one):
I. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector _ -___ _.
6. Other
Contact Person: Phone #:
oft
SECTION 8 - CONSTRUCTION SERVICES
8.1 Licensed Construction Supervisor: --f��---- Not Applicable ❑
Name of License Holder : ` p, ..l...R I
License Number
I Yid C � 7.�� o C o % mod
Address J Expiration Date
3 -P'eA„n C � G6
Signature Telephone
9:; Registered Improvement.Con ractor " -: .. , ., <,,,.,,2a;, .,4ifi -, , ,. s _,.. Not Applicable ❑
V-Q < C6-1"4-:( C6-1"-� / 1;4
C ompany It ame Registration Number
Address Expiration Date
Telephone
„ 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 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
- ISTortl amptonLLUidinances; Staf and 1✓o afi . r - Massadmsetts General - - Laws - Annotated.
Homeowner Signature
•
SECTION 5- DESCRIPTION OF PROPOSED WORK (check all applicable)
New House ❑ Addition ❑ Replacement Windows Alteration(s) ❑ Roofing ❑
Or Doors 0 _
Accessory Bldg. ❑ Demolition ❑ New Signs [0] Decks [D Siding [0] Other S]
Brief Description of Proposed( �y
Work: OZSikC-La — 45arogQ ' lJ 1�
�/ 0
Alteration of existing bedroom Yes No °J Adding new bedroom Yes No
Attached Narrative Renovating unfinished basement Yes No
Plans Attached Roll - Sheet
ea C�nC�����gsea�ld�araciiiifiir��tae�sti�4 fi "o�islnq,caiii�C��e�th� faCii'�W�t��:
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. Masscheck 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 .
1. 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
hereby authorize
to act on my behalf, in all matters relative to work authorized by this building permit application.
Signature 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
Signature of Owner /Agent Date
emo
,
1
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
— _ — _:44.4 ._____.�. _ _. _ _ _ °,..._
Frontage __.__ _ :
Setbacks Front 40 i L 43'0 ./
Side L: ° ,,. 2 w R..., LO ' L .. _... R °Z w
,,,,,.,
Rear I (� ..� (CIY?..
Building Height ""
Bldg. Square Footage *ir Y/ !
Open Space Footage i / -_.
(Lot area minus bldg &paved � tr � !_ f 0 /%66
parking) 7 , ??: ` �
# of Parking Spaces
Fill: ;S II
(volume & Location) _.._....�.°......,.„.__. _._ -,--- _ °.
A. Has a Special Permit /Variance /Finding ever been issued for /on the site?
NO 0 DONT KNOW P YES
IF YES, date issued:: °
IF YES: Was the permit recorded at the Registry of Deeds?
NO (3 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 ® DONT KNOW 0 YES 0
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained Obtained 0 , 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 ci or ad Ors gns 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 a common plan
that will disturb over 1 acre? YES 0 NO
IF YES, then a Northampton Storm Water Management Permit from the DPW is required.
e ..n.4143
City of Northampton S,,tatttOUP:e1741 s,""",§
, ^ Building Department -
212 Main Street ,00 "Walla .`tci
Room 100 • Northampton, MA 01060 k" ^ A,9atODIA
\
4 4 4 • A n r-- A 4 o.--1 4 n-7 4,'`';
t PI lone 0-;...)0 - I L'fl..1 inX 9. I J I I /
't74rX, U Vr.L. P...""
MePbpe , '175 14,42'4 - 4
° `.• 4•21.,
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
Z 5 ir,tr iet,L Map Lot Unit
f trteA- C Zone Overlay District
Eftn.St District CB District
SECTION 2- PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
62 /do
Name (Print) Current Mailing Address:
cy‘ 4/97,
Telephone
Signature
2.2 Authorized Agent:
o(ccz,
C 4 Ar 44AA,
Name (Print) Current Mailing Address:
6 /
Signature Telephone
SECTION 3 -ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost (Dollars) to be Official Use Only
completed by permit applicant
1. Building r 0 C-0 (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
'MAW;
6. Total = (1 + 2 + 3 + 4 + 5) 0 o Check Number ■ .
This Section For Official Use Only
Date
Building Permit Number: Issued:
Signature:
Building Commissioner/Inspector of Buildings - Date
File # BP- 2010 -0383 0 -CA 614 1
APPLICANT /CONTACT PERSON DEAN COUTURE
ADDRESS /PHONE 1A OLD CHESTER RD HUNTINGTON (413) 667 -0061
PROPERTY LOCATION 85 OVERLOOK DR
MAP 29 PARCEL 254 001 ZONE URA(100) / /WSP
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out r/ °
Fee Paid (�/ y�
Typeof Construction: CONSTRUCT 20 X 20 DET GARAGE
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/ Statement or License 072541
3 sets of Plans / Plot Plan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INFORMATION PRESENTED:
Ni 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
:C9Z;
Signature of Building Offi al 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.
85 O VERLOOK DR BP - 2010 - 0383
GIS #: COMMONWEALTH OF MASSACHUSETTS
•B o ::M- 254 # 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 g BP- 2010 -0383
Project # JS- 2010 - 000506
Est. Cost: $11000.00
Fee: $80.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: DEAN COUTURE 072541
I of Size(sq. ft.): 15812.28 Owner: ROSA SONIA E
Zoning: URA(100) / /WSP Applicant: DEAN COUTURE
AT: 85 OVERLOOK DR
Applicant Address: Phone: Insurance:
l A OLD CHESTER RD (413) 667 -0061
H UNTI NGTONMAO1050 ISSUED ON:10/26/2009 0:00:00
TO PERFORM THE FOLLOWING WORK:CONSTRUCT 20 X 20 DET GARAGE
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:
FeeTvpe: Date Paid: Amount:
Building 10/26/2009 0:00:00 $80.00
212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272
Building Commissioner - Anthony Patillo
CIOt f ,JJ 11.-1'VVVAJVV _
Fs, . Cost: S1 1000 .00
Fee: $80.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
t !se Group__ DEAN COUTURE 072541 C 4: t i= E, 7 t; s (4:-:( 9
Lot Size(su. ft.): 15812.28 Owner: ROSA SONIA E •,
Lon.in tilzAut00) //WSP Applicant: DEAN COUTURE
AT: 85 OVERLOOK DR
Applicant Address: Phone: Insurance:
IA 01 I) C1- IESTLI: i) (413) 667 -0061
HUNTINGTONMAt; =' 13.50 ISSUED ON :10/26/2009 0 :00 :00
TO PERFORM THE FOLLOWING WORK: CONSTRUCT 20 X 20 L)ET GARAGE
POST TIIIS CARD SO IT IS VISIBLE FROM THE STREET
inspector of Plumbing Inspector of Wiring D.P.W. Building Inspector
Underground: Service: Nleter: � /
Footings:e,jr 1/- y -a�
Rough: Rough: Dec 1 G { r " m3i, House # Foundati n•
c �° t� Driveway Final:
k 2.4 i. ! �� / i - 9" _ - Q q _
1
Villa!: Final: '�P1/ R. 4 -r4 /
udni Rough Frame:
(431\em, ,
".l AN: - - Fire Department Fireplace /Chimney:
Rough: Oil: Insulation: OK cif c. i t s
Final: Smoke: Final: oic 0 I /r .
THIS PERMIT MAY BF REVOKED BY THE CITY OF NORTHAMPTON UPON.VIOL_,ATiON OF'
ANY OF ITS RULES AND REGULATIONS. -
Certificate of Occupancy Si ~nature: r
FeeType: Date Paid: Amount:
Building 10/26/2009 0 :00:00 5
212 Main Street, Phone (413)587 -1240, Fax: (413) 587 -1272 .
Building Commissioner - Anthony Patillo
Building ...
ink, 10/26/2009 0 :00:00 , $ **y'"`�" � ;"""" --.:.- --_
212 Main Street, Phone (413) 74.2 F'e : 413) - 587- 1.272. _
« Bunting commissioner - Anthony Panto •°