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Zoning
Miscellaneous Additions, Repairs, Alterations, etc. Tel. No. :.5d' -5:66 16 Alterations
44 NORTHAMPTON, MASS. 19 Additions
111 APPLICATION FOR PERMIT TO ALTER Repair
/ �r Garage,
1. Location .5 7 f Hi re�e_ d Aid r/`I1i. p/ Lot No.
2. Owner's name Ani1CA. fn( L T j P C -t ki Address .11'3 l O r e t JTe 4/. 11) 'i -
3. Builder's name Address
Mass. Construction Supervisor's License No. Expiration Date
4. Addition
5. Alteration
6. New Porch
7. Is existing building to be demolished?
8. Repair after the fire
9. Garage No. of cars Size
10. Method of heating
11. Distance to lot lines
12. Type of roof Q yVICi /d Si t r'Y; re,s h i /e„
13. Siding house
14. Estimated cost_- /2_0 dT)
The undersigned certifies that the above statements are true to the best of his, her
knowledge and belief.
aro a) ( A ) OrU.mw
Signature of responsible annicant
Remarks
9 ��`" 'jr, ft :..., c" t Qf Nar*i ant tart ► _ #_ �
a � -, ,� , - , SEP 3 0199 , = :' ►—
y4 t x�4 xssxr asrtis
re m '' = V 1►JSP !..A O1 G`f,t� r�i'S D ARTMENT OF BUILDING INSPECTIONS ,
p�RtHAM P t dN
212 Main Street 'Municipal Building_
Northampton, Mass. 01060
WORKER'S COMPENSATION INSURANCE AI'NmAVIT
()et re
(licenser/permittee)
with a principal place of business/residence at:
.5 9 d /Trice _ ei Ah 4/rill/pi-Of) M4 (phone #) ,i7.5"
(street/city /state/rip) J7O,64)
do hereby certify, under the pains and penalties of perjury, that:
( ) I am an employer providing the following worker's compensation coverage for my
employees working on this job:
(Insurance Company) (Policy Number) (Expiration Date)
( ) 1 am a sole proprietor, general contractor or homeowner (circle one) and have hired
the contractors listed below who have the following worker's compensation policies:
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(Name of Contractor) (Insurance CompanyiPolicy Number) (Expiration Date)
(Name of Contractor) (Insurance Company/Policy Nnmtrr) (Expiration Date)
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(shade addit oval sled. ifnoccssu) to include infonnafion pertaining to all ooaradors)
( ) 1 am a sole proprietor and have no one working for me.
(1. am a home owner performing all the work myself.
NOTE: please be aware that while homeowners who employ parson: to do m , construction or repair work on a dwelling of
not mom than throe units in with the homeowner resides or cc the grounds appurtenant theccto are not generally considered to be
employers under the worker oompeas anon Act (GL152,s3 1(5)), application by a homeowner for a license cc permit may evidence the
legal etatus of an employee under the Wonders Compensation Act
I understand tad a Dopy of this aatemer t raw bo forwarded to tbo Depar t:owl of Industrial ,a-3& Oflioe of Irrarrtoce for the
coverage verification sad that failure to seatre coverage under section 25A of MOL 152 can lead to the imposition of criminal penalties
consisting of a fine of up to 51,500.00 andlor imprisonment of up to one year and civil penalties in the form of it Stop Work Order and a
fine of 5100.00 a day against me.
Signed this day of , 1997 For depadmcotal use only
Permit Number
'`W... (Y1 , il_.. sL4 Map# Lot #
Signature of Liccnsee//Permittce
1 j 11 G IJ
X I u�'i $ sEP 3 0 1997 ' 0z r`f Nort � alll p ton
. ii' ` .. ('` a �ASOAclittortlz = F
�`, �NORTHAMPTON T OF SU.... O IOF G INSPEG#� R MENT OF BUILDING INSPECTIONS :_� =�_ :: MA '
INSPECTOR °1 a Street ' Municipal Building No rtham P ton, Mass. 01060 \tttr air' f
HOMEOWNER LICENSE EXEMPTION
(�
(Please Print)
DATE: --q a. 30 i qQ 7
JOB LOCATION: 7 - 4 - SiT
/� (Map) (Parcel) (Subdivision)
HOMEOWNER: / 1,14 - ,. rn (DeLu.2 rF'ouL'er.
(N"ame & Address)
/
, c!0 '58 7 * st. �h
(Home Phone) (Work Phone)
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. CMR780 Section 109.1.1
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. ,,, (444--) 0 HOMEOWNER SIGNATURE /PA /1 , ✓ISZVe
BUILDING PERMIT #
10. Do any signs exist on the property? YES NO L/
IF YES, describe size, type and location:
Are there any proposed changes to or additions of signs intended for the property'? YES NO
IF YES, describe size, type and location:
11. ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE DENIED DUE TO
LACK OF INFORMATION.
This column to be Pilled in
by the Building Department
Required
Existing Proposed By Zoning
Lot size
Frontage
Setbacks - frnpt
- side L: R: L: R:
- rear
Building height
Bldg Square footage
%Open Space:
(Lot area minus bldg
&pa ged parking)
# of `parking Spaces
it of Loading Docks
Fill:
vo1 -ume -& location)
13. Certification: I hereby certify that the information contained herein
G is true and accurate to the best of my knowledge.
DATE : � �� i qq 7 APPLICANT 's SIGNATURE 6LnAlct 0'1 04. ' ?i l,2)
NOTE: lassuaricie of air zoning permit does not relieve an a ~
pplioant's burden to oomph/ witty , all
zoning requirements and obtain all required permits from the Board of Health, Conservation
Commission, Department of Public, Works and other applicable permit granting authorities.
FILE if
s�UJS Fr,
:51 I , R I;
SEP 3 0 1997
DEPT OF BUILDING INSPECTIONS File No. ?, &GQ
NORTHAMPTON, WA 01060
ZONING PERMIT APPLICATION ( §10.2 )
PLEASE TYPE OR .PRINT ALL INFORMATION
'( Name of Applicant: 14 h✓? /J De L #
Address: / lcj i &ic % Nekk n-► jelephone: S <S UcJ /(-
2. Owner of Property: S /9/
Address: `SYrm E Telephone:
3. Status of Applicant: Owner Contract Purchaser Lessee
Other (explain):
Q
4. Job Location: 79 �z %x ,'"`
Parcel Id: Zoning Map# (- Parcel# District(s):
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/Property c,t
6. Description of Proposed Use/Work/Project /Occupation: (Use additional sheets if necessary): •
A-64-4( 7 /1/e-k 5 .0,64, 5 „,
7. Attached Plans: Sketch Plan Site Plan Engineered /Surveyed Plans
Answers to the following 2 questions may be obtained by checking with the Building Dept or Planning Department Files.
8. Has a Special PermitNariance/Finding ever been issued for /on the site?
NO DON'T KNOW / YES IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO DON'T KNOW YES
IF YES: enter Book Page and /or Document #
9. Does the site contain a brook, body of water or wetlands? NO DON'T KNOW YES
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained Obtained , date issued:
(FORM CONTINUES ON OTHER SIDE)
T lJ LS ' lJ U ;..
Lii
SEP 3 01997 FILE # 962848
G i l l r l
APPLICANT /CO T CT PERSON: __E i 5175 6,
D . 'Tr )7'f. WI; VG illi : E
NORTHAMPTON, MA OIG' ___ . ,_
PROPERTY LOCATION: '2 9 9 %-4 P
al
MAP h' PARCEL: s� ZONE
'm IS SECTION FOR - OFFICIAL USE ONLY: .
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FT(INT) MIT t.-----
Fee Pair!
Building Permit Filler! not `'''-'
Fee Pair! ii._
Remodeling Interior A -t,,- CL.ci 41 -/V
.1
Addition to FYicting , - -e % ry�� . .•t-11O
Accessory Structure
Bnildin • ' nc Tnclrrde&
• i• .I •.s . •u•1 a • • II •:
3 Sets of Plans / Plot Plan
TBE LOWING ACTION HAS BEEN TAKEN ON THIS AP' ICATION:
!! //Approved as presented/based on information presented
Denied as presented:
—
Special Permit and/or Site Plan Required under: §
PLANNING BOARD ZONING BOARD
Received & Recorded at Registry of Deeds Proof Enclosed
Finding Required under: § w /ZONING BOARD OF APPEALS
Received & Recorded at Registry of Deeds Proof Enclosed
Variance Required under: § w /ZONING BOARD OF APPEALS
Received & Recorded at Registry of Deeds Proof Enclosed
Other Permits Required:
Curb Cut from DPW Water Availability Sewer Availability
Septic Approval -Bd of Health Well Water Potability -Bd Health
Permit from Conservatio om r.i /
/
Signature of Building Insp or Date
NOTE: Issuanoe of a zoning permit does not relieve an applioant's burden to oompty with all
_ zoning requirements and obtain ail required permits from the Board of Health, Conservation
Commission, Department of Publio Works and other applioable permit granting authorities.
g City of Northampton REQUIRED
,'� �`'^' a 1. Footings and Walls
v : ; / -. BUILDING DEPARTMENT 2. Structural Components in Place*
• 3. Complete Building*
No. 947 Office of the Building Inspector
Zoning Form No. 962848 Date 10/2/97 Fee$ Check # 185
Page, 37 Parcel 4 , Zone SR Section 127 ❑ Yes ® No
BUILDING PERMIT
* Plumbing and Electrical Inspections required
THIS CERTIFIES THAT Anna DeLue Powers before Building Inspections
has permission to '6trip & shingle house, garage & sunporch Inspection on Site — Foundations
situated on 579 Florence Road Inspection of Plumbing —Rough
provided that the person accepting this permit shall in every respect Inspection of Plumbing— Finish
conform to the terms of the application on file in this office, and to the Gas Inspection
provisions of the Statutes and the Ordinances relating to the Construction, Inspection of Wiring —Rough
Maintenance and Inspection of Buildings in the City of Northampton.
Any violation of any of the terms above noted is an immediate revocation Inspection of Wiring— Finish
of this permit. Expires six months from date of issuance, if not started. Building Inspection —Rough
Note: A certificate of occupancy will be issued by this office upon return Insulation Inspection
of this card signed by the Plumbing, Wiring and Building Inspectors.
Building Inspection— Finish
** Install per Manufacturer's information: windows, vinyl siding, roofs Smoke Detectors (Fire Department)
and woodstoves
Other
THIS CARD MUST BE DISPLAYED IN A CONSPICUOUS PLACE ON TI,PREMISES
Certificate of Occupancy ''' - a „� j
Building Inspector