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Zoning
Miscellaneous Additions, Repairs, Alterations, etc. Tel. No. L fC`Li -7 / -t Alterations
%r NORTHAMPTON, MASS. 7/025 1 9Z Additions
F %4� � APPLICATION FOR PERMIT TO ALTER Repair
Garage
1. Location /o ■ .*/ZS ,e e. ce Lot t No.
2. Owner's name e0 49 e �? / Shft. b' 0i 4f4'H Address 62.,•g y am `- / 44'//, .eGIUG lO '
t'6
3. Builder's name - e.") f" ?n. _DE/ a�, °e L/ Address /7 A zi j x/ `" C"
Mass. Construction Supervisor's License No. t Expiration Dat"
4. Addition ivy'
5. Alteration
6. New Porch ..7 `/— S
7. Is existing building to be demolished? /ltd
8. Repair after the fire fU /'
9. Garage /V 1}- No. of cars Size
10. Method of heating
11. Distance to lot lines /U f9
12. Type of roof /l/
13. Siding house /// //i
14. Estimated cost: -
,,Ir 4 aDIJ
The undersigned certifies that the above statements are true to the best of his, her
know -.:: , d belief. (/( ��//
Signature of responsible applicant
Remarks 1 . d" » / S Q e - i .• i . • e 7 --- 4dL .
. ttAMP2 b
�� .,R —4 j ; 'tit (iii �r �f �z s r 11 5 p uiY 1 * =a te — 1
-• JUL 2 8 1997 =Air t=
DEPARTMENT OF BUILDING INSPECTIONS ,==.__'% _ '
ll
INSPEC 0Re ',' 212 Main Street 'Municipal Building F
~ -- -- .,...:. ...._� .,; _ e _ Northampton, Mass. 01060 "
HOMEOWNER LICENSE EXEMPTION
— J (Please Print)
DATE: ' U! J / 77 7
JOB LOCATION : O " z 3 ,— /d „4 I0� C c.. / / .
( c e i Map )� ,4 c c// (Subdivision)
H OMEOWNER:
( Name &. Addr T
��/
(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 ��
HOMEOWNER SIGNATURE', ' `�`'`
BUILDING PERMIT #
•
It 2 B \9
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1 A b„ • it ii \ (rz[� > axfll &mp±on . _�
C!1► ` :44 " / a3fRCh[ifrtlf =1.a , r
� DEPARTMENT OF BUILDING INSPECTIONS ` {{ � ` _
212 Main Street • Municipal Building !
Northampton, Macs. 01060 r' -s
•
WO RICER' S COMPENSATION INSURANCE AIT DAVIT
2 o B e P , 0'1 & v -r 1 a__,
N :ns,Jp ttc�.)
with a principal place of business/residence at:
n I /
60 -3 1 6 2�u_G `L° IC-Ol ` (phone -4 ) L .3 - g• Sa /z7
(strr deity /stair/ zip)
do hereby certify, under he pains and penalties of perjury, thai
( ) 1 am an employer providing the following \' or'r:er's compensation coverage for my
employees wort, -ing on this job:
•
(insurance Company) (Policy Number) (Expiration Darr)
( ) I 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) 1nszuanc Company/Policy Number) (Expiration Date)
(Name of Contractor) (Insurancz Company / Policy Number) (Expiration Date)
(Name of Contractor) (lnsuranc Company/Policy Numtxr) (Ex-piration Date)
(Name of Contractor) (Lasuranc Company/Policy Number) (Expiration Date)
(n113ch ditic al rboct if nora=ary to ioc1udc infortnrri on pert_imxig to all oou:r-..r on)
( ) 1 am a sole proprietor and have no one working for me.
(v am a home owner performing all the work myself. to /a.. ✓t
NOTE: picot be avearc that vihi]o homeowner who employ persom to do ocainianoce, west ructioo repair work on a avert ling of
not mote th_.n throo units in which the botnoown r rccido or oo the grounds appurtenant thereto are oot generally ooaridcred to be
emplaym under the wok PCI1xpcasztion Act (GL152,3:s 1(5)), apportion by a homeowner for a ticcn a cc permit may Cvidm« the
141.1 rtauua of an caployee under tho Worico'i Compeosat.ioa AAC
1 unda that a. copy of thin catczamt may be forwarded to the Depart coot of Indu tri d Ancidoat a OISoo of laaucnow for tlae
coverage verification and that failure to scam cavern,' under section 25A of MOL 152 nn toad to the itnpositioa of criminal pcaaltics
ooasittiug of a fax of up to S1,500.60 and/or iu prisoameat of up to one year and aver pemhin in the font of a Stop Work Order and a
fine of S 100.00 a day against me. .
Si a. �. this ver day of 1 199 7 For departmental ttzoonly
/ / / Permit Number .
i u Map# Lot #
Signature of LiccnscdPc •. -ttcc
10. Do any signs exist on the property? YES NO
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 filled in
.. by the Building Department
Required I
Existing Proposed By Zoning
Lot size
fo - 9. 4 'S ,gyp
Frontage �63 r 25 >a�
Setbacks - frnnt I 1 f)7 - ,30
- side L: R: L: o D 020 R: a? l a d
- rear /gr."- '7` 0
Building height
S,L0 y S a e
Bldg Square footage b c9 I t
%Open Space:
• (Lot area minus bldg UI N `
A- 1, � 76
' &paved parking; ,V v ►j'
# of parking Spaces N I ,/I /0 i pi
1
_...,
of Loading Docks V /r , j
#� ' I r
Fill: }
=(vol -rime - -& location) +N N K •
1
13. Certification: 1 hereby certify that the information contained herein
is true and accurate to the best of my kno dge.
DATE: Z%S247 a APPLICANT 's SIGNATURE NOTE: 1 no f a zoning permit does not relieve an applioanYs •
urden to comply withall
zoning requirements and obtain all required permits from the Board of Health, Conservation
Commission, Department of Publio Works and other applioable permit granting authorities.
FILE #
Y t�
JUL 2 81991
/
File No. 96 �5 6
ZONING PERMIT APPLICATION ( §10.2)
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant: / 8 € ( jq . /14 cc r Tc.. 1 a___
Address: ck? f' l2 GCic c°_ YC d • Telephone: .5" - — 5 2
2. Owner of Property: 4 I8 / e i . i /s a.. o fro Al f" t 44- /'—
Address: /v Telephone:
3. Status of Applicant: l—Owner Contract Purchaser Lessee
Other (explain):
4. Job Location: G a2 J 9- 104 e.x.c� led • •
Parcel Id: Zoning Map# (37 Parcel# C District(s):
(TO BE FILLED IN BY THE UILDING DEPARTMENT)
5. Existing Use of Structure/Property �s ' d P c
6. Description of Proposed Use/Work/Project /Occupation: (Use additional sheets i necessary): - •
/4- of el / o aPCA ( /o ,e oo � ) f6 7 Cr a 4../7 o e , s - zu?
S- f-ruc- u y- �e c2 57 X T
7. Attached Plans: /X.6 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 Permit/Variance/Finding ever been issued for /on the site?
NO V 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 /o moment #
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)
FILE # 9 6 2 5 9 6 rj i l 1
-t ; JUL 2 8 99 (
M .. ig-lil Ci cCC� '3 /Y APPLICANT /CONTACT PERSON:
- ADDRESS/PHONE:
. , PROPERTY LOCATION: 'd3 .--- L, /65 .
MAP L2 7 PARCEL: /G ZONE 5/<
THIS SECTION FOR - OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE LO
ZONING FORM FTT ,T .F.TI OTTT
Fee Paid /
Rnilding Permit Filled niit t/
Fee Paid 75 a ✓�
Type of Cnnstriirtinn• r
New f nnstrnrtinn % / . /.� �
Remneling Tnterinr Cy" 5` )7
Additinn to Existing
Areessnry Strnetiire
J3nildin. Plant Included- /
wn • .ti ant Statement nr License •
y y r Sets of Plans Pl Plan
TLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION:
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. 6ommissio
Signature of Building Ins or Date
•
NOTE: Issuanoe of a zoning permit does not relieve an applloant's burden to oomply with all
zoning requirements and obtain all required permits from the Board of Health, Conservation
Commission, Department of Publio Works and other applioable permit granting authorities.
A go City of Northampton REQUIRED INSPECTIONS
' • 1 1. Footings and Walls
• . _ 4
BUILDING DEPARTMENT 2. Structural Components in Place*
d� e
3. Complete Building*
No. 741 Office of the Building Inspector
Zoning Form No. 962596 Date 8/6/97 Fee $40.00 ch # 275
Page, 37 Parcel 10 , Zone SR Section 127 ❑ Yes 0 No
BU11,DING PERMIT
* Plumbing and Electrical Inspections required
THIS CERTIFIES THAT RnhPri Marttn1 a before Building Inspections
has permission to construct front porch 24' X 8' Inspection on Site — Foundations
situated on 623 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
Smoke Detectors (Fire Department)
Other
THIS CARD MUST BE DISPLAYED IN A CONSPICUOUS PLACE ON) 1 P' . MISES
Certificate of Occupancy _ -
Building Inspector