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29-452 (5) • • r Z > - Z p Zoning Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. � Alterations NORTHAMPTON, MASS. /t (�. 19 Additions a APPLICATION FOR PERMIT TO ALTER Repair Garage 1. Locationtr� Lot No. 2. Owner's name S G-A) 2 , -f LCAQ< Address Vel C L71//L ORIIAL�- rJM6Wl� 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 OIL 11. Distance to lot lines Ile r 12. Type of roof 9�7M.1,46 13. Siding house 1.4 0AA1,1 14. Estimated cost:- The undersigned certifi s that the above sLuemcnLs are we to the best of his, her knowledge and belief Si azure�•iesponsible appicant Remarks ® • • . • 3 F LIVING ROOM STORAGE —., BATH _wa,y t _.....5� LAUNDRT R i WEIGHT HHHL HHHM TABLE Co 24' ��r� ® • t ¢KtUMPT of r � T DE#''ARTMENT OF BUILDING INSPECTIONS INSPECTOR 212 Main Street ' Municipal Building Y'U. Northampton, Mass. 01000 HOMEOWNER LICENSE EXEMPTION (Please Print) DATE: A6_0 —� JOB LOCATION- (Ma (�S F( `\21C)-�!� 4Y 45rl t�? l ie HOMEOWNER: `S%��� � (Name & Address) – �;�19 7�r ,,SAY C>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 Stat Building Code, City of Northampton Ordinances, State and Local Z ping Laws, Stat of Massachusetts General Laws Annotated. HOMEOWNER SIGNATURE BUILDING PEf2MIT # " I'> : �D4TT0 9 6 Q-�Sf�--af wart 4a11y f oll �. °. ias'snchn%ctta NOV 51998 DEP TMENT OF BUILDING INSPECTIONS 212 Main Street ' Municipal Building a Northampton, Mass.* 01060 WORICER'S CO'NUENSAnON INSURANCE A I ,, A.VIT (li c:,nsecJpermi ttcc) with a principal place of business/residence at: Shy,90 (str�t/ci ty/s7alrJz�p) do hereby certify, under the pains and penalties of perJury, that: O I am an employer providing the follol ing worker's compensation coverage for my , employees worming on this)ob: (ns=ce- Company) (Policy Number) (1 piration Date) ( ) I am a sole proprietor, general contractor o homeow circle one) and have hired the contractors listed below who have the following worker's compensation policies: (N—ame of Contractor) aP.s'u=ZIc:, Conloaayll dUc- ""UmCr;) (E1�1S1C O Date) (Nainc of Contii?ctor) (IJ'Sd ?1C Conloalivipok-r Nlll1C?r) (Exoiralion Da(c) (Name of Contractor) (Insurance Company/Policy Number) (Expjmboa Date) (Name of Contractor) jmurau� ComoaayJPolicy Nhlubes) (Expira[ion Date) (attach additicoA zhcct if nc xary to ioc"6( iaform-Eca pcctainiag to all o.Datr on) ( ) I am a sole proprietor and have no one wor4dno for me. ( ) I am a home owner performing all the work myself. NOTE:please be aware that wb:ilo homCoAmcrl wbo a=play perso0a to do main�CM31TU —'Or rrpair work oo a dwelling of aot mocc the tbroo tarts in which the bomocr%mr r=Jc3 oc oo the grounds appu�tbcdo arc oot&,o y cooaidacd to be employers under tho workcrt x ocaqc=tieo Act(G L152,=1(5)),apptica6on by w a homeo oa for a liecase a permit may erdeooe the legal OwLu of an employoe under tbn Worlcoda C,onapomati AU- 1 undcrAAnd that a oopy of thin mtcmcat may be foravrd.od to the Dcpnrt—d of InrSutrinl Anodca&Offioa of lraurzoee for th, covcn ge vrrificaiioo and the t(:ailttrc to se a m cc vcrabro under soctioa 25 A of MOL 152 can load t0 tbd impositioa of crimiatl pcazltics ooatisaiag of a of ttp to S 1 SOO,AO andlor impx aocmeat of tip to one ycr and and pemltia in the form of a Stop Work Order and a l fmo 0(51 00. a�'day agaiaA the n b / For dgmii�tiro only PcrmltNtlmber st Li ' 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 cols to be fi22,ad is by the P— ding, Departzmeat Required Existing Proposed By Zoning Lot size Frontage Setbacks - side L: R: L: R: - rear Building height Bldg Square footage %Open Space: (Lot area minas bldg &p?ved park.Lng) # of -Parking Spaces f of Loading Docks Fill: (vol-ume -& location) 13 . Certification: I hereby certify that the informa on contai rein is true and accurate to the best of my knowledge DATE: //A APPLICANT's SIGNATURE NOTE: lssuanoe of a zoning permit does not relieve an ap i no's b rd Wph all zoning requirements and obtain all required permits from the 13 rd 0"0 , oneervation Commission, Department of Publio Works and other appiiooble permit granting authorities. FILE # • i LS 4 1 ,��p_,,/ , Fi 1 e No. E61 ; J7 F F i , °�0 `V1AN'N"r0'4° ',jA�r66 ING PERMIT APPLICATION (§10 . 2) PLEASE TYPE OR PRINT ALL INFORMATION 1. Name of Applicant: SL - Address: Ve (yEj&6 ) ,Q&IE5 rvAg&ate= Telephone: y 9c/r 2. Owner of Property: Address: Telephone: 3. Status of Applicant: Owner Contract Purchaser Lessee Other(explain): 4. Job Location: Parcel Id: Zoning Map# 0-1'% Parcel# District(s): (TO BE FILLED IN BY THE BUILDING DEPARTMENT) 5. Existing Use of Structure/Property We 6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary): 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 Permit/Variance/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) File#BP-1999-0477 APPLICANT/CONTACT PERSON Steven Slezek ADDRESS/PHONE 584-9011 PROPERTY LOCATION 40 CRESTVIEW DR MAP 29 PARCEL 452 ZONE JtP, 0 THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out Fee Paid & 7 Zi O_, �l Type of Construction: New Construction Non Structural interior renovationsaCZE/1����� , Addition to Existing Accessory Structure Building Plans Included: Owner/Occupant Statement or License 4 3 sets of Plans/Plot Plan ' THE OWING 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 UQvAvf-c Ar rqv ., Well Water Potability Board of Health Y d I'erirtit from onservation Co ission Signature of Building Off 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. Reference No- BP-1999-0477 Department: ................................... Building, Electrical & Mechanical Permits .................................................................... .................... Fee Type-. Receipt No.- Non structural interior renovations l*'C I -1999-001282 Paid By- Paid..i.n.F.u.I.I..0.n............ Steven Slezek Fri Nov 06,1998 ...............------------------------------------------------------------- ............. .. ...... ..... Received By- . k C.h.ec .No...................... Linda Lapointe 1047 ......................................................................................... .................... -----------------PARTMENT'S COPY Amount: $40.00 --------------------------- 1)EPARTNI[':I'N 1' FILE, COPV 40 CRESTVIEW DR CITY OF NORTHAMPTON BUILDING PERMIT Owner's pulling their own permits or dealing with unregistered contractors for applicable work do not have access to Guaranty Fund(MGL 142A) Issued: Permit No: Inspector: Tracking No.: Fee: BP-1999-0477 $40.00 GIS #: Map Block: Lot: Address: Zoning: Use Group: Lot Size: 5173 29 452 001 40 CRESTVIEW DR URA 10018.8 Contractor: License Type: Insurance: Homeowner as Contractor Address: License No.: Insurance No.: LiLE State: Zip Code: Phone: Proiect No: Category of Work: Const. Class: Cost Estimate: JS-1999-0909 Non structural interior renovati $4,500.00 Description of Work: FINISH BASEMENT GeoTMS@ 1997 Des Lauriers&Associates,Inc. Signature: