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29-518 �. _...._.. . . > a � Z > Z .: m r, Zoning Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. 586-9"8 Alterations ti NORTHAMPTON, MASS. MAv S __19-2-& Additions Repair ' APPLICATION FOR PERMIT TO ALTER Garage 1. Location /.s A��4M Lot No. 2. Owner's name tf7lty JS £lcsi jaoc= Address /s TX9 IQA F/o efneer /4%9 3. Builder's name Address_ ^,�/A Mass.Construction Supervisor's License No. NIA Expiration Date 60A 4. Addition - 5. Alteration ADD ,,el LID!a C Di M : 6. New Porch /✓6 7. Is existing building to be demolished? MCI 8. Repair after the fire 9. Garage &V A No.of cars Size 10. Method of heating Oi� �BJ'/�✓ 11. Distance to lot lines //' A D' 12. Type of roof 13. Siding house Vlvyl 14. Estimated cost:- iylZ� The undersigned certifies that the above statements are true to the best of his, her knowledge and tef. Signature ojresponsi6ie app,icant Remarks C0 i 3 a MAY 8 W8 �xfn >a 1rz#I �111�7 tII1 8 B },I{asaachctsctte e DEPARTMENT OF BUILDrNG INSPECTIONS 212 Main Street ' Municipal Building Northampton, Mass. 01060 WORKER'S COMPENSATION INSURANCE AFFIDAVIT (li censeeJpel-mi ttl;c> with a principal place of b jj.qjn ess/residence at-. 9:; - f=Kn .��:. 2C�Ue I Flc"RMp n► 010(10%- (phonef�) Stg-92.4$ (st1�t/city/stateJzi p) do hereby certify, under the pailis and penalties of pe£St1ry, that ( ) I am an employer providing the following v,ortem veage o tn fmy employees working on this job: (Insurance Company) (Policy Number) (,_xpim on Date) I am a sole proprietor; general contracror o (circle one) and have hired the contractors listed below who have the following worker's compensation policies: (Name of Contractor) (Insuran(_- Company/Poticy Number) (Expiration Date) (Name of Contractor) (Insurance Company/Pohcy Number) (Expiration Date) (Name of Contractor) (Insi=ce Company/Policy Number) (Expiration Date) ;i,:ar�te of Contractcr) (1'LSZ1=C1;Compauy/Policy NuLubcr) (Exp;—z Lion Date) (attach additicaal shed if noccs to iachidc infocautioa pertainuig to a ooat"n rs) a sole proprietor and have no one working for me. (.�I a home owner performing all the work myself. NOTE:please be awatn that whilo homcowD=who employ pca=w do aiam •,, fiction or repair work ou a dwelling of not moire:than thmo units is which the lwcrmeowncr rt:sides or on the groin appurtenant tharto arc not gcocrally 000ndcrcd to be -Vloyaa under the wocka'i=np=&s ca Act(GL 152,ss 1(5)�application by a homeowocr for a liccilsc or Pamir may cvi&noe the legal etahsa of an employer under tho Workoea Compeoi t Act I understxad that a copy of this ctatcmcat may be forwarded to the Dcpar�of Indautrial Acadcn&OISoo of Inwrsooe for the cove tge verification and that fail=to secure covango undex suction 25A of MoL 152 can lead to the imposition of criminal Penalties comistiag of a-fine of up to S1,500.00 wiNor imlxisonmcnt of tip to one year and civil peaalti cs in the form of a Stop W ode prdes and a find of 5100.00 a day against tnr– For dcputmmtll u-+e only Permit Number Map#--Lot# Sigriab=of LiccnseelPcrmitt,ce ` (G .f 1r N e MAY, 8 ! CE, of 'W arl]jail1P fall s + �iiasaxcftusrtte DEPARTMENT OF BUILDIXG INSPECTIONS ' INSPECTOR 212 Main Street ' Municipal Building Northampton, Mass. 01060 HOMEOWNER LICENSE EXEMPTION �5�98 (Please Print) DATE: JOB LOCATION: Z9 (Ma } (Parcel) ( Subdivision) HOMEOWNER- T (Name & Address ) ( 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 Loca ning Laws, and State of Massachusetts General Laws Annotated. HOMEOWNER SIGNATURE BUILDING PERMIT # , o some,' Depot #2662 , 179 DAGGET DRIVE,` W. SPRINGFIELD, MA 0108 Sun May 03 11: 28 11 1998 The materials in this deck will cost $1220 . 03 File saved as: c : \cgdesign\decks\5869268a .DEK 3D View F M AY 8 ' DEFT OF B, C ;Y to 4 MAY 8 1998 k- ¢pqq tA zz' Ro s t a i B 4 6 { R ti t 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 Existing Proposed By Zoning Lot size ) s Frontage Tr Setbacks - frnnt - side L: R: R: L:.�_ - rear 2v Building height I• S s� � !j Bldg Square footage %Open Space: (Lot area minas bldg ,-7-3 S��- •-700S V # of -Parking Spaces 101A # of Loading Docks NIA Fill: -(vol-ume -& location) 13 . Certification: I hereby certify that the information contained herein G is true and accurate to the best of my knowledge. .1 DATE: &-19� APPLICANT's SIGNATURE NOTE: Issuanoa of a zoning permit does not relieve a p ant's burd n to oomply Wito'au zoning requirements and obtain all required permits f e Board of Health, Conservation Commission, Department of Publio Works and other applicable permit granting authorities. FILE # 1 V MpY 8 X998 File No. (a e�;Sv ZONING PERMIT APPLICATION (§10 . 2 PLEASE TYPE OR PRINT ALL INFORMATION 1. Name of Applicant: JffftIgy A O:°iyV, V rt Address: /VA Tf1/2� �2• _Telephone: yt1,2__ 0,4062_ 2. Owner of Property: 5"if Address: G Telephone: 3. Status of Applicant: ✓Owner Contract Purchaser Lessee Other(explain): ^ 4. Job Location: �,� l ✓-�'✓ ( .Z '�� Parcel Id: Zoning Map#—= Parcel# District(s):_ -1 (TO BE FILLED IN BY THE BUILDING DEPARTMENT) 5. Existing Use of Structure/Property A2,1 rc. 6. Description of Proposed UseNVor roject/Occupation: (Use additional sheets if necessary F /VOTE. • i nc�i�Dt4 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) . I n FILE # v + f MAY 8 � APPLICANT/CO TACT PERSON: DEPT sir ADDRESS/PHO E: /4dU 7 1'72 -3 VdJ- PROPERTY LOCATION: /cJ Lam. MAP PARCEL: �,;/ ZONE_ THIS SECTION FOR-OFFICIAL USE ONLY: PERK UT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM VR,T,FD OUT Fee pnid Fee PAid 5'd ;26_lk— t/' _ Tvne of Construction- New Adfjition to Existing Building, Mans Included- 3 Sets THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS AP ICATION: Approved as presented/based on information presented II,_. 1 � Denied as presented: Sl (�G f rjP��aJ1r�L� S�' �S d 3U � Special Permit and/or Site Plan Required under: § \S�kQ . PLANNING BOARD ZONING BOARD Received & Recorded at Registry of Deeds Proof Enclosed — {,j 15 /UPS p Finding Required under: § w/ZONING BOARD OF APPEALS Received & Recorded at Registry of Deeds Proof Enclosed_ Jew v 641 dll 0 !/ Variance Required 6�_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 Conservation Commission Signature of Building Inspector Date NOTE:Issuanoe of a zoning permit does not relieve an applioant's burden to oompty 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 authoritles. ...� -. � � I .. 62,..�.,-.�.-•• FILE # 1*1 T/C®NTACT PERSON: ,,6ADDRE-SS/PIJONE: ZED- 7", Fff6PERTY LOCATION: MAP PARCEL: �'/ - ZONE THIS SECTION FOR-OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM EITLIED OUT Fee Paid Buil ing Permit Filled nut Fee Pnid Type of Conctrnrtion- New Construction Addition to Existing C ArrPCCpry ,';trllrtnrP T OLLOWING 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 P t fro .Vonse ati _olnmis i Signature of Building ector D to NOTE:Issuance of a zoning permit does not relieve an applioant's burden to comply with all zoning requirements and obtain all required permits from the Board of Health, Conservation Commission. Department of Publio Wcwks and other applicable permit granting authorities. f g � � r { Coy o x e Yu t v S k r y wax Town ST-nol p Sft '+x NT i. x ro- A filial, S r 104V Vol { e R too AT am a? € .. Won lie a IN sly ,r ny AS ANY s v i t F at F n .ti Z as � s. z Ln CA ri C4 tD �+ �• o �t S' 9) n A g• w rr y CA Ila n n CO2 mot rt n • y y oa hH -- rA. 5 an n /1 � ° �, �+ ' . s rt t3. ems► Olt i tos � Via• , °'q N) CD il IQ � y � � � � � � � �. o � big• ® °Q� c°o ° � �•�. o can 'E' A f9