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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. / Tel.No. �� Alterations
NORTHAMPTON, MASS. rl r �l 19 Additions
APPLICa ATION FOR PERMIT TO ALTER Repair
Garage
1. Location / Lot No. j
2. Owners name Z A w dy to 4 c auz Address ��� �+�✓�S „��r?� ��/ 1C/z,,.Legce
3. Builder's name SL CD Le A4 �c� ,� Address 34 dy cat,e, J D✓ Fl c✓r ure t t A
Mass.Construction Supervisor's License No. Expiration Date
4. Addition
5. Alteration
6. New Porch —
t .�o„ir` G�
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
13. Siding house
14. Estimated cost:- � 2�(J� 00
7 The undersigned certifies that the above statements are we to the best of his, her
knowledge and belief.
2 --
Signature of responsible 6P ,cant
Remarks
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DEPT OF BU' iMSPECTIONy, DPPARTMENT OF BUILDIT G INSPECTIONS
INSPECTOR �- 212 Main Street ' Municipal Building '
Northampton, Mass. 01060
HOMEOWNER LICENSE EXEMPTION
(Please Print)
DATE:
JOB LOCATION:
(Map) 1 (Parcel) (Subdivision)
HOMEOWNER: c� -A n d y t 4 1—e b Q L'
(Name & Andress)
(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 #
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APR 1 31999
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DEPT OF B INSPECTnOtr�
m DEPARTMENT OF BUILDING INSPECTIONS
212 Main Street ' Municipal Building '
Northampton, Mass. 01060 '
WORKER'S COMTENSA`T ION INSURANCE A t t AVIT
with a principal place of businessJresidence at:
(phone#)
(stme i/ci ty/SLUC/zs P)
do hereby certify, under the pains and penalties of pegury, that:
( ) I am an employer providing the following worker's compensation coverage for my
employees wor—ng on this job:
(Insurance Company) (Policy Number) (Fxpiration Date)
1 I am a sole proprietor, general contractor r homeowner cle one) and have hired
the contractors listed below who have the following wor e1's compensation policies:
(Name of Contractor) (Lnsurancc Company/Policy Numbcr) (Expiration Date)
(Name of Contractor) (Insurance Company/Poky Number) (Expiration Date)
(Name of Contractor) (Imurance Company/Policy Number) (Expiration Date)
(Name of Contractor) (Insurance Cotnpany/Policy Number) (Expiration Date)
(attach additiooit sbcc(tfnocasary to mchxk inform+IIon pc:taunng to all ooafrad4n)
( ) I am a sole proprietor and have no one worlang for me.
am a home owner performing all the work myself.
NOTE:please be awuc that whAo homco"-ncn wbo employ pcti to do—,Tf ,moc coastrucuoa or repair work on a dwelling of
not moan than throo units is vAnch the bomrww mr r=den or oa the grounds appurtcnaat there wv ox gawrally ooasidcrcd to be
cmployera ruder the woziccr's oompcnu4on Act(GL1524=1(5)),apptiertion by n homeowner far a ticcnsc cc permit may cvidcaoc the
legit etatts of an omployer under tbo Workoeg coatponsalion AeL
I understand that a oopy of thin sZstzmcoi may bo forwarded to tbo Aoci�O1Soe of la"'o'for dw
oovaa ge verificatioa and that failure to too=covcrnga under section 25A of MOL 152 can lad to tbo'impontson of aiminal Penalties
oomisting of a fine of up to S 1.500.00 sad/or impri3otmxnt of tip to one yur and ciYU pemttia is the form of a Slop Work Otder and a '
find of Stoo.00 a day t:gdnat tae.
For dq=twcabl uao only
Permit Number
Iot#
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�.�� APR 1 31999
?Fpz OF ALE
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1 \
ins a 'st on the roe YES NO
10 Do any signs � property?rte/?
• t
IF YES, describe size,type and location:
Are there any proposed changes to or additions of signs intended for the property?YES NO y
IF YES,describe size,type and location:
11 . ALL INFORMATION MIDST BE COMPLETED, or PERMIT CAN BE DENIED DUE TO
LACK OF INFORMATION.
Thin columm to be filled in
by the &uilding Drpartmeat
Required
Existing Proposed By Zoning
Lot size /, Ol "'l I-e�
Frontage
Setbacks - frnnt
- side L: d R: L: `- R: —
- rear --
Building height
Bldg Square footage / 74r
%Open Space:
(Lot area minus bldg
&peved Fay ICLn i
# of -Parking spaces
#
of Loading Docks
Fill:
-(volume -& location)
13 . Certification: I hereby certify that the information cont "ne herein
G is true and accurate to the best of my knowledge
L
DATE: �-- APPLICANT'S SIGNATURE
NOTE: 1 suanoe of zoning permit does not relieve an applioa s burden comply wit" oil
zoning requirements and obtain all required permits from the oard of HAflalth. Conservation
Commission. Department of Publio Works and other applioable permit granting authorities.
FILE #
y� t
APR
Fi 1 e No t
DEPT OF Sll IPdSPECT'��t+
. ----"'°TONING PERMIT APPLICATION (§10 . 2)
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Ap licant:
I K �
Address: elephone: _ g 670
2. Owner of Property: �d i'b L')
Address: V�7{�cl /V- Z!rfelephone:
3. Status of Applicant: Owner Contract Purchasgr Lessee
Other(explain):
4. Job Location: _ {�
Parcel Id: Zoning Map# j2? Parcel# District(s): t
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5, Existing Use of Structure/Property
6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary):
zA . y 16, Zie�L- -?k Vet-Mc
ZL4�&, /'
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 KNO:^:�_ 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 Z 1 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-1999-0837
APPLICANT/CONTACT PERSON LEBEAU ANDREA M&EDWARD R
ADDRESS/PHONE 577 BURTS PIT RD 584-6708
PROPERTY LOCATION 577 BURTS PIT RD
MAP 29 PARCEL 555 ZONE URA
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out
Fee Paid
T_ypeof Construction: EXISTING 12 X 16 DECK FOR PORCH W/SLIDER&WINDOWS
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included•
Owner/Statement or License
3 sets of Plans/Plot Plan
THF„FOLLOWING 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
z ` Well Water Potability Board of Health
rP:i` x 4i
Pernut from Conservation mmission
Signature of BuildingOOfficial 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.
'.� u�'
577 BURTS PIT RD BP-1999-0837
GIS#: COMMONWEALTH OF MASSACHUSETTS
MW-Block:29-555 CITY OF NORTHAMPTON
Lot:-001
Permit: Building
Category:alteration-addition BUILDING PERMIT
Permit# BP-1999-0837
Project# JS-1999-1483
Est.Cost:$2250.00
Fee:$40.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group:
Lot Size(sg.ft.): 43995.60 Owner: LEBEAU ANDREA M&EDWARD R
Zoning:URA Applicant—
AT.- 577 BURTS PIT RD
Applicant Address. Phone: Insurance:
ISSUED ON.•41wig99 o:oo.oo
TO PERFORM THE FOLLOWING WORK.-EXISTING 12 X 16 DECK FOR PORCH W/SLIDER &
WINDOWS
POST THIS CARD SO IT IS VISIBLE FROM THE STREET
Inspector of Plumbing Inspector of Wiring D.P.W. Inspector of Buildings
Underground: Service: Meter: -
Footings:
Rough: Rough: House# Foundation:
Final: Final:
Rough Frame:
Gas Fire Deaartment Fireplace/Chimney:
Rough: Oil• Insulation:
Final: Smoke: Final: 6 r /2-V•`t q
THIS PERMIT MAY BE REVOKED BY THE CITY O NORTHAMPTON UPON VIOLAT 6N OF
ANY OF ITS RULES AND REGULATIONS.
Certificate of Occupancy
Fee Type: Receipt No: Date Paid: Check No: Amount:
Building 4/16/1999 0:00:00 $40.00
212 Main Street,Phone(413)587-1240,Fax:(413)587-1272
Building Commissioner-Anthony Patillo