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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. S Y �� Alterations
NORTHAMPTON, MASS. 19 Additions
APPLICATION FOR PERMIT TO ALTER Garair
Garage
LLocationJ y t-1 /)(2 f 2 8RCf2tk Lot No.
Q--Olner's name �� Address��{ - 4C f a 04
3. Builder's name Address
Mass.Construction Supervisor's License No. Expiration Date
4. Addition 2 1/3�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
13. Siding house
mated cost- C>
undersigned certifies that the above statements are true to the best of his.
L,- knowledge and belief.
SgRaiure of responsible app scant
Remarks
i��4'SKMIpTOy (�
c �� ., 1�836AC��l18ttI8
FEB 2 2 2004
m DEI?fiR�TMENT OF BUILDING INSPECTIONS
INSPECTOR t °-.c21- 2 Main Street ' Municipal Building '
Northampton, Mass. 01060
HOMEOWNER LICENSE EXEMPTION
f v�
DATE: eyvc (Please Print)
l dy (�^
JOB LOCATION.
� (Map) (Parcel) (Subdivision)
vHOMEOWNER:
(N rAddress)
) SS 6,)062_ 58y 3�°�,
(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
Gen al Laws Annotated.
OMEOWNER SIGNATURE
BUILDING PERMIT #
4 T
�0 � 0 y
9 P1
FEB 2 2 2000 " asEArt(RSrttE
DFpARTMENT OF BUILDENG INSPECTIONS
E('1 0F 8! {F�''72`2 Main Street ' Municipal Building
2rTorthampton, Mass. 01060
WORKER'S COWL ENSATION INSURANCE A YMAVIT
- ,C
-------
with/a principal place of business/residence at:
(su-�t/ci ty/stalcin p)
do hereby certify, under the pans and penalties of pequiy, that
( ) I am an employer providing the following worker's comFensanon coverage for my
employees working on tills job:
(Insu=ce Company) (Pe1icy Nu nbcr) --_ (Expiration Date)
( ) 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:
(Nome of Contractor) (Insurance Company/Poticy Number) (Expirnion Datc)
(Name of Contractor) (Insurance Comparyi?oLicv Numc°r) (Expiration Date)
(Name of Coatnctor) (Insuranc Company/Pokcy Number) (Expiranoa Date)
(Name of Contractor) (I-tistuance Company/Policy Number) (Expiration Date)
(attach additiccal shoct ifnecessary to mchvc c iaformaIion pcztaining to all xcvrado a)
O I am a sole proprietor and have no one working for me.
am a home owner performing all the work myself.
NOTE:please be aware that wtt:lo homcrntincra wbo cmplay pczioas w do=Lij:�cor==ction or repair work on a dwcrling of
not mote than throe units in which the homy owncr resides or oo the go,z appurtcasni thactn arc oot gcnaally 000sidcrcd to be
earploycn undo the veoaic�compr;:s4m Act(GL152,sa 1(5)),applimbon by a homrow=for a license cc permit may Mdcnoc the
Icgal ctatiia of au employer under the Workce&Compomatioo Act_
I unders and that a copy of this etatc rif may be forwami.ed to rho Dcgwt� 2 of rndw,"rial Arridarb'Offioo of lrL"lirari0a for tho
coverage vaificstioa and that failurc to scam coven under section 25A of MGL 152 can Icad to the imposition of crimiwd penalties
coasutnrg of a fine of up to S 1,540.00 andlor imps-moemcat of up to one year and civil pmaltia ie the form of a Stop Wo&Ord-and a
fim cf S 100.00 a day against mc.
For dcpartootc;t l uac poly
r Permit Number
_ Mao Lot n _
Si of Liccnsce/Pcrmittce �
10. Do any signs ebst 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 cola= to be filled in
by the Bnildiny Lbpartment
Required I
Existing Proposed By Zoning
Lot size
Frontage
Setbacks _
- side L• R: L: R:
- rear
Building height
Bldg Square footage
%Open Space:
(Lotarea minus bldg
&paved parking)
# of -Parking Spaces
f of Loading Docks
Fill:
{vol-ume-4 location)
13 . Certification: I hereby certify that the information contained herein
is true and accurate to the best of my knowledge.
D E: _01 ICANT's SIGNATURE
OT
E: lasuanoe of a zonin mit does not relieve an applioont's burden to comply Wit" all
zoning requirements and obtain all required permits from the Board of Health, Conservation
Commission, Department of Publio Works and other applioabla permit granting authorities.
FILE if
o FEB 2 z u
File No. 73
FPT OE SU �'�INSPECTIONS d
MA X1660
ZONING PERMIT APPLICATION (§10 . 2)
PLEASE TYPE OR PRINT ALL INFORMATION
�ame of Applicant:
� r e 09 Y?"/� ! Telephoner G�ress:a yA t
2. Owner of Property:
Addresso-114 y 4 c r P of 44-r 1-141ae Z&- Telephone: s 8 14�
3. Status of Applicant: `. Owner Contract Purchaser Lessee
Other(explain): 9
✓4. Job Location:
Parcel Id: Zoning Map# Parcel# � District(s): G --
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/Property
r_
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/Vahance/Finding evefor/on the site?
NO DON'T KNOW �4- 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 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
244 ACREBROOK DR BP-2000-0736
GIs#: COMMONWEALTH OF MASSACHUSETTS
MaRBlock:29-335 CITY OF NORTHAMPTON
Lot: 01
Permit: Building
Cate gm: oodstove BUILDING PERMIT
Permit# BP-20QO-0736
Pro,�ect# JS-2(300-1366
Est.Cost:$0.00
Fee: 25.00 PERMISSION IS HEREBY GRANTED TO:
Const."Class: Contractor- License:
Use Group:
Lot Size(sq.fo: 10018.80 Owner` ALVARDO JOSE ANTONIO&YOLANDA
Zoning:URA Agg icunri ALVARDO JOSE ANTONIO & YOLANDA
AT-244 ACREBROOK DR
Applicant Address. hh one Insu�ranee'
244 ACREBROQK DR
FLORENCEMA01062 ISSUED ON.'2 23104 0:00:00
TO PERFORM THE FOLLOWING WORK:INSTA,LL WOODSTOVE
POST_THIS CARD 5O 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 Department Fireplace/Chimney:
Rough: il: Insulation:
"Final•.. Smoke•
Final: (5 r,-
THIS PERMIT MAY BE REVOKED BY THE CIT OF NORTH N' 'VO LATION OF
ANY OF ITS RULES AND REGULATIONS.
Certificate of Occupanc si nature:
Fee Ty pe� Receiiut Nom ate Paid- Check No: Amount:
Building 2/23/00 0:00:00 4294 $25.00
212 Main Street,Phone(413)587-1240,Fax:(413)587-1272
Building Commissioner-Anthony Patillo