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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations
aNORTHAMPTON, MASS. 19 Additions
APPLICATION FOR PERMIT TO ALTER Repair
,./ f Garage
1..L Location 1111 r Lot No.
11 Owner's name �•�Wkc!!� �S(-( 'I, Address c:2mr
3. Builder's name Address
Mass.Construction Supervisor's License No. Expiration Date
4. Addition 11
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
k1f.--Type of roof S
13. Siding house
VY"Estimated cosL- C O , C)o
�e undersigned certifies that t ove star is are true to the best of his.
owle e belief
Signature of responsible app icant
Remarks
t �
sCrier of wart 11a»r}rfoil _
DEPARTMENT OF BUILDING INSPECTIONS
INSPECTOR- 212 Main Strect • Municipal Building
Northampton, Mass. 01060
OCT 2 1 1999
HOMEOWNER LICENSE EXEMPTION
( Please Print )
DATE;
JOB LOCATION:
-_� (Map) ( Parcel ) ( subdivision)
wN E R: Jy�1 Swt3 l_.t0QY9< i -N torQ&cp 1�
(Name & Address )
� '__7 TiC. - S-C-C -?a X a
(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
coristruc.ts more than *one home in a two-year . per-iod shall not be
considered a homeowner. Such "homeowner" shall submit to t B
he uilding
Official , on a form acceptable to the Building Official, that he/she
shall. be responsible for all such work performed under: the bui°ldihi
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.
Als.o 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 undersigried "homeowner" certifies and assumes responsibility
for compliance with the State Building Code , City of . Northampton
Ordinances, State and Local Zoning and State of Massachusetts
General Laws Annot-a
VH
` OMEOWNER SIGNATURE
BUILDING. PEf2MIT
M-
�O4�HAMpTO
s OCT 2 1 1999 Of 'Wert4amptun
$e � �liSfa[l�nftllE
DEPARTMENT OF BUILDWG INSPECTIONS '
212 Main Street ' Municipal Building '
Northampton, Mass. 01060 '
WORKER'S COMPENSATION INSURANCE AFFIDAVIT '
(��UAae-O-A<�
oicense&permittee)
with a principal place of business/residence at:
` a C�— re*-Ce W\ O t `(phone#) �
(stMWcity/staW2iP)
do hereby certify, under the pains and penalties of perjury, that:
( ) I am an employer providing the following worker's compensation coverage for my
employees working on this job:
(Insurance Company) (Policy Number) (Expiration Dale)
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:
� Mco C
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(attach addi6ocal shed if neoessary to include infotmaaoa pataining to all ooatractors)
( ) I am a sole proprietor and have no one working for me.
( ) I am a home owner performing all the work myself.
NOTE:please be aware that while homeowners who employ pemm to do maiatcnzacr,oonstnwion or repair work an a dwelling of
not more than three units is which the homeowner resides a m the grounds app=tenantthrnto are not generally oom idered to be
employers under the worker's oompensation Act(GL152,n 1(5))�application by a homeowner for a license cc permit may evidence the
legal status of an employer under the Worirees C,ompamation Act
I understand that a copy of this statement may be forwarded to tho Departmant of IndWhial AoddaW Office of laxuwoe for the
ooverage verificatioe and that failure to secure coverage under soction 25A of MGL 152 can tad to the imposition.of aimioat penalties .
Consisting of a fine of up to S1,5W-00 andlor i vrisomnent of up to one year and civil pemhia in the form of a Stop Work order and a
Sao of$100.00 a day spier t me.
For dgmt n=W use only
/ . Permit Number
✓ Mao _Lot#
awt�ilr��• �., iceosee•JPermittx
V
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 =2== to be filled in
by the Baild=g Department
Required
Existing Proposed By Zoning
Lot size
Frontage
Setbacks
- side L• R: L: R:
- rear
Building height
Bldg Square footage
%Open Space:
(Lot area minus bldg
&pat,ed parkingi
# of -Parking spaces
t of Loading Docks
Fill:
{vol-ume--& location)
13 . Certification: I hereby certify that the information contained herein
is true and accurate to the best of my wled YA
ICANT's SIGNATURE
issuanoe
of a zoning permit does not relieve nap li nts burden o oompty with .atl
zoning requirements and obtain all required permits the Board of Health, Conservation
Commission, Department of Publio Works and other applioabla permit granting authorities.
FILE #
x
OCT 2 1 1999 ti
File No.
ZONING PERMIT APPLICATION (§10 . 2)
PLEASE TYPE OR PRINT ALL INFORMATION
Name of Applicant:
,/Address: (�Ce Telephone: 5 'At
VA_
2. Owner of Property: t5 �
Address: Telephone:
3. Status of Applicant: ✓,/Owner Contract Purchaser Lessee
Other(explain): f
4. Job Location: '7" l TJ�
Parcel Id: Zoning Map#_"� - Parcel# District(s):
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/Property
Description of Proposed Us or roject/O cupation: (Use ad itionaI h ets 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 4- 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--.44
41 ALAMO CT BP-2000-0437
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 29- 130 CITY OF NORTHAMPTON
Lot:-001
Permit: Building
Category:roofing BUILDING PERMIT
Permit# BP-2000-0437
Project# JS-2000-0751
Est. Cost: $6000.00
Fee: $25.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Groin
Lot Size(sq.ft.): 12283.92 Owner: SMOLENSKI JOHN A&ELLA L
Zoning:URA Applicant:_
AT. 41 ALAMO CT
Applicant Address: Phone: Insurance:
ISSUED ON:1012111999 0:00:00
TO PERFORM THE FOLLOWING WORK.-STRIP & SHINGLE ROOF
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 Department Fireplace/Chimney:
Rough: Oil: Insulation:
Final: Smoke: Final:
THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF
ANY OF ITS RULES AND REGULATIONS.
Certificate of Occupancy Signature:
Fee Type: Receipt No: Date Paid: Check No: Amount:
Building 10/21/1999 0:00:00 $25.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Building Commissioner-Anthony Patillo