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Zoning
,4iscellaneous Additions.Repairs,Alterations,etc. Tel.No. Alterations
NORTHAMPTON, MASS. 19 Additions
APPLICa ATION FOR PERMIT TO ALTER Repair
Q ,/ Garage
1. Location / e A4 Lot No.
-?7 Owner's name A)/j J ti i: pt&1.)KI TAI -Address 6 /C ,/,9/✓ /C,') A q
3. Builder's name :524M E Address
Mass.Construction Supervisor's License No. Expiration Date
:. Addition
3. Alteration
�. New Porch
?. Is existing building to be demolished?
s. Repair after the fire
>. Garage No.of cars Size
). Method of heating
'.. Distance to lot lines
'. Type of roof
3. Siding house
/Estimated cost:-
��>pU, v O
�he undersigned certifies that the above statements are we to the best of his, her
knowledge and belief.
Signature of responsible app,icant
emarks
O��NMfplO 1 �
6114 of 'War#iramptall
M r
$ .l uss Etc lr its atIs ^
DEPARTMENT OF BUILDING INSPECTIONS -
s
I SPECTCSI�'V 1 9 1'998 212 Main Street - Municipal Building %� t
t Northampton, Mass. 01060
HOMEOWNER LICENSE EXEMPTION
(Please Print)
DATE: �� ��= /�T, //� S�
JOB LOCATION• Y1
(Map) (Parcel) ( Subdivision)
HOMEOWNER: I J A 1-Ti=0 _7-/P,
j10 X/� (Name & Address)
y/n/ ILA 1) oo/61
(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
4 s
� k
R
NOV 91
DEP TMEITT OF BUILDING INSPECTIONS
212'Main Street ' Municipal Building
Northampton, Mass.* 01060
WORKER'S CMYTENI SATI O N' IN SURA-N CE A , 1 A r1'
(licettscrJpermi ucc)
vitL a principal place of residence at:
' (sir�!/ci ty/stalcla p)
do hereby certify, under the pains and penalties of perjury, chat:
O I am an employer providing the folloNVWg worker's compensation coverage for my
employees working on this)ob:
(Lns=icc Comfy) (P o Licy Number) (L-xpimtion 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 compemahon policies:
:{ (�iiltll- Oi ContilClof) (II1Si ^Cc COITIpa T)'/POl1C{�uL?tlrr) (~\7ltai?0a Date)
(i`iaunc of Coutractor) -- - 0-pssu:anec ComDaawPolic Xur ---r) (Expiration Date)
(Name of Contractor) Qostlrance Company/Policy Number) (Exp.ration Date)
(Name of Contractor) (Insurance Comoag•/Policy Number) (Expiration Date)
(attach--imitic"nccc(iracoea,.ry to iadudc icrc•rmi:ien pcxt minC W.13 ooatr C .�)
Y I am a sole proprietor and have no one wor4•dng for me.
( ) I am a home owner perfolTaing all the work myself.
NOTE:please be aurae alit wtriJc homcoHOm wt)o cmplay pa-som co do m: i •�comtructioa-or repair work on i d..tlling of
ant most tb_n Lbroo units in wbf i.cil the bomoouocr rniao oc oo the Uoun&zppuitcaani the ,o,not Cmm oomidcrod to be
cmploycn under tha veork='i oeaVcssstioa Ad(G L152-m t(5)),appU-15oa by►homcoavcr for a 60axx cc permit r -+Y c'rdcnoc tbc
legzl rt-,hu or as aaptoyx uader the Workces Compens.6ou Ave.
I aadczstAad tb,a a copy of lbi,mtccacai auy be for%vr to tbe.Dcv.v t of Ie6,b i al Ao6d Otto°of hxpm mo.fx tb.
covaagc vrrificaiioa aad tlsst fs u=to S,==covcta v uadcr soctioa 23A of MQL 152 an Ind to tbd impasitioa of tximiasl pcailtia
oogmtcn of&•fine tf up to s 1,�50oA_0 anNor impriso cat of up to om ycr.od an7 prmltia zo the form oCa Slop Work Ocder.ad>
find ors L00.00 a day-.Vdc d.tn�
- FordcpaCaxstat tiro oaty, .
Pcimit-Numbcr
bake
��� - ',�' � .,1� ,, � . .-,;,apt,��ioc:�-, • - ,
... L'.. .. - l
.S1gAww7I1:
-. - ...- ( .���J.:.✓ �.t..MM+..�4v"CY�Y�'�'«L1�Sw✓.� ... .... �:�Vh•.Ww+.wM--..f rr
/ f
10 Do any signs exist on the property? YES NO /s
IF YES,describe size,type and location:
Are there any proposed changes to or additions of signs intended for the property?YES NO v
IF YES, describe size,type and location:
11. ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE DENIED DUE TO
LACK OF INFORMATION.
This col-= to be filled in
by the Building IXpnrtment
Required-
Existing Proposed By Zoning
I Lot size
Frontage
Setbacks
- side L: R: L: R:
- rear -�
Building height
Bldg Square footage
%Open Space:
(Lot area minus bldg
&pac,ed parking;
# of Parking spaces
# of Loading Docks
Fill:
-(volume--& location)
13 . Certification: I hereby certify that the information contained herein
G is true and accurate to the best of my knowledge.
.a
DATE:_// S APPLICANT's SIGNATURE
NOTE: lu uanoe of a zoning permit does not relieve an applioant's burden to ply 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 authorities.
FILE ,#
s NO Y 9 ;998
File No. �� t
ZONING PERMIT APPLICATION (§10 . 2)
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant: 1 c'/-, 14 , ,CA 0
Address: Aydl-) k) `l.(;ZcwcA` Telephone: S Y-�yc�'
2. Owner of Property: SS /,,
Address: Telephone:
3. Status of Applicant: v/Owner Contract Purchaser Lessee
Other(explain): pp
4. Job Location: &/7ti" A0,4D /!CJ✓2 Of,c,�� Z,
Parcel Id: Zoning Map# - Parcel# District(s):
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/Property rw rNC,C
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.
S. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO DON'T KNO:tir I,' 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 l/ 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)
Reference No: BP4999-0514
Department: ...................................
Building, Electrical & Mechanical Permits
.........................................................................................
Fee Type: Receipt No:
Roofing Rf'C-1999-001396
......................................................................................... ..... ................................
Paid By: Paid in Full On:
Walter Sadlowski Jr Thu Nov 19,1998
......................................................................................... ......................................
Received By: Check No:
Linda Lapointe 1932
......................................................................................... ......................................
DEPARTMENT'S COPY Amount: S20.00
---------- -----------
DEPARTM U'INT FILE COPY 960 RYAN RD
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:
19 Nov, 1998 BP-1999-0514 $20.00
GIS Map Block: Lot: Address: Zoning: Use Group: Lot Size:
6868 35 051 001 960 RYAN RD SR 14941.08
Contractor: License Type: Insurance:
Homeowner as Contractor
Address: License No.: Insurance No.:
Li!n State: Zip Code: Phone:
Project No: Catep-ory of Work: Const. Class: Cost Estimate:
JS-1999-0981 roofing $2,000.00
Description of Work:
STRIP,PLY, & SHINGLE ROOF
GeoTIVIS@ 1997 Des Lauriers&Associates, Inc. Signature: