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29-063 (2) z a Om Lr) C: ft Z Z �. O CID C :U Zoning Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. 70 i Alterations NORTHAMPTON, MASS. 19 Additions APPLIC4a ATION FO PERMIT TO ALTER Repair Garage 1. Location g 4 r try�,f n l c-) K—.t r,12 Lot No. 2. Owner's name (tai I1)Cj�C- L�o ���lam' J�l�• Address -1► 3. Builder's name DniaL 7'cCb Zor _ Address c7X 010 q ti"I udKe , pljr Mass.Construction Supervisor's License No.g, _Expiration Date 11.14, 4. Addition 5. AlterationOC�►� i 6. New Porch 7. Is existing building to be demolished? I\J a 8. Repair after the fire 9. Garage No.of cars Size 10. Method of heating prupd 11. Distance to lot lines 3aek(4 0, eco- 12. Type of roof 13. Siding house 14. Estimated cos - J 0 O The undersigned certifies that the above tatemcnts are we to the best of his, her knowledge arLd belief. 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C7 m 4 (mn H,, n '� H ,�r�; H 3•�yz = ` 0 H m 9'H y'G .. r r7 Fl e t-im r z aoo `3" m.a o m o z �..ia.I H O ro N 0 N-4- N n Hr H H O w Pj oo0 G x oHH omw qd z H oo00o (D mow mom m •• H H N r'o N 10 w H O H oom o00 o ro m ooa o00 o io w 111 1 l L 4u` Lj I {' I N I c f1 �� u no OAT 1l/af A�• ? .Y. ..> ii• .;?i'a..-�3�i"?}�„ a �z z I sat fU T � ,, LPA,,1 LINT'OF BUILDING INSPECTIONS ' INSPECTOR 3+ 12 Main Street ' Municipal Building 41EPQF�=' Northairipton, Mass. 01060 HOMEOWNER LICENSE EXEMPTION (Please Print) DATE: ol 9cp JOB LOCATION: -p L 6, (Map) ( Parcel ) (Subdivision) HOMEOWNER: ffi d]I C' , i sn //6 )R C t C (Name & Address ) 7 , YJ)l0 (Home Phone) Work Phone) The current exemption for "home wners" was extended to include Owner-occupied Dwellings of one ( 1 )or ttvo (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__%.,ork performed under the bui ldinq 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 . a 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 lial)le 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. r ? HOMEOWNER SIGNATURE BUILDING PF,RMIT ## 0 JUL f 51,998 of 'Wart4ttntptuil 9 �asaachnsrtta 5 DEPARTMENT OF BuiLDrNG INSPECTIONS 212 Main Street ' Municipal Building a Northampton, Mass. 01060 SV�y WORKER'S COMPENSATION INSURANCE AFMI A.VIT (licezls Peimittee) with a principal place of business/residence at: _ l! i(l a re/- (phone#) �O (st=Ucity/statelap) 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 Daze) Y I am a sole proprietor, general contractor o homeowner ' cle one) and have hired the contractors listed below who have the following wor e s compensation policies: (Name of Contractor) (Insurance Company/Policy Number) (Expiration Date) (Name of Contractor) (Insurance Compary/Poliq Number) (Expirauoa Date) (Name of Contractor) (Insurance Compare/Policy Number) (Expiration Date) (Name of Contractor) (Insurance Company/Policy Number) (Expiration Date) (attach additioml shoot if nearssry to include inform on pertaining to all ooatm ors) ( ) 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 pazom to do mam,Im.nce c=tuuctiou or repair work on a dwelling of not more than three waits is which the homeowner reidcs or oa the gounr appruteaarri th=w an not generally ooasidemd to be employers under the worfcces oompatsatica Act(GL152,ss 1(5)),application by a homeowner for a Uccax or permit may evidence the legal status of an employer under the Worker's Compaoutioa Ac I understand that a copy of this stat=ed may be forwarded to the Dcpertmcat of Industrial Ac=dmti Office of Imuuance for the ooverago verification and that failure to secure coverage under section 25A of MGL 152 can lead to the imposition of criminal penalties ooaibaing of a fine of up to S1,500.00 andlor imprison of up to one yew and civil pc mtWes in tf>c form of a Stop Work order and a fine of 3100.00 a day against ttte. For d putt W use aalY Permit Number p/y?� Mao -- L-ot# o Li CC rtnitice f a 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,.,OL IF YES, describe size,type and location: 11. ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE DENIED DUE TO LACK OF INFORMATION. This —7— to be filled in by the Building Department Required Existing Proposed By Zoning Lot size 7 17 �� �C.),UU—v Frontage J Setbacks ---- - side L: Ruza�_*_ LA�L__R: - rear Building height o20 Bldg Square footage 7 r°�_^A-roo t l —M,.4V %Open Space: (Lot area minus bldgP�� 90f &paved parking) /// J # ., f Parking Spaces ffof Loading Docks Fill: 4 vol-time--& location) 13 . Certification: I hereby certify that the information contained herein is true and accurate to the best of my knowled e. _1 DATE: 7`- I(? APPLICANT s SIGNATURE ' NOTE: lssuano® of a zoning permit does not relieve an appiloant' b r n to 0o wit4'.�111 zoning requirements and obtain all required permits from the Board of Health, nservetion commission, Department of Publio Works and other applionble permit grantin uthoritias. FILE # JUL 1 519W 4�, DEPT OF Blt' ^,;.,�«� � File No. P J 0 NORi ZONING PERMIT APPLICATION (§10 . 2) PLEASE TYPE OR PRINT ALL INFORMATION 1. Name of Applicant: tilt 1 h cu(w\ r, Address: q 9 Gj rte► n 7c-r(\ra Telephone:_ 2. Owner of Property: .f)0 h rj_A4,\ C _ ln 6e JIP , Address: �7 / r-nj 1 1 e P Po C E� Telephone: 7Q L_7 _7 3. Status of Applicant: _Owner Contract Purchaser Lessee Other(explain): 4. Job Location: �� ^ Parcel Id: Zoning Map#4�2 Parcel# District(s): (TO IN BY THE BUILDING DEPARTMENT)- 7 5. Existing Use of Structure/Property v 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/Variance/Finding ever been issued for/on the site? NO DON'T KNOVV__ 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) Department: Reference No- BP-1999-0056 ................................... Building, Electrical & Mechanical Permits ......................................................................................... Fee Type: Receipt No: Above ground pool REC-1999-000070 .................*..................."......"...... ................................. ...................................... Paid By: Paid in Full On: William Loiselle Jr Wed .ful 15,1998 ................. ....................................................................... Received By: ... .................................. Check No: Linda Lapointe 1398 ......................................................................................... ...................................... DEPARTMENT'S COPY Amount: $20.00 ........................... DEIPAR,rMENTFILE COPY 39 GILRAIN TERR 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: Trackint!No.: Fee: BP-1999-0056 $20.00 GIS Map Block: Lot: Address: Zoning: Use Group: Lot Size: 4789 29 063 001 39 GILRAIN TERR URA 17685.36 Contractor: License Type: Insurance: Homeowner as Contractor Address: License No.: Insurance No.: 9-ty-i State: Zip Code: Phone: Project No: Category of Work: Const. Class: Cost Estimate: JS-1999-0067 Above ground pool $4,100.00 Description of Work: INSTALL 27'ABOVE GROUND POOL GeoTMS@ 1997 Des Lauriers&Associates,Inc. Signature: r ..r w File#BP-1999-0056 APPLICANT/CONTACT PERSON William Loiselle Jr ADDRESS/PHONE 39 Gilrain Terr (413)582-7017 O PROPERTY LOCATION 39 GILRAIN TERR MAP 29 PARCEL 063 ZONE URA/WSP THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out Fee Paid / ✓ v Type of Construction: New Construction r� ELI Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/Occupant Statement or License# 3 sets of Plans/Plot Plan TZeLL' OWING ACTION HAS BEEN TAKEN ON THIS APPLICATION: Approved as presentedibased 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 oard,of,Health Well Water Potability Board of Health Permit from Conservation mmisssioon/ Signature of Buildin facial 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.