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Zoning
Miscellaneous Additions,Repairs.Alterations,etc. Tel.No. Alterations
NORTHAMPTON, MASS. 19 Additions
APPLICATION FOR PERMIT TO ALTER Repair
a
Garage
1. Location 3 C gL �� Lot No.
2. Owners name PA U L D. J,4 c-or3 S Address a 3
3. Builder's name -------— ! Address 514 e5—
Mass.Construction Supervisor's License No. Expiration Date
4. Addition
A. Alteration PLY/L21/C 771/2 C60 2C3OF LAC—��S INS TX Z-L A`/Lk/ ROOF'-
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 5 N A-1
13. Siding house
U,JA. Estimated cost:-
The undersigned certifies that the above statements are we to the best of his.
knowledge and".
Signature responsible app icant
Remarks
Grif� of wort 11milp fall
J�aaancltnarttn
PLAY 3 I99CIDEPARTMENT OF BUILDING INSPECTIONS _
INSPECTOR 212 Main Street ' Municipal Building '
Northampton, Mass. 01060
HOMEOWNER LICENSE EXEMPTION
f/ ( Please Print)
DATE: 3 ��I ��`� `�
JOB LOCATION:
Q (Map)/ (Parcel) (Subdivision)
HOMEOWNER: `a l P. Jq C-od.S a--3
(Name & Address )
F Lett f 1yC4f___ .58q-- 89 2-6/
(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 p CMR780 Section 109. 1 . 1
, . provided that the owner acts as supervisor.
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 undersigried "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
f•
1P
s" DEPARTMENT OF BUILDING INSPECTIONS
INSPECTOR 212 Main Street • Municipal Building '>,
Northampton,MA 01060
Applicant Information
Name------- PAUL JrgG �-----------
Location ----o23 _713------
City-- F-�� -- G -----�-- Q
�I am a homeowner performing all work myself
❑ I am a sole proprietor and have no one working in any capacity
❑ I am an employer providing workers' compensation for my employees working on thisjob.
Company Name ------------------- --
Address
City-- --- --- -----Phone#--------
Insurance Co._------------_—Policy#------ --_
Company Name
Address
City Phone#
Insurance Co. Policy#
Failure to secure coverage as required under Section 25 A of MGL 152 can lead to the imposition of criminal
penalties of a fine up to$1500.00andlor one years'imprisonment as well as civil penalties in the form of a STOP
WORK ORDER and a fine of$100.00 a day againstme. I understand that a copy of this statement may be
forwarded to the Office of Investigations of the DlAfor coverage verification.
I do hereby certify under the pairs and penalties of perjury that the information provided above is true and correct.
Signature Y Date 3 Z/V I 1�
Print Name Phone#
Official Use Only Do not write in this area to be completed by city or town official
City or Town PerrnitlLicense# ❑ Bu2drtcDept
❑Licensing Bond
Check if immediate response is required
Contact Person ❑Se�'D
Phone#
❑ HeaM%Dept.
s.
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_C,,--
IF YES, describe size,type and location:
11 . ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE DENIED DUE TO
LACK OF INFORMATION.
Thin column to be filled in
by the Building Department
Required
Existing Proposed By Zoning
Lot size
Frontage
Setbacks - frnnt
- side L: R: L: R:
- rear --�
Building height
Bldg Square footage
%Open Space:
(Lot area minus bldg
&paved parkingi
# of Parking Spaces
#
of Loading Docks
Fill:
Avolume-& location)
13 . Certification: I hereby certify that the information contained herein
is true and accurate to the best of my knowledge.
DATE: APPLICANT's SIGNATURE � ,C ,
NOTE: Issuance of a zoning permit does not relieve an applicant's ktq rden to comply With 4111
zoning requirements and obtain all required permits from the Board of Health, Conservation
Commission, Department of Public Works and other applicable permit granting authorities.
FILE #
9 t
MAY 31999
File No.'mot/
ZONING PERMIT APPLICATION (§10 . 2)
PLEASE TYPE OR PRSNT ALL INFORMATION
1. Name of Applicant: VC �I
c, k/ . t/q colt S
Address:a,3 CAH/LL,JNC— %LC /y 7-6141 Telephone: 5-8 r/�3
2. Owner of Property:
Address: Telephone:
3. Status of Applicant: _Jzowner Contract Purchaser Lessee
Other(explain):
4. Job Location: Si9�T'IE�
Parcel Id: Zoning Map# � _ Parcel# District(s): _
(TO BE FILLED IN BY THE UILDING DEPARTMENT)
5. Existing Use of Structure/Property RN S1 061V 7-//l L-
6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary):
7-AIZ /'APE/ .
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/Vadance/Finding ever been issued forlon the site?
NO DON'T KNOW ✓ee 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)
23 CAHILLANE TERR BP-1999-0911
G1S#: COMMONWEALTH OF MASSACHUSETTS
Map.Block: 35 - 109 1 CITY OF NORTHAMPTON
Lot.-001
Permit: Building
C�itegorv:roofing BUILDING PERMIT
Permit# BP-1999-0911
Project# JS-1999-1453
Est. Cost: $1500.00
Fee: $20.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group:
1,ol Size(sq. ft.): 10541.52 Owner: JACOBS PAUL D
7.01 Applicant:_
A_ T: 23 CAHILLANE TERR
Applicant Address: Phone: Insurance:
ISSUED ON.514/1999 o:oo:oo
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 5/4/1999 0:00:00 $20.00
212 Main Street,Phone(413)587-1240,Fax:(413)587-1272
Building Commissioner-Anthony Patillo