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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. S� a Alterations
NORTHAMPTON, MASS. �� a b 19 a"V Additions
APPLICa ATION FOR PERMIT TO ALTER Repair
Garage
1. Location S4 1 N GT M Pr J r= Lot No.
2. Owner's name C W�A'( ,S Al I C Address S N 9 S l 1 f G?�1� f U i-
3. Builder's name -SQ M e Address
Mass.Construction Supervisor's License No. Expiration Date
4. Addition
5. Alteration �t�Sr�.n4 t3 rn '• 4? �/Gk /ep�cce iy•r�t(t;G.�S ��D t�G � eltef�C r r�A�tC SG�C ftdn , ld9Gj (,-1'e,c 4c,,Uf
t+tJ
6. New Porch
7. Is existing building to be demolished? MID
8. Repair after the fire
9. Garage No.of cars Size
10. Method of heating r?le Li r�
11. Distance to lot lines
12. Type of roof S "^ IR�2
13. Siding house Cedar
14. Estimated cost:- 10 •-/S thecrSI:4
The undersigned certifies that the above statements are we to the best of his, her
knowledge and belief.
Signature of responsible app icant
COQ
Remarks uf,I.i!7 Stnk �Gr+,t�� Ptr�t`cgf+etcPtf rr��.ic3 SfC.,P C`c4fuC t�ee•r�"�rct Ft�.,•- af�c#f.� h«r
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$ 6 .,� I A"r;assatllaaetla ;,
k OCT 2 8 1`' `'8DEPt TMENT O,a BUILDITIG INSPECTIONS `
212 Main Street ' Municipal Building
INSPECTOR '���, p g Northampton, Mass, 01060
HOMEOWNER LICENSE EXEMPTION
(Please Print)
DATE: N?
JOB LOCATION•
(Map) (Parcel) (Subdivision)
HOMEOWNER: C H Iq R z E S M i C K
(Name & Address )
5'L/ W q 41N&-'ro0 A u SAS °q 741 , 5 6 ')co Wed
(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 C A ' •f)')-d
BUILDING PEIZMIT # :,-
�
9 6` OCT 2 8 199$ tl:saachttvcIt%
u DEPARTMENT UP BUILDITNG INSPECTIONS
212 Main Street ' Municipal Building '
Northam-:ton, Mass. 01060 '
WORxCER'S Co',�IeENSAUON INSURA-NCE AFMAVU
>,. C H OR(-Es /n(6
(li�nsxJpermittcc)
%vith a principal place of businessJresidence: at:
�� 0)06�
6'� WON � 6,700 Pue �16k�t�a (phoner�) ui� °S S-1 ?y
(s'l1�u ct ty/scair_Ja p)
do hereby certify, under the pains and penalties of pegury that
O I am an employer providing the following workers compensation coverage for my ,
employees working on this)ob.
(Lnsi=cz- Company) (Policy Ntltnber) (Expiration Date)
O I am a sole proprietor, general coot actor or homeowner (circle one) and have hired
the contractors listed below who have the: following worker's compensation policies:
(7flam° of Cont,`rlCior) )is-a?o"a Date)
(Nallic of Contfa Ctor) - (11LS 2ilC OII1D u1\'/POt1C,'NllrIlG�r)-- (E?.-p1mulon Date)
(Name of Contractor) (Las-u-2acr Company/P oLcy NumbLr) (E\pimbon Date)
(Name of Contractor) (lnsurluce Comoa-•/Policy Nlamb-s) (Expiration Date)
(&ttach--MjtiCa.a1 C
rh (ifnCc�to informa_ica Potlining to all codsnc;n:-s)
O I am a sole proprietor and have no one wor�dng for me.
I am a home owner performing all the work myself.
NOTE:please be aw-im that xhilo homcoxacn x'.>o cep lay porno:to do m mtr-,•••n coa5z'ucti00'or rcpair work oa a disc Z of
aot morn Lb--n throo units in%%inch the bo -ocr rcxidca oc oa the yjouo,,apptutcn_r1 thGCto 10 Ccam1YY oomiducd to be
employm under tha Act(G L152_=If' appliration by a homeoxv s for n G«nx ee permit maY ev dente th
kgal ctstra of an amp loyoc under db wo"t Cowpomalio+i Ad
I uo&re and th:i a copy of.thu ch�may be forv�v id d to the Depnrm>m2 of jo>d d A,6&ote Of oo of Lr m r o foc t6.
covcszgc vcrMcatica and that U=to s==covcrabo under soc ion 23A of b(01-152 can Ind to tbd impoMtioa of crimmw peasltin
o0o,n3t WZ of a-fine of trp to S 1•SOOAO enNoc bnp-isoemcat of tip to one yar and dQ pcmtlia in the form of a Stop Work Order end a '
fine oCS100.00&.&Y LpisA me
. ' For d,p u"ocay
„ PcrtnitNutnbe?'
Si of-Li ccnscccrmiucc .
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. (
'1'�/� ( J
o 4 p r•• 6 b✓,(LI in) This cclamm to be filled in
/ by the Bnildiag 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
&paved parking)
# of -Parking Spaces
f 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 knowledge.
a
DATE: I G/���c7�' APPLICANT'S SIGNATURE
NOTE: Issuanoe of a zoning permit does not relieve an applioanVe burden to oomply w!Wall
Czoning requirements and obtain all required permits from the Board of Health, Conservation
ommission, Department of Publio Works and other appiiomble permit granting authorities.
FILE #
Is 1�
OCT 2 8 i998
ftEF1 File No. -N;?`
R1 A."ijN MA
ZONING PERMIT APPLICATION (§10 . 2)
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant: C H A R l.r K
Address: s LI WA S M IIV G 1 G IV �U c_ Telephone: SAS �1 c(
2. Owner of Property: A NN `E C N K t E S m l c�
Address: S'� WAS H /m,-To ry Telephone: IFS ^9 7N
3. Status of Applicant: Owner Contract Purchaser Lessee
Other(explain):
4. Job Location: URN JNHWO floofL pJ� ti
Parcel Id: Zoning Map#_&/)9 Parcel# District(s): �
(TO BE FILLED IN BY'THE BUILDING DEPARTMENoT)
5. Existing Use of Structure/Property W Op-k swop st d R AG E co, 06 F
6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary): No c)4aIR ,►; Vrc.
m5ulafe +,.tlof k M6p Jolr�we(I (JD C)p2f-adC efec4i,,c Serj,ce /Qdo( �A4S; o,+(e4 f
r
elect,-,c herf- n rep(cce d(d Sgs /�ne 0 Odd Sink AaHilpo,
wurlc mace ( febj,(J Y'fG,,'Cchr �o Per lctemc,f- w,id0c,'6 (( ;cpfGCc we^n f,ct�
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 PermitNadance/Finding ever been issued for/on the site?
NO—X_ DON'T KNOW _ 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)
File#BP-1999-0463
APPLICANT/CONTACT PERSON CHARLES MICK
ADDRESS/PHONE 585-9741
PROPERTY LOCATION 54 WASHINGTON AVE
MAP 31A PARCEL 198 ZONE.VAk
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid _
Building Permit Filled out
Fee Paid '
Type of Construction:
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/Occupant Statement or License#
3 sets of Plans/Plot Plan
THE LLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION:
proved as presented/based 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
A� 1 Well Water Potability Board of Health
Permit from Conservation mission
Signature of Building �ficial 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.
Reference No- BP-1999-0463
Department, ...................................
Building, Electrical & Mechanical Permits
.........................................................................................
Fee Type'. Receipt No:
Building - Renovation
ICI:(: 1999-0{)1265
.........................................................................................
..... ................................
Paid By: Paid in Full On:
(I
harles Mick Thu Nov 05,1998
............................. .............. ........................... ................
......................................
Received By- Check No:
Linda Lapointe 2411
.........................................................................................
.............................. .......
DEPARTMENT'S COPY Amount: $40.00
----------- -----_------
D 1`111ARTM E NT F 1,L E COPY 54 WASHINGTON AVE
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:
BP-1999-0463 $40.00
GIS Map Block: Lot: Address: Zoning: Use Group; Lot Size:
5806 31A 198 001 54 WASHINGTON AVE URB 11238.48
Contractor: License Type: Insurance:
Homeowner as Contractor
Address: License No.: Insurance No.:
LiLE State: Zip Code: Phone:
Project No: Category of Work: Const. Class: Cost Estimate:
JS-1999-0899 alteration-addition $10,000.00
Description of Work:
GARAGE SIDING & WINDOWS,PARTITION S,SINK
GeoTMS(D 1997 Des Lauriers&Associates,Inc. Signature: