17D-013 (7) X1 'C
C
< ;V
III CO
C '0 3. -v
. a — 3 0 O m cn
` ° R b =
F w
env..`' N _
�- n "'s Z
,��i j - f Z b CA 0
'
Cr
!,a ,r4 n
Zoning
Miscellaneous Additions, Repairs, Alterations, etc. Tel. No. Alterations
?%r NORTHAMPTON, MASS. 1 9 Additions
t ccc"
APPLICATION FOR PERMIT TO ALTER Repair
a Garage
1. Location C Ci I, t (I 7 GA r f r 1 ri It J ( , Lot No.
2. Owner's name .c'ert t'V ).-1-p› K Address 5 ia-vt d 7 r r tn! e• 1d r ie-
3. Builder's name ce et rl / . %, /c- Address J to vi `- 7 (p- f ri e 1 cd k U e
Mass. Construction Supervisor's License No. Expiration Date
4. Addition
5. Alteration
6. New Porch j l,l c -i" t"I,ti.St;. k f a C . J) Y r >( � l
7. Is existing building to be demolished? k-) C,
8. Repair after the fire N C)
9. Garage i■..; ' 4 No. of cars Size
10. Method of heating IT I f}'
11. Distance to lot lines
12. Type of roof
13. Siding house
14. Estimated cost: -
N. 0-ti 1
5 ��' -'. �-`' The undersigned certifies that the above statements are true to the best of his, her
knowledge and belief.
r 41 Lt cri:). L)-1---' - 1 .-9-i- 1- sc . , d)zriw 4/1--
"./ Signature of responsible applicant
Remarks
/ .
... .„_ --..
. /
_
,..
A i ...,--)
,
,r ,
1,
.. i \
.■
\ - f
\ IL.'
...- _
I
.... -
. I -.- ••.,
•''''""
4-
1
I
4
I ,
' 1
1'
1 f .
! X", 4 - I
r I •
1
t 1 v
......4 I
.. ...4.-........: t _ L
- J
- _
i L!!."_ . , , • - f <-- (..) _ IL -..-
i
r
‘-'i /,__ - i -
,..._
)
• � o 4•c TO 4,. t 998 (Cx >a CTZ X111 1 — # °'
s 411 '
4.:4 � , i 1 0. p 1 ' ►_—
, • { / y ` • . it , f � JUl_ 2 1 a53Atl(ItStllII e�'o
�W s, DEPT OF ' £ ; ,'l 1 LPAPTMENT OP BUILDING INSPECTIONS ='_` i
212 Main Street • Municipal Building
.
Northampton, Mass. 01060 •
NMI yam
WORKER'S COMPENSATION INSURANCE AI'F DAVIT
1 , — E4/ .
(li permittee)
with a principal place of business/residence at:
-f `7 (ii ti e' // ge e 1'1(4 eilcc ti 6A,(„2 (phone #6 3) 54 /
(street/city/state/71p)
do hereby certify, under the pains and penalties of perjury, that:
( ) 1 am an employer providing the following worker's compensation coverage for my
employees working on this job:
(Insurance Company) (Policy Number) (Expiration Date)
( ) 1 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:
(Name of Contractor) (insurance Company/Policy Nuinnbcr) (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 additioaal sheet if necessary to include information pertaining to all contractors)
( ) I am a sole proprietor and have no one working for me.
N 1 am a home owner performing all the work myself.
NOTE: please be aware that while homeowners who e play persons to do mwintrnnnrr, construction or rcpa-ir work on a dwcilicg of
not mote than throe units in which the homeowner resides or oo the grounds appurtenant thereto are not generally ooasidcrcd to be
employers under the worker's compensation Act (GL152,ss 1(5)), application by a homeowner fora license or permit may evidence the
legal crams of an employer under the Worker's Compensation Act
I understand that a copy of Oita statement may be forwarded to the Department of Industrial Aociders Offioo of Insurance for the
coverage verification and that failure to secure cove-rags under section 25A of MOL 152 can lead to the imposition of criminal penalties
comisting of a fine of up to S1,500.00 and/or imprisonment of up to one year and civil penalties in the form of a Stop Work Order and a
fine of 5100.00 a day against tae. ' "
For departmental use only
44 9 bA2/ Permit Number Map# Lot #
(� Da
v �iSt» of LiccnscelPermittee
:rxa~x
•
" 1 1$ ...o. 0* of XorfIj&ntptou = *_ L+
4
, DEPARTMENT OF BUILDING INSPECTIONS 4 `_
INSPECTO'7 J - 2 1 I � 8 212 Main Street ' Municipal Building
g
Northampton, Mass. 01060 us "'
DEPT Of
HOMEOWNER LICENSE EXEMPTION
DATE: / / J (Please Print)
7 k
JOB LOCATION: ,} z.,titi. 4 7 ( . v 1 �- c / c/ v
_
(Map) (Parcel) (Subdivision)
HOMEOWNER: <)-/- J t, , ) r-
6-� el r7 rrn t ( Name I d AddresV ) I
(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. CMR7$0 Section 109.1 .1
DEFINITION OF HOMEOWNER: Person(s) who own a parcel of land on
which he /she resides or intends to reside, on which there is, or is
intended to be, a one or two family dwelling, attached or detached
structures accessory to such use and /or farm structures. A person who
constructs more than one home in a two -year period shall not be
considered a homeowner. Such "homeowner" shall submit to the Building
Official, on a form acceptable to the Building Official, that he /she
shall be responsible for all such work performed under the building
permit.
As acting Construction Supervisor your presence on the job site
will be required from time to time, during and upon completion of the
work for which this permit is issued.
Also be advised that with reference to Chapter 152 (Workers'
Compensation) and Chapter 153 (Liability of Employers to Employees for
injuries not resulting in Death) of the Massachusetts General Laws
Annotated, you may be liable for person (s) you hire to perform work for
you under this permit.
The undersigned "homeowner" certifies and assumes responsibility
for compliance with the State Building Code, City of Northampton
Ordinances, State and Local Zoning Laws, and State of Massachusetts
General Laws Annotated.
/ 40MEOWNER SIGNATURE -/cc( al) ( kJ)2'
BUILDING PERMIT #
f
-THIS PLAT NOT FOR RECORDING PURPOSES-
a
�' - j1 2 ;1 1 998
N - DEM'T'OF R, - r F`4 - FC f,J4ev
N NORP 6
rk to
CI w
a o
Ii 4. ,.:, > a o
3i U
329.27' -,1- - v
.P iii
r , 1L+ S . �.9 :
PLAN BOOK 115, PAGE 52 co
o LOT #2 s
oN
o
N
69.96
rn to {
O 0 tat (J) i� 4l
O 4 (tf 0 (t nr U
o U +1 rU
O as n O -:
U
tU
137.01' �n .a
rte
w
k e 4 3-$, -3 i
TO THE BANK OF NEW ENGLAND WEST & X"
THE TICOR TITLE INSURANCE COMPAN'' ,
I HEREBY REPORT THAT I HAVE EXAMINED THE PREMISES, AND BASED ON EXISTING
MONUMENTATION ALL EASEMENTS, ENCROACHMENTS, AND BUILDINGS ARE LOCATED ON
THE GROUND AS SHOWN AND THAT THE BUILDINGS ARE ENTIRELY WITHIN THE LOT
LINES. I FURTHER REPORT THAT THE PROPERTY IS NOT LOCATED IN A FLOOD PRONE
AREA AS SHOWN ON FEDERAL INSURANCE MAPS FOR COMMUNITY NUMBER 2 50167 •
DATED: DECEMBER 20, 1989 = - NOTE -
_ f THIS PLAT FOR MORTGAGE LOAN PURPOSES ONLY
SURVEYOR i �Y/ C^ AND DOES NOT CONSTITUTE A PROPERTY SURVEY
, `* CI Jr - MORTGAGE LOAN INSPECTION PLAT-
L' MA ID �r % , NORTHAMPTON, MASSACHUSETTS !
x L ■ _ PREPARED FOR
•
{3 EATO4 JOANNE MONTGOMERY
No. 21•311 A
" re 0 a`
�' SCALE:1 " =80' DECEMBER 20, 1989
�.
Gt4i L'"i- ' HAROLD L. EATON AND ASSOCIATES, INC.
R PROFESSIONAL LAND SURVEYORS
23 -; RUSSELL STREET HADLEY - MASSACHUSETTS
z�
--�-"
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
IF YES, describe size, type and location:
11. ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE DENIED DUE TO
LACK OF INFORMATION.
This column to be filled in
by the Building Department
Required
Existing Proposed By Zoning
Lot size , --7 /' x ' � b tr
/ �1X1 ��
Frontage g�
9
Setbacks - frnnt
- side L: R: L: R: a0 i
-rear
Building height
Bldg Square footage
1 `3
%Open Space:
(Lot area minus bldg
&paged parking)
J(/'{-c r
# of Parking Spaces
#` of Loading Docks
Fill:
-(volume -& location)
13. Certification: I hereby certify that the information contained herein
is true and accurate to the best of my knowledge. 1lA
DATE: `2 f i % Y APPLICANT 's SIGNATURE)( ✓ -C /�v// "
NOTE: Issuan a of a zoning permit does not relieve an epplloanes burden to oomply with all
zoning requirements and obtain all required permits from the Board of Health, Conservation
Commission, Department of Publio Works and other appiloable permit granting authorities.
FILE #
, T ________.--ic ---- q % \ ci ,
v ------"'" ---1
i\
I
W - - File No. Pd —6 /9 1
ZONING PERMIT APPLICATION ( §10.2)
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant: 5 1-iki F� '��
Address: c � 7 r/ l (K // / e /e-' Telephoned 47 j) y - 7 '?
2. Owner of Property: 5 rT 7 ��i�/2e 1/ /1dam --
Address: f ff dye o C C' /1 Telephone: (4))) ,(L f - 7 , 5 ,
3. Status of Applicant: Owner Contract Purchaser Lessee
Other (explain): ,�
4. Job Location: .. 4,t `� ° � c It e 4 k 6 Li / 6 z� 1 ,p 1
Parcel Id: Zoning Map# / 7 D Parcel# /) District(s): /6
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/Property p - 76"./2f,6" 4
6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary):
/v %- / x c7 9 ' 4,t1 (5
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 PermitNariance/Finding ever been issued for /on the site?
NO --/ 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 -0080
APPLICANT /CONTACT PERSON Sean Hok
ADDRESS/PHONE 5 Garfield Avenue (413) 584 -7321 ()
PROPERTY LOCATION 5 GARFIELD AVE
MAP 17D PARCEL 013 ZONE URB
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT ,/
Fee Paid
Building Permi Fil ed out
Fee Paid tr ' %4V
T . e of Construction: ,y,r1 *it i''
New Construction ` �r 41 14 ,
Non Structural interior renovations
Addition to Existing
Accessory Structure
Buildini Plans Included:
%, 1- a c :,., :,__ .tement or License # ✓�
sets o Plans/_Eleipan
THE1'OLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION:
Approved 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
Septic Approval Board of Heal 4. : Well Water Potability Board of Health
Permit fromConnservat Commission
AP
Signature of Build- g Official 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.
Department: Reference No: BP - 1999 - 0080
Building, Electrical & Mechanical Permits
Fee Type: Receipt No:
Building - Renovation R1C 1.999 - 0001
Paid By: Paid in Full On:
Scan Ilok Tue Jul 21,1998
Received By: Check No:
Linda Lapointe 1099
DEPARTMENT'S COPY Amount: $40.00
DEPARTM FILE COPY 5 GARFIELD 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 -0080 $40.00
GIS #: Map Block: Lot: Address: Zoning: Use Group: Lot Size:
1966 17D 013 001 5 GARFIELD AVE URB 68389.2
Contractor: License Type: Insurance:
Homeowner as Contractor
Address: License No.: Insurance No.:
City: State: Zip Code: Phone:
Project No: Category of Work: Const. Class: Cost Estimate:
JS- 1999 -0115 alteration - addition $400.00
Description of Work:
12 1/2 X 2T roof over
GeoTMS® 1997 Des Lauriers & Associates, Inc. Signature:
o _ ',- o •
• City of Northampton
,p` ff
uildin Department
f ; .r : r ‘r4 F
-.:.t:.,,,
R, Ming Department Office of the Building Inspector
Permit No: BP- 1999 -0080 Date issued 23- Jul - 1998 Fee $40.00
Map 17D Block 013 Lot 001 Zone URB Section 116 iii Yes ❑ No PERMIT
BUILDING This certifies that Sean Hok
has ' ermission to 12 1/2 X 27' roof over walk out basement Inspection on site - Foundations 4 i- S 7 r S' v
p p � ® l� � a -�l Oe❑
at 5 GARFIELD AVE
provided that the person accepting this permit shall in every respect Inspection of Plumbing - Rough Over ❑
conform to the terms of the application on file in this office, and to the
provisions of the Statues and the Ordinances relating to the construction Inspection of Plumbing - Finish Over ❑
Maintenance and Inspection of Buildings in the City of Northampton.
Any violation of any of the terms above noted is an immediate revocation Gas Inspection Over ❑
of this permit, Expires six months from date of issuance, if not started.
Inspection of Wiring Service Over ❑
Inspection of Wiring - Rough Over ❑
Note: A certificate of occupancy will be issued by this office upon return
of this card by the Plumbing, Wiring and Building Inspectors. Inspection of Wiring, - Finish Over ❑
Building Inspection - Rough Over ❑
*Plumbing and Electrical Inspections required before
Building Inspections Insulation Inspection Over ❑
, ,
Building Inspection - Finish c� Over ❑
.*.:1,410444* g p (� t' L � � � ` G � v
Smoke Detectors (dire Department)
T ',j4; • d .1 s 1 • 1 •,.. •d on si • visible from ublic way
Certificate of Occupancy „f
Building Cmmissioner