17C-066 (4) a
v v o•
_ D m XI 3 o a rw
0 cm
Z5? 7t7 0 c O
O -�
N
Z!'-- o 0 0
J ro
Zoning
Miscellaneous Additions, Repairs, Alterations, etc. Tel. No..5 to 1 Alterations
T %�r NORTHAMPTON, MASS. y// 1 9.' Additions
Repair
;
APPLICATION � F r OR PERMIT TO ALTER R age
1. Location / cc C I - � ✓/ /" t� / / " 7.- it Lot No.
2. Owner's name ' /41 \ t ‘ y Address 1(,1 C 4- CZ S1 , It /
3. Builder's name At ' .A• lir Address O1t�c ' , /f// 77)/1
Mass. Construction Superviso 's Lic se No ' 0 1g7 �► Expiration Date
4. Addition l %",' y �1 ' „'j 4,s..*.:. �!<.. M)6 ~» - 4 : f "elfZG - L ! �v
[ � �
5. Alteration �� � t � ' , � - �:.'s'C � r.;.
: �� i Vii e
6. New Porch .7
s ! 6 (( Z fri 7-)
1
7. Is existing building to be demolished?
8. Repair after the fire iev
9. Garage - No. of cars Size_
10. Method of heating 1 -tZ-- /( —) CV" e.../.../ D/ -r Uzi Cam d (21 eJ C✓ - � )
11. Distance to lot lines .11-5716641---'
I -� , -� �r
12. Type of roof 1 664 -- / /
13. Siding house eA c s ft ! , ,a
14. Estimated cost: -
1 /.jO 5
The undersigned certifies that the above statements are true to the best of his, her
knowledge and belief.
Signature of responsible appicant
Remarks
o4 K 1tAMPy�
B^ t ±t rff NLTrf11 &nt 1 _'♦_4
a' � e� / '` j( 1'f 2 . a } xssartlnsetta :'v =
�VI.' DEPARTMENT OP BUILDIJZG INSPECTIONS • it f
;ii ,
212 Main Street ' Municipal Building r
Northampton, Mass. 01060 ' "
WORKER' S COMPENSA'T'ION INSURANCE AI{ i {1llAVTT
v J Pell/ L - Li-
(li censer/permi ttee)
with a principal place of business/residence at:
I. W ( Ci. & l sr A ,7(7)0„/ (i4/, (phone#) 1<,3 �l (�3
(sti =I/city /stair/zip)
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 Co mpany) (Policy Number) (Expiration Date)
( ) I am a sole proprietor, general contracto or homeowner (. le one) and have hired
the contractors listed below who have the fol. ti e t e. ! . - s compensation policies:
,. li.„ 8c;s(, o 66 (
(Name of Contractor) (Insurancc Company/Policy Number) (Expiration Date)
(Name of Contractor) (Insurance Company/PoLicy Number) (Expiration Date)
(Name of Contractor) (Insurance Comparry/Policy Number) (Expiration Date)
(•ame of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(attach aGiitioml shed if ooccn -y to mcJudc infonnitioo pcztaining to all cootrnctors)
( ) I am a sole proprietor and have no one working for me.
( ) I am a home owner performing all the work myself.
NOTE_ pica= be aware that while homeowoen who employ person to do maintriaancic, mun repair work on a dwelling of
not more than thrco units in which the hots oowocr rniidcs or on tho groutxls appurtenant the cto arc Dot goafy ooasidcrcd to be
=playas under the worker's compassaiica Act (GL152,n 1(5)), application by a homeowner for a licczzsn ce permit may cvidcaoc the
legal status of an employer under tho Worlcore Compomaiion Act
I understand that a copy of this uatemcni may bo forward..a to the Depart of In t,i el Anadcaa[e OfSoo of Iawnnco for the
coverage verifieaiioo and that failure to secure coverage under section 23A of MOL 152 can kid to the i oa of aiminat pcaaltia
coniisling of a.-fine bf up to S1,300.00 andfor imprsson tad of up to one ytxr and civil pca fowl attics in the fo of a Stop Wok Order and a ,
finq of S100.00 a day against me
For d L one
Permit Number
, igz}afure of Liccnsee/Permittec - Da
41 pT
,q,� 1• ' -• (!i xf f N ort a n t f.�n ° *=
r r % % . ' ! ,inssnchusrtt —" T I
' ; ;,$,. , MAY 2 2 ►99 — _ _ ► i =
DEPARTMENT OP BUILDING INSPECTIONS '� =41 ° '
' ' OF 212 Main Street • ' Municipal Building
INSPECTOR p g
"-` --- °-"-- Northampton, Mass. 01060 ow'''
J
HOMEOWNER LICENSE EXEMPTION
c / (Please Print)
DATE: �J /! /
JOB LOCATION : l l / 7 e ! 6 (p _ t. : ,
JI l e _ � gel ) (Subdivision)
HOMEOWNER: ,, " I +" �' t
/t; ( C .. ( 57 & N r liL d 6 l(3 Sef‘ 00131-(0 �--6
(Home Phone) (�rl k 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 Annotat -. _
HOMEOWNER SIGNATURE r �'
BUILDING PERMI
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 1
Existing Proposed By Zoning
Lot size 44 G} ' v7 6' 4...0_,L--r---
Frontage 4 CV
Setbacks - frnnt C3z) /5
- side L: R: L: R:
- rear
3U 'I/
Building height
Bldg Square footage
%Open Space:
(Lot area minus bldg
62
&paved parking)
# of 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.
DATE: �� ,)\e APPLICANT'S SI'GNATU • jn
NOTE: Is canoe of a zoning permit does not relieve , - pplioant's burden to oomp with'ell
zoning requirements and obtain all required per rem the Board of Health. C servtation
Commission. Department of Publio Works and of : applioable permit granting authorities.
FILE #
I MAY 2 File No. 3.5 1
..g
/
li L y ` ° °� "!` Z ONING PERMIT APPLICATION 2)
PLEASE TYPE OR PRINT ALL INFORMATION
1. Nam o f Applicant: _ ,f. , di i i i- 1 ' 11/ '�
t' _
L ( Address: ,/ s' i � �''4, Telephone:
2. Owner of Property: �. 1) 11"-I J A l.4'-- r
� A q �
Address: /67 ( 5r /(PIP t i,f`' Telephone: ¥' 3 SS G � ,.
3. Status of Applicant: .
pplicant: Owner Contract Purchaser Lessee
..4 Other (explain): //
4. Job Location: /55 ( d�fu �e .
Parcel Id: Zoning Map# /,e Parcel# t f' District(s): ./.e.../Z.41 -
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/Property 6 F/1
6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary):
f . ab el
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 X 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 .
O
X 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)
f FILE # / )
II 7
637
MAY 2 2 1998 .�
APPLICANT /CONTACT PERSON: �/i -P - 5g( ( -6 L '3
` ,DDRESS/PHONE: /4'7
Ct
PROPERTY LOCATION:
MAP / PARCEL: 6(p ZONE
THIS SECTION FOR -OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FIT .T.ET) OUT tom'
FPP Paid
Building Permit Filled nut
Fee Paid / i
New C'nnstrnetinn /7.) i �7j/
'7
RPmndeling Tnterinr �/'' ��n _
G _)_12 2s
Additinn to Existing /i� /Z,it4C? 1
A rressnry Structure
Building Plans Included-
vr r /Occupant Statement nr License*
3 Sets n�PTanc ,' Pint Plan
TH 6LLOWING 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/ZON1NG 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:
pt. fr. +, APW , : Water Availability Sewer Availability
ifreie `' • ?l 1 ealth Well Water Potability -Bd Health
! P ar fro o at• Co
Signature of Building ector Da e
NOTE: Issuenoe of a zoning permit does not relieve an applicant's burden to oompty 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.
, .. ,..,„Amp
oti City of Northampton REQUIRED INSPECTIONS
} t ''+ t 1. Footings and Walls
W BUILDING DEPARTMENT 2. Structural Components in Place*
i a, a_ 33 . Complete Building*
4
No.
1637 Office of the Building Inspector
Zoning Form No. 963579 Date 6/2/98 Fee $60.00 Check # 1
Page, 17C p arce l 17 66 , Zo ne URA 1 g d,`( R Q Section 127 ❑ Yes 0 No
BUILDING PERMIT .
* Plumbing and Electrical Inspections required
THIS CERTIFIES THAT Joanne Montgomery before Building Inspections
has pe to remodel interior per plans , add walls & `replacement Inspection on Site — Foundations
situated on 155 Chestnut Street Inspection of Plumbing —Rough
provided that the person accepting this permit shall in every respect Inspection of Plumbing— Finish
conform to the terms of the application on file in this office, and to the Gas Inspection
provisions of the Statutes and the Ordinances relating to the Construction, Inspection of Wiring —Rough
Maintenance and Inspection of Buildings in the City of Northampton.
Any violation of any of the terms above noted is an immediate revocation Inspection of Wiring— Finish
of this permit. Expires six months from date of issuance, if not started. Building Inspection —Rough
Note: A certificate of occupancy will be issued by this office upon return Insulation Inspection
of this card signed by the Plumbing, Wiring and Building Inspectors.
Building Inspection— Finish
' ** Install per Manufacturer's information: windows, vinyl siding, roofs Smoke Detectors (Fire Department)
and woodstoves
...: Other
THIS CARD MUST BE DISPLAYED IN A CONSPICUOUS ' A O ,i . MISES
Certificate of Occupancy
Building Inspector