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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. S "?0 Alterations
NORTHAMPTON, MASS. /— ,3 19d-0 Additions
APPLICa ATION FOR PERMIT TO ALTER Repair
D Garage
� /
1. Location q \0S eJ— 51 Lot No.
2. Owner s name ✓ Address
3. Builder's name i l H-. ills rte►t::� Address
Mass.Construction Supervisor's License No. C9,5:N,1 i Expiration Date
4. Addition c
5. Alteration
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
13. Siding house
14. Estimated cost:- /0 1 0-io)-0
The undersigned certifies that the above statements are we to the best of his
knowledge and bylief. n ,
Sign/-re of r sponsible app item V
Remarks -
��HN'1 Pp
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CritR laf 'Wart4amptan
e ♦ �i7DDtltnftttD
DEPARTMENT OF BUILDING INSPECTIONS
212 Main Street a Municipal Building '
Northampton, Mass. 01060
WORKER'S COMPENSATTON INSURANCE AFFIDAVIT
t I t 12
(L censcr'Jpermi flee)
with a principal place of business/residence at:
:� J- 1J YTd.,z . LtL (phone#) Jk,'�— 97401
(street/city/stafdrip)
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 Date)
I am a sole proprietor, general contractor homeowner cle one) and have hired
the contractors listed below who have the follo wor el's compensation policies:
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(Name of Contractor) (Insurance Company/PoGcy Number) (Expiration Dale)
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(attach additiond sbeet ifneoessuy to uwlu a information patu=ng to all coutradm)
( ) 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 aw=tbA while homeowaots who cmploy parsons to do=kdcasacr,ooaswLw!cn or rspairworic oa a dvrelling of
not mote than three uab in whichtbe bomeowDw resides or on the grounds app xt=u ttbwd*are not sax any aomidaed to be
employrts under the wotica's oompeasat=Art(GLI52,ss1(5)),application by a homeow=fora Grease or permit may evidence rho
kgal dxft"of an employer uoderthe Wakces Compamatim Act
I aodmunddu t a copy of thin alatemmt may be forward♦d to the Deputaxms of Iahutlid AAddW&Offm of Insurance for the
covatV v=T=dion Sad that failure to$carte oovcrago cadet secctioa 25A of MGL 151 can lad to the imposition of"kind ptaeltks
000sisting of a fine vfup to S1,500.00 andlot imprssocment of up to one ycw and civil pea&Wcs in the fam of a Stop Wodc Order and a
fim of 3100.00 a day against me
Zl� � FxdcQiatmmtaluwmty - -
_ _ Permif Num6rr-
{ii f S fI U Map# Lot#
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186
96 36 54
TRBD DISH. 24" S 4DB15
15FB FB
56
W33 33
15FB F TF 114
78 W21 TD9 36
30
FBR
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SL 6-R FB B42FB
22
DW30-R W2130FB 0 0
141
morgan2 Scale:318"=1' Design: 12116/99 Dw9
n
Al dimensions&size designations This is an original design and must Date : 01/04/00
given are subject to verification on not be released or copied unless
job site and adjustment to fit job applicable fee has been paid or job
conditions. order placed. Designer
p e CrifLT >rf wort 11 illpfan
DEPARTMENT OF DUILDI)�,,G INSPECTIONS
INSPECTOR 212 Alain Street ' Municipal Building
Northampton, Mass. 01060 �•
HOI•fEOWNER LICENSE EX 0- ,PTION
( Please Print)
ATE: /
JOB LOCATION: 2 V,9 5 d+T
(Map) ( Pa e ) S bdi ision )
, OMEOWNER: Z 5
(Name & Addre s )
( Home Phone) (Work Phone)
The current exemption for "homeowners" was extended to include
Owner-occupied Dwellings of one ( 1 )or tt•ro (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 i's, 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 . pe 'r'iod shall not b.e -
considered a •homeowner. • Such "homeowner" shall submit to the Building
Official, on a form acceptable to - the Building .Official, Oiat' he/she
shall. be responsible for all such work performed under, th"el buildinq
permit'.
As acting Construction Supervisor your presence on tPie; j:ob 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 m, ay 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
G neral Laws Annotated.
HOMEOWNER SIGNATURE
BUILDING. PEi=T
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 MAST BE COMPLETED, or PERMIT CAN BE DENIED DUE TO
LACK OF INFORMATION.
This colm= to be filled in
by the Building Department
Required
Existing Proposed By Zoning
Lot size � /1
Frontage /�-
Setbacks
- side L: R: L: R:
- rear
Building height A A-
Bldg Square footage w A
%Open Space: !^"
(Lot area minus bldg
&paved parking) ,yam
# of -Parking Spaces
t of Loading Docks
Fill:
{vol-ume--& location) A0-
13 . Certification: I hereby certify that the information contained herein
is true and accurate to the best of my knowledg
1
DATE: �— 3 � � Aj'PLICANT's SIGNATURE .
NOTE: lanuanoe of a zoning permit does not relieve an a
zonin ppli nYs burd to comply with +pl!
g requirements and obtain all required permits from ttYb Board of Health, Conservation
Commisslon, Department of Publio Works and other applioable permit granting authorities.
FILE #
y D.a,
I t
JAN 3 2000 Fi1e No.VfA�t(
?FF?OF Blii r„'�('INSPEC IONS
9 `L----- ��NG PERMIT APPLICATION (§10 . 2)
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant:
Address: �S �J �� ��• 1, Telephone:(q
2. Owner of Property: aJ� Wvt � r
Address: s��) �r Telephone:
3. Status of Applicant: Owner Contract Purchaser Lessee
✓Other(explain): t AL'
4. Job Location:
Parcel Id: Zoning Map# Parcel# District(s):
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/Property et s i kt k S.M_ =
6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary):
Jac),— 9
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 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-2000-0634
APPLICANT/CONTACT PERSON WIELAND PATRICIA
ADDRESS/PHONE 23 RANDOLPH PL (413)584-8404 Q
PROPERTY LOCATION 229 PROSPECT ST
MAP 24D PARCEL 004 ZONE URB
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building,Permit Filled out
Fee Paid
Typeof Construction• REMODEL KITCHEN&INSTALL EXT DOOR&WINDOW
New Construction
Non Structural interior renovations
Addition to Existing Accessory Structure
Building,Plans Included: -
Owner/Statement or License
3 sets of Plans/Plot Plan
THE LLOWING 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 Health Well Water Potability Board of Health
Permit from Conservation Comm' i
Signature of Building Officia Zte
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.
229 PROSPECT ST -0634
GIs#: COMMON - 7, 'S
Map.Block: 24D-004 CITY OF NORTHAMPTON
Lot:-001
Permit: Building
Cate :r renovation BUILDING PERMIT
Permit# BP-2000-0634
Proiect# JS-2000-1143
Est.Cost:$10000.00
Fee: $50.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group:
Lot Size(sq. ft.): 6621 .12 Owner: WIELAND PATRICIA
Zon.in :URB Applicant: WIELAND PATRICIA
AT. 229 PROSPECT ST
Applicant Address: Phone: Insurance:
ISSUED ON:117100 0:00:00
TO PERFORM THE FOLLOWING WORK.-REMODEL KITCHEN & INSTALL EXT DOOR &
WINDOW
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: AAA 1'1* House# Foundation:
Final:Q�q/�O jL'/3 Final:
f� Rough Frame: OK 44e.cX �� d
`Z-z /—1 y-a0
Gas Fire Department Fireplace/Chimney:
Rough: Oil: Insulation:
Final: Smoke: Final:4A—
THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF
ANY OF ITS RULES AND REGULATIONS.
Certificate of Occu anc Signature:
Fee Type. Receipt No: Date Paid: Check No: Amount:
Building 1/7/00 0:00:00 537 $50.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Building Commissioner-Anthony Patillo