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29-555 (2) • . • • > o a 'v ary, a in Z cn O m O r r Zoning Miscellaneous Additions,Repairs,Alterations,etc. / Tel.No. �� Alterations NORTHAMPTON, MASS. rl r �l 19 Additions APPLICa ATION FOR PERMIT TO ALTER Repair Garage 1. Location / Lot No. j 2. Owners name Z A w dy to 4 c auz Address ��� �+�✓�S „��r?� ��/ 1C/z,,.Legce 3. Builder's name SL CD Le A4 �c� ,� Address 34 dy cat,e, J D✓ Fl c✓r ure t t A Mass.Construction Supervisor's License No. Expiration Date 4. Addition 5. Alteration 6. New Porch — t .�o„ir` G� 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:- � 2�(J� 00 7 The undersigned certifies that the above statements are we to the best of his, her knowledge and belief. 2 -- Signature of responsible 6P ,cant Remarks � l- LLL gt APR 1310 .�} Crif� of Narf11amptol1 4 G' $ � �assacltusetts � '_' �y c DEPT OF BU' iMSPECTIONy, DPPARTMENT OF BUILDIT G INSPECTIONS INSPECTOR �- 212 Main Street ' Municipal Building ' Northampton, Mass. 01060 HOMEOWNER LICENSE EXEMPTION (Please Print) DATE: JOB LOCATION: (Map) 1 (Parcel) (Subdivision) HOMEOWNER: c� -A n d y t 4 1—e b Q L' (Name & Andress) (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 BUILDING PERMIT # gig 4 ter` ViJ l ( O4TttA).{ APR 1 31999 $ � �:stttrhtttrrlla .. DEPT OF B INSPECTnOtr� m DEPARTMENT OF BUILDING INSPECTIONS 212 Main Street ' Municipal Building ' Northampton, Mass. 01060 ' WORKER'S COMTENSA`T ION INSURANCE A t t AVIT with a principal place of businessJresidence at: (phone#) (stme i/ci ty/SLUC/zs P) do hereby certify, under the pains and penalties of pegury, that: ( ) I am an employer providing the following worker's compensation coverage for my employees wor—ng on this job: (Insurance Company) (Policy Number) (Fxpiration Date) 1 I am a sole proprietor, general contractor r homeowner cle one) and have hired the contractors listed below who have the following wor e1's compensation policies: (Name of Contractor) (Lnsurancc Company/Policy Numbcr) (Expiration Date) (Name of Contractor) (Insurance Company/Poky Number) (Expiration Date) (Name of Contractor) (Imurance Company/Policy Number) (Expiration Date) (Name of Contractor) (Insurance Cotnpany/Policy Number) (Expiration Date) (attach additiooit sbcc(tfnocasary to mchxk inform+IIon pc:taunng to all ooafrad4n) ( ) I am a sole proprietor and have no one worlang for me. am a home owner performing all the work myself. NOTE:please be awuc that whAo homco"-ncn wbo employ pcti to do—,Tf ,moc coastrucuoa or repair work on a dwelling of not moan than throo units is vAnch the bomrww mr r=den or oa the grounds appurtcnaat there wv ox gawrally ooasidcrcd to be cmployera ruder the woziccr's oompcnu4on Act(GL1524=1(5)),apptiertion by n homeowner far a ticcnsc cc permit may cvidcaoc the legit etatts of an omployer under tbo Workoeg coatponsalion AeL I understand that a oopy of thin sZstzmcoi may bo forwarded to tbo Aoci�O1Soe of la"'o'for dw oovaa ge verificatioa and that failure to too=covcrnga under section 25A of MOL 152 can lad to tbo'impontson of aiminal Penalties oomisting of a fine of up to S 1.500.00 sad/or impri3otmxnt of tip to one yur and ciYU pemttia is the form of a Slop Work Otder and a ' find of Stoo.00 a day t:gdnat tae. For dq=twcabl uao only Permit Number Iot# Li signature of 13cc Am AM AR AW 4ft AW AIM AW AIM ANW, eee AIW AR 4m APW elm AIR ANW, AW AM, 4M, t AW low- Ak APR ar- _tDIEEII Bll Ak Ift Aft �.�� APR 1 31999 ?Fpz OF ALE t r.. tom^ 3 & t 1 1 \ ins a 'st on the roe YES NO 10 Do any signs � property?rte/? • t IF YES, describe size,type and location: Are there any proposed changes to or additions of signs intended for the property?YES NO y IF YES,describe size,type and location: 11 . ALL INFORMATION MIDST BE COMPLETED, or PERMIT CAN BE DENIED DUE TO LACK OF INFORMATION. Thin columm to be filled in by the &uilding Drpartmeat Required Existing Proposed By Zoning Lot size /, Ol "'l I-e� Frontage Setbacks - frnnt - side L: d R: L: `- R: — - rear -- Building height Bldg Square footage / 74r %Open Space: (Lot area minus bldg &peved Fay ICLn i # of -Parking spaces # of Loading Docks Fill: -(volume -& location) 13 . Certification: I hereby certify that the information cont "ne herein G is true and accurate to the best of my knowledge L DATE: �-- APPLICANT'S SIGNATURE NOTE: 1 suanoe of zoning permit does not relieve an applioa s burden comply wit" oil zoning requirements and obtain all required permits from the oard of HAflalth. Conservation Commission. Department of Publio Works and other applioable permit granting authorities. FILE # y� t APR Fi 1 e No t DEPT OF Sll IPdSPECT'��t+ . ----"'°TONING PERMIT APPLICATION (§10 . 2) PLEASE TYPE OR PRINT ALL INFORMATION 1. Name of Ap licant: I K � Address: elephone: _ g 670 2. Owner of Property: �d i'b L') Address: V�7{�cl /V- Z!rfelephone: 3. Status of Applicant: Owner Contract Purchasgr Lessee Other(explain): 4. Job Location: _ {� Parcel Id: Zoning Map# j2? Parcel# District(s): t (TO BE FILLED IN BY THE BUILDING DEPARTMENT) 5, Existing Use of Structure/Property 6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary): zA . y 16, Zie�L- -?k Vet-Mc ZL4�&, /' 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 KNO:^:�_ 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 Z 1 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-1999-0837 APPLICANT/CONTACT PERSON LEBEAU ANDREA M&EDWARD R ADDRESS/PHONE 577 BURTS PIT RD 584-6708 PROPERTY LOCATION 577 BURTS PIT RD MAP 29 PARCEL 555 ZONE URA THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out Fee Paid T_ypeof Construction: EXISTING 12 X 16 DECK FOR PORCH W/SLIDER&WINDOWS New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included• Owner/Statement or License 3 sets of Plans/Plot Plan THF„FOLLOWING 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 z ` Well Water Potability Board of Health rP:i` x 4i Pernut from Conservation mmission Signature of BuildingOOfficial 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. '.� u�' 577 BURTS PIT RD BP-1999-0837 GIS#: COMMONWEALTH OF MASSACHUSETTS MW-Block:29-555 CITY OF NORTHAMPTON Lot:-001 Permit: Building Category:alteration-addition BUILDING PERMIT Permit# BP-1999-0837 Project# JS-1999-1483 Est.Cost:$2250.00 Fee:$40.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: Lot Size(sg.ft.): 43995.60 Owner: LEBEAU ANDREA M&EDWARD R Zoning:URA Applicant— AT.- 577 BURTS PIT RD Applicant Address. Phone: Insurance: ISSUED ON.•41wig99 o:oo.oo TO PERFORM THE FOLLOWING WORK.-EXISTING 12 X 16 DECK FOR PORCH W/SLIDER & WINDOWS 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 Deaartment Fireplace/Chimney: Rough: Oil• Insulation: Final: Smoke: Final: 6 r /2-V•`t q THIS PERMIT MAY BE REVOKED BY THE CITY O NORTHAMPTON UPON VIOLAT 6N OF ANY OF ITS RULES AND REGULATIONS. Certificate of Occupancy Fee Type: Receipt No: Date Paid: Check No: Amount: Building 4/16/1999 0:00:00 $40.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Building Commissioner-Anthony Patillo