29-350 a R Crii� of �\Tci rfljalliptoil
DEPARTNIEIrT OP DUILDTNG INSPECTIONS
212 Alain Strcct ' Municipal Building
Northampton, Mars. 01060
`1'OMCER'S CONUENSAIION MSUR"CF AI?FMANTIT
(Ii ccusc clperrni ct cc)
V'rith a PI-incipal plat` of business/residenc-c at:
��� ��A_M/�1FO�1 �IGL /U(�tt/�tl9ry� U hone ')_6-8' S-/627
(stmt/ci ty/stalcfzi P)
do hereby certify, under the pains aad penalties ofperjury, .1121
( ) I m a ) employer providing the ioi!owin %vorl'u's compcnsr.�Jo, cove:-2,- of my
eluplovecs worialig on U1is job.
(Insv_r -c: Corp r ) (Pclic: ?�u�irr) ---- - (�:pir tior Datc)
XI am a sole proonctor, general contractor or homeowner (title ore) aid have hired
the coni,Tactors listeJ below wLo hive the follotvi�Q ��rort er's ca ncn don policies:
(Nnmc o;Co tr aorl (ln-,�-urancc CoinoaTI)-Oj c,6c'i Numb-F) bate)
+� (Name of Coo[TaC10C) - — (insuranc COM0a-U-VIPot1C-' \utnc^F) (Ex-DIMe.ilon Daic)
(Name of C0=cto,) Gasutanc: Compan)•lPotic) NzIMb:.r) (E."piratioo Datc)
(Name of COn[Tac(Gf) Raaitana� ComraQy/Poticy gums) (Expiration Date)
(ceaG�:-ddi�«:�l c'.r:c:iI❑<�c:. to�'>`.'u�iafocai:i OC fcrl ininf;to.L ega'r_C.o7)
(t am a sole proprietor and have no one worlang for lire.
( ) I am z home owner perforruing all tlae work- myself.
140T E:plc L:cc uc(h, wt�o cmplcy Pc 0=to 6:) r r�" u"O( oo,d.•c11= of
c
one wort tLn t_`sc=l�l'J in«',:ic!'the bornoo..'ac rcido a oo t1l,V-OUZrt ZPTNtrt<a_r-±thcc,.n c.-c Dx G= _ily to tti
c ut)Ioy=- ua?--t_'�11.112 ld —xy—_tiea/ri(GLI52.zz I(5)�r.-pptica,6cn try L bomooax fm c 6=--:or pcml t r y nid,-noc LL'--
Iegl rta_'ire of e —Toyer under d3 Wor4dr Co�n�,_
[undcj r--d t:.n>entry of tbii asi.®cw ovy bo f«�nrdoE to tbo Deputmcrst of indiss�cj Motur�'OfLo of l+ucznoo foe th<
oovm sc vcri(clioo a.•td th_t(_iJt7t to mane covn�mldcr ioc6cn 25 A of MOL 152 cm lad to the�-,->Osi6oa of cimmaj perm[=
ooaiis%of a Cm:of up W s 1500.00 arwcx ca uooa t of up to one year L-.d aril pca,hio in dc form of a Stop Work Otdcr Lad a
rite of 5100.00 l d_y cpinn me
FZ "t Wnbcr
Lot
Sig n Ittt -of Li -,_,ccAIcrrttittc- —�
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@plli, 111
Q CONSTRUCTION SERVICE,
s
_.t Licensed Construction Supervisor: Not Applicable ❑.
Name of License Holder :
License Number
Address Expiration Date
Signa Telephone
.2
H;i ,e Iijiffi'mlcnt/Conf(af Not Applicable ❑
Company Name Registration Number
t �`7 �E��-1�ri,�s�o� y�i�v� ��,►�wx,,�o�v �/s�i g
Address Expiration Date
Telephone S S 6 Z-7 2 3 ZOO Z
0, V, "
fCTION Y0;WORKERS t COMPENSATION INSURANCEAFFIDAVIT{M'G L 152, 25C(6)) ek
Workers Comper_E ion Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit
will result in the cemat of the issuance of the building permit.
"Tned Affidavit F;ttached Yes ...... 0 No...... ❑
The curr:iii exemption I'o1 'homeowners"was extended to include Owner-occupied Dwellings of one(1) or two(2)families
and to ,;!l„w such honer,+\�ner to engage an individual for hire who does not possess a license,provided that the owner acts
as su isor. CMR 7S.”. Sixth Edition Section 108.3.5.1.
Delin,�:,,n of liomco_: �:Person(s)who own a parcel of land on which he/she resides or intends to reside,on which there
is,or is l!"ceded to br. a orie or two family dwelling,attached or detached structures accessory to such use and/or farm
struct::.. . A person \L, �onstructs more than one home in a two-year period shall not be considered a homeowner.
Such I.k.:;;cuwner" si..... ...ibmit to the Building Official,on a form acceptable to the Building Official,that he/she shall be
respon.it,le for all such N%,ork performed under the building permit.
As act Construction Supervisor your presence on the job site will be required from time to time,during and upon
compl,t i,m of the wort: t'k r which this permit is issued.
Also .,,k iced that N : lerence to Chapter 152(Workers' Compensation) and Chapter 153 (Liability of Employers to
Emp: :,)r injure: i . resulting in Death)of the Massachusetts General Laws Annotated,you may be liable for person(s)
you hirr to perform \\o; I lOr you under this permit.
The u. .:: r iyned"hur;. r"certifies and assumes responsibility for compliance with the State Building Code,City of
Nora:., r: ,:n Ordinau t: s. )tate and Local Zon�inng�:Laws and State of Massachusetts General Laws Annotated.
Honicu,\ncr Signature l 1
wwry
N ESCRIPTIONOF PROP, I ` c 1 006
,., tea: _..,, -H :, n,.�. ,�; ,�, • ��� 0 • -
New House ❑ Addition ❑ Replacerneril.Windows Alteration(s)❑ Roofing ❑
Or Doors [
Accessory Bldg. ❑ Demolition❑ New Signs [ ] Decks [ ] Siding[� Other [ ]
Brief Description of Proposed Work': ✓1t NUV 4_ S f V ,v 1( ' &), -
Alteration of existing bedroom Yes No Adding new bedroom Yes No
Attached Narrative - Renovating unfinished basement Yes No
Plans Attached RolI Sheet[_!`
Ouse and o`r-addit ofi < _ :I �Mffl , M
a. Use of building One Family Two Family_ Other
b. Number of rooms in each family unit: Number of Bathrooms
c. Is there a garage attached? D
d. Proposed Square footage of new construction. Dimensions
e. Number of stories?
f. Method of heating? Fireplaces or Woodstoves Number of each
g. Energy Conservation Compliance. _Mascheck Energy Compliance form attached?
Type of construction
i. Is construction within 100 ft. of wetlands? Yes . No. Is construction within 100 yr, floodplain Yes No
j. Depth of basement or cellar floor below finished grade
k. Will building conform to the Building and Zoning regulations? 1/ Yes No
I. Septic Tank __ City Sewer Private well City water Supply
u t V 3rd r
ECT� OWNER AUTHORIZATO aw EC O MPLET€ED WHEN
ION _
oY+[ 1l3 S GENT OR CONTRACTOR APPEIEShF01t BUILDING PERMlT
"'d,R.
. 'jam Q .
I, T 1111.5_. 1 '��/>f 0 , as Owner of the subject property
hereby authorize __ tT '`A T7_ to act on
my behalf, in all i natters relative to work authorized by this building permit application.
Signature of Owne Date
as Owner/Authorized Agent
hereby declare tr at the statements and information on the foregoing application are true and accurate, to the best of my I
knowledge and belief.
"''tined under the pains and penalties of perILLry.
J >E
Nq4
Print Name
QL_0 A, /0 A�
Signature of Owner, `,ent Date
Section 4:
ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE
DENIED DUE TO LACK OF INFORMATION
Existing Proposed Required by Zoning.
This column to be filled in by
Building Department
s
Lot Size 131000
Frontage_
/ b0 `
Setbacks Front 3-7 '
Side L: 51) R: I1C) L: R:
1
Rear 7D
Building Height
Bldg. Square Footage �/� / oio
Open Space Footage !P °ro
(Lot area minus bldb&paved
parking) /
#of Parking Spaces
Fill:
volume Location)
A. Has a Special Perm it%Variance/Finding ever been issued for/on the site?
NO i' 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#
B. 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:
C. Do any signs exist on the property? YES NO
IF'YES, describe size, type and location:
D. A�tre any,proposed changes to or additions of signs intended for the property?YES_
No
IF YES, describe size, type and location:
# cC.
* R 5
3 u rrx#r A �j . b t �rF�• -
rV a.. ,n s
City of Northampton
Building Department
212 Main Street
Room 100
Northampton; MA 01060
phone 413-587-1240 Fax 413-587-1272
APPLICATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
ECIQ�!ISITE INFORMATION -Nv..
1.1 Property Address:
yy N Cher 1.,
C? 4 o e;'
aSECIiON PROPERTY OWNERS HIP/AIITHORIZED AGENT
2.1 Owner of Record:
TO -T�4k 1,1A)4KkAf1
,Ame(Print Current Mailing Address:
Telephone - V c o1
Signature ` ,
7 S
2.2 Authorized Agent:
r /Val o0
Name(Print) Current Mailing Address:
.'7
Signatur Telephone
SEC7 ION 3 "ESTIMATED CONSTRUCTION COSTS'
7777. ,-
Item Estimated Cost(Dollars)to be c1a�tlse On
completed by ermit applicant
1. Building (a Bu�[clmg Pere �
2. Electrical (b) strnattlotaf
3. Plumbing Buiidmg
4. Mechanical (HVACn `
5. Fire Protection
6. Total—(1 + 2 + 3 +4+ 5) fit)
�1
is eC 16, nor.
Number ' Y �� s
�
a1ding Commlissionerlln"s
48 AUSTIN CIR BP-2001-0379
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map:Block:29-350 CITY OF NORTHAMPTON
Lot:-001
Permit: Building
Gateggry:replacement windows/siding BUILDING PERMIT
Permit# BP-2001-0379
Project# JS-2001-0612
Est. Cost: $5400.00
Fee: $25.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: J C Pratt Builders 115419
Lot Size(sq. ft.): 13852.08 Owner: TATARO THOMAS A&WENDY L
Zoning:URA Applicant. J C Pratt Builders
AT. 48 AUSTIN CIR
Applicant Address: Phone: Insurance:
147 Westhampton Rd. (413) 584-5504
FLORENCEMA01062 ISSUED ON:10 110 100 0:00:00
TO PERFORM THE FOLLOWING WORK:INSTALL VINYL SIDING & REPLACEMENT
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 Department Fireplace/Chimney:
Rough: Oil: Insulation:
Final: Smoke: Final:
THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF
ANY OF ITS RULES AND REGULATIONS.
Certificate of Occupancy Signature:
Fee Type: Receipt No: Date Paid: Check No: Amount:
Building 10/10/00 0:00:00 2250 $25.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Building Commissioner-Anthony Patillo