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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. 59 7 -C?C 7 q Alterations
NORTHAMPTON, MASS. J L4 `� & rf Additions
APPLICATION FOR PERMIT TO ALTER Repair
a
Garage
1. Location q O A i,AM 6 L 0 44 IL-T FL,b r- r, 4 "-x A o I a 6 2 Lot No.
2. Owners name 4 S r:G' ► t N'-,t IJ Address c A L A-M(, c C u(Z-F, r'o c�`�^`�:€ , fv)A
z
3. Builder's name Address
Mass.Construction Supervisor's License No._ Expiration Date
4. Addition
5. Alteration — i r i 5f) -A L tj 0 0 t. S-� v,, I su X 1 t_(A iEl
6. New Porch —
7. Is existing building to be demolished?
8. Repair after the fire �j C
9. Garage Y w S No.of cars Size I )
10. Method of heating t'r (> Nvt A- 6AS
11. Distance to lot lines —
12. Type of roof C:- rV) '
13. Siding house 6,44)A-7- H IJ L T I I ► D ^�c'
14. Estimated cost- j e Vr
The undersigned certifies that the above statements are we to the best of his, her
knowledge and belief.
Signature of responsible app,icant
Remarks (ni Iry Q S 1 U+'fee r ilrJ N c�l �. 'Y" 13L4t -{-t P,((- A E—t a t5?�'- Ae f41 IV r
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DEPARTMENT OF BUILDING INSPECTIONS
INSPECTOR 212 Main Street ' Municipal Building '��.
Northampton, Mass. 01060
HOMEOWNER LICENSE EXEMPTION
(Please Print)
DATE: P-N uI (a
JOB LOCATION:
. (Map) (Parcel) (Subdivision)
HOMEOWNER: 1�� 5 ICJ IN S n 14 t4 y Ac—A M e- ('.co iZ r ( r ti Z
(Name & Address )
s�7 c:u 7 y w +�3 S7 17 - 92z
( Home Phone) (Work Phone )
The current exemption for "home'ewners" 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. o
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 #
4
�Z1 OfIJ �j�Ill ? IIIt
• • �assttc4asctls
DEPARTMENT OF BUILDIXG INSPECTIONS
212 Main Street a Municipal Building
Northampton, Mass. 01060 "
WORKER'S COMPENSATION INSURANCE AFFIDAVIT
(licenserlpermitree) -
with a principal place of business/residence at:
4 U A A v C, r�r � re-y)c ' (phone#) 5 —0 v
(strccucity/staldup)
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 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 Number) (Expiration Date)
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(Name of Contractor) (Insurance Compauy/Policy Number) (Expiration Date)
(Name of Contractor) ¢nsumce Company/Policy Number) (Expiration Date)
(aauh-kh6oml sheet ifneoeuuy to inch)de wfbn s on perw=ng to aU=dmd m)
( ) I am a sole proprietor and have no one working for me.
I am a home owner perfonning all the work myself
NOTE:ptewe be aware that Ahire bomcowocta who employ pusons to do=%+*a = coosuudicu crrepair viwk an a d tWwg of
not moan d=theca unite in vt"the bomeowaerresidea ar on the gman&apputt=wttbKdo=not Scurally oomic a to be
euVioyas underthewodtet'soomp=sfim Aa(OL15?,xst(5)),application by a hommw=fara Sccasa ccpan3idmay evideme the
legal ctahts of an amployr<uodKt6s Wocica�a Compemation.�,d.
I undastii ad that a copy of this natem ca=y be rocw+ to the DV"t=as of Iodostrid Aoeid W oTw of Imuewos for the
owmavvaifici ion and got faihtretosooure eovetago order socdm 25A ofMGL 15$can lmdto the impos;t?onafaruninat penalties
oomistittg aI a fine of ttp to 51 00.00 sailor aapaiso oftip to ame year aid evil pe dtks in the foam of s Stop Wodc Order and a .
fim of S100A0 a day against m
Fardgmt xdduseody
_ --
t
-Map#.
crmt
rryy Signature of
-X. -. -
10. Do any signs ebst 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 celmm to be filled
by the Building Depaz—nt
Required
Existing Proposed By Zoning
Lot size
Frontage
Setbacks - frnnt
- side L: R: L: R:
- rear
Building height
Bldg Square footage
%Open Space:
Lot area minus bldg
&Paired Parking)
# of "Parking spaces
f of Loading Docks
Fill:
vol-ume--& location)
13 . Certification: I hereby certify that the information contained herein
is true and accurate o the best of my knowledge.
D7><T f o v AP CANT's SIGNATURE h1l -yL4
1 ua oe of a zoning p it does not relieve a applioanrs jb den to oomply with-ell
oning requirements and n all required permits from the Boa` f Health,
Commission. Department of Publio Works and other applioabla permit granting authorities.
FILE #
Fi 1 e No.
ZONING PERMIT APPLICATION M0. 2)
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant: u u 1 P S e 1 I c./+ 4T L p
{ �G'J_er�cF�
Address: L4 b 1� L P VVI ° C �l 2 Telephone:
2. Owner of Property: SL rJ /-j 7
Address: t L P cc i"l rL t Telephone: S� 7 � L, c' -
3. Status of Applicant: J' Owner Contract Purchaser Lessee
Other(explain):
4. Job Location:
Parcel Id: Zoning Map# Parcel# District(s):
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/Property :5F11
6. Description of Proposed Use or roject/Occupation: (Use additional sheets if necessary):
/N S L C 1,00 1-1 S vc j.v XtS fiAJ
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 PermiWariance/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)
rr wr
40 ALAMO CT BP-2000-0645
GIS#: COMMONWEALTH OF MASSACHUSETTS
• 6:alock:29- 129 CITY OF NORTHAMPTON
}got:,001
Permit: Building
Cateaorv:woo4istove .
BUILDING PERMIT
Permit# BP-Z00Q-0645
PSoject# 1S-2000-1165
Est.Cost:$1000.00
Fee' i5. o PERMISSIONIS HEREBY GRANTED TO:
Const.Class:. Contractor: License:
Use QM:
Lot SikW.ft.l: 81892.$0 Owner: ROBINSON ELIZ SETH M
zoning: &LrFang ROBINSON ELIZABETH M
AT. 40'ALAM0 CT
Analicant Address: Ph__one; Insurances
ISSUED'ON•1/¢/40 U;U0;04
TO PERFORM THE FOLLOWING WORK INSTALL WOODSTOVE
POST THIS CARD SO IT IS VISIBLE FROM TRE'STREET
Inspector of Plumbing Inspector of Wiring D.P.W. Inspector of Buildings
Underground: Service: Meter:
Footings:
Rough: Rough: House# Foundations
Final: Final:
Rough Frame:
Gas Fire Department Fireplace/Chimney:
Rough: Oil: Insulation:
Final: Smoke; Final: ((�° �; ;8'' O e
THIS PERMIT MAY BE REVOKED BY THE CITY OF RTHAMPTON UPON VIOLATION OF
ANY OF ITS RULES AND REGULATIONS.
Certificate of ccu nc si nature:
Fee Type: Receipt No: Date Paid: Check No: Amognt:
Building 1!6100 0:00:00 547 $25.00
212 Main Street,Phone(413)587-1240,Fax:(413)587-1272
Building Commissioner-Anthony Patillo