35-121 (4) M
Cn m
v D
w F = °
Cl,
nn o
N L
t1 1�--D > —3
Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No.S<6,--}-A J Alterations
NORTHAMPTON, MASS. 19 Additions
APPLICa ATION FOR PERMIT TO ALTER Repair
Garage
1. Location 3\ (3(zy—W o ` 2t-- t,�L C Lot No.
2. Owners name Address
3. Builder's name w ns rJ u >J Cn 'i�1�= Uy • Address
Mass.Construction Supervisor's License No. Expiration Date
4. Addition Q.�
5. Alteration
b. New Porch 1 1 C)
7. Is existing building to be demolished? N
8. Repair after the fire N
9. Garage N) d No.of cars Size
10. Method of heating N\'A
11. Distance to lot lines N�)�,
12. Type of roof
13. Siding house��
1 t e-b
14. Estimated cost:-
The undersigned certifies that the abo a statements are we to the best of hi,
kno ledge and belief.
St nature of responsible app.icant
Remarks
•O + 2
a� e. APR 2 1999 Crzf� of wart11ally fall T
DEPARTMENT OF BUILDING INSPECTIONS
INSPECTOR 212 Main Street ' Municipal Building '
Northampton, Mass. 01060
HOMEOWNER LICENSE EXEMPTION
G (� (Please Print)
DATE:
JOB LOCATION:
(Map) (Parcel) (Subdivision)
HOMEOWNER:
(Name & Address )
3\ �� �,-�5�.N �Q . �-\ �IL�rL-2 `t�3 - 5��-1`�13 • �t t 3-554-`.t 25� .
(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 . i
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 bukldifig
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 PFAZMIT # L
4� pr
zt of Nort4ani tart
z
"'T' ` APR 2 21999
k Y p� DEPARTMENT OF BUILDITjG INSPECTIONS
INSPECTOR 212'Main Street • Municipal Building -•'�
Northampton,MA 01060
Applicant Information
Name Q -------------- —
Location C)Q-E\,J S"L!�1—�� ---- ------
city 1 �U IBS )_. — -------------------
C5` 1 am a homeowner performing all work myself
❑ I am a sole proprietor and have no one working in any capacity
❑ I am an employer providing workers' compensation for my employees working on this job.
Company Name—
Address
City------------------- Phone#----------
Insurance Co._------------_—Policy#------ --_
Company Name
Address
City Phone#
Insurance Co. Policy#
Failure to secure coverage as required under Section 25 A of MGL 152 can lead to the imposition of criminal
penalties of a fine up to$1500.00and/or one years'imprisonment as well as civil penalties in the form of a STOP
WORK ORDER and a fine of$100.00 a day againstme. I understand that a copy ofthis statement may be
forwarded to the Office of Investigations of the DIAfor coverage verification.
I do hereby certify under the pairs and penaltie of pe'ury that the information provided above is true and correct.
Signature Date —
Print Name a�,-)Auu I; 1 Phoned x"113`
Official Use Only..Do notwrite in this area to be completed by city or town official
City or Town Permit/License# ❑ BuMriicDept
Licensing Boazd
Check if immediate response is required
❑Sekc1xt='Dept.
Contact Person Phone#
Beakh Dept.
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
Existing Proposed By Zoning
I Lot size
Frontage
Setbacks - frnnt
- side L: R: L: R:
- rear --�
Building height
Bldg Square footage
%Open Space:
(Lot area minus bldg
&paved parkingi
# of :Parking Spaces
# '8f Loading Docks
Fill:
-(volume -& location)
13 . Certification: I hereby certify that the information contained herein
is true and accurate to the best of my knowledge.
DATE:
APPLICANT's SIGNATURE
NOTE: Issuance of a zoning permit does not relieve a pplioant's b rden to ocmply With-aU
zoning requirements and obtain all required permits i m the Boa of Health, Conservation
Commission, Department of Publio Works and other applicable permit granting authorities.
FILE #
a
age 2 21
'np
pE.F�4F.81i
l.ticp£C1 .s y File No
ZONING PERMIT APPLICATION (§10 . 2)
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant:
Add resQ,1 Telephone:413 -s`b a-1413
2. Owner of Property:
Address-S\ O(L- �U CL IE-tC�Telephone: 413-'6t a—141 3
3. Status of Applicant: _Owner _Contract Purchaser Lessee
Other(explain):
4. Job Location:
Parcel Id: Zoning Map# sJ J' Parcel# l / — District(s): 5P
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/Property 'oo
6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary):
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 veever been issued for/on the site?
NO DON'T KNOW J/ YES IF YES,date issued:
IF YES: Was the permit recorded at the�Reegistry of Deeds?X
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_y__ 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)
- a
31 DREWSEN DR BP-1999-0875
GIS#: COMMONWEALTH OF MASSACHUSETTS
Ma-Block: 35- 121 CITY OF NORTHAMPTON
Lot:-001
Permit: Building
Category:roofing BUILDING PERMIT
Permit# BP-1999-0875
Project# JS-1999-1521
Est. Cost:$1500.00
Fee: $40.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group:
Lot Size(sq.ft.): 10497.96 Owner: THIBEDAU JOSHUA
Zoning: SR Applicant:_
AT: 31 DREWSEN DR
Applicant Address: Phone: Insurance:
ISSUED ON.4122/1999 o:oo:oo
TO PERFORM THE FOLLOWING WORK.-STRIP, PLY & SHINGLE ROOF
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 4/22/1999 0:00:00 $40.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Building Commissioner-Anthony Patillo
wt
31 DREWSEN.DR 8A-1999.0875
COMMONWEALTH OF MASSACIVS-E A'TS .
My Mk=33-121 CITY OF NORTHAMPTON
Permit: Buldirta
BUILDING PERMIT
Permit# BP-19!99-t}8?5
ftipa.0 aI99a- 521
FA Qgjl500.00
i
$40.. PEN ISSIONIS HEPEBY GRANTED TO.
Lcrost Class: ContraMor. License.
WSJ �:. 10497-28 .. '
.. n:.-. EDNU Agg&_ant.-•ant.
A T. 31 QUZ=N OR
li+cn ddr+e s: Ph_one: &LeLang e:
TO PERFORM THE FOLLOWING WORK:s
- TRIP, PLY & SHINGLE ROOF
POST TM C S VI FRt3 THE T
Inspector of Plumbing Inspector of Wiring D.P.W. Inspector of Buildings
Underground. Service: Meter:
Footings:
Rough: Rough; House# Foundation:
Fluid: Final:
Rough Frame.
Gas fire 1tili Fireplace/Chimney;
Rough; Oil• Insulation:
Final: Smoke: Final: lit"
THIS PERfor MAY BE REVOKED BY THE CITY NORTHAN TTON UPON VIOLATWN OF
ANY OF ITS RULES AND REGULATION5
Certificaui of 0=0a i e:
Fee es Receipt No: Date Paid: Check No: Amount:
Building 4/22/1999 0:00;00 $40.00
212 Main Street,Phone(413)587-1240,Fax:(413)587-1272
Building Commissioner-.Anthony Patillo