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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. (� S '�`(y -1 Alterations
NORTHAMPTON, MASS. \Aj1\jV-, (�7 19 L Additions
a APPLICATION FOR PERMIT TO ALTER Repair
Garage
ct' Lot No.Location 71 6rj�5 r Cs;,�,Je
r r1
2. Owner's name (,qA r t-�flw)14 l Address ;x 7Jr!�'c- 5 iL%° G,N2C�
3. Builder's name � �� � / Address
Mass.Construction Supervisor's License No. Expiration Date
4. Addition
5. Alteration
6. New Porch
7. Is existing building to be demolished?
8. Repair after the fire E'Vt
No.of cars Size
9. Garage
10. Method of heating
11. Distance to lot lines (�� 7 33
12. Type of roof
13. Siding house
14. Estimated cost:- C)Q
The undersigned certifies that the above statements are we to the best of his, he,
knowledge and belief.
Signature of responsible app,icant
Remarks �� (1_ __�I)Ot,"C Ati o ()k
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.aa O RTMENT OF BUILDIIG INSPECTIONS
ain Strect ' Municipal Building
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INSPECTOR $n c�D P g
rthampton, Mass. 01060
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HOMEOWNER LICENSE EXEMPTION
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DATE: ( Please Print)
- � � B
JOB LOCATION:— =� i� /
(Map) ( Parcel) /1 ( Subdivision)
HOMEOWNER: /�(�rr L 'IM 0i L,5i o1-?f (Y ,kSiL� CYIde , i��oP&.Uce MIS
(Name & Address)
y(5 S7g6L(fa1 , q13 51�;g 4176 X51
(Home hone) (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 underr, the buildinq
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 G /�n�•
BUILDING. PEIMIT
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$ 6 'g� �i �asaschtuctta
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Of
DEP T ENT OF BUILDrNG INSPECTIONS '
DEPT OF BUILDING INSPFfT,,2V iin Street • Municipal Building
INSPECTOR A 01060 Northampton, MA 01060 y
Applicant Information
Name— — -&1�� �------------------ —
Location -&(1 (;&ok5je
City
I 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 against me. I understand that a copy of this statement may be
forwarded to the Office of Investigations of the DIA for coverage verification.
I do hereby certify under the pairs and penalties of perjury that the information provided above is true and correct.
Signature Date 6
Print Name r � Z— Phone Q3 58'6 c/(-/
Official Use Only-,..Do not write in this area to be completed by city or town official
City or Town PermiVLicense41 ❑ B-IdinSDept
❑LiensixK Bond
Check if immediate response is required
Contact Person 0
Phone#
Q Health Dept.
14
THIS PLAT NOT FOR RECORDING PURPOSES B V-.541 o, PG.&3
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TO!EASTHAMP-r0N 5A141 NG5 BA►.1%4 LAWYERS TITLE IA45.CO.
I HEREBY REPORT THAT I HAVE EXAMINED THE PREMISES,AND BASED ON EXISTING MONUMENTATION,ALL EASEMENTS, ENCROACHMENTS
AND BUILDINGS ARE LOCATED ON THE GROUND AS SHOWN AND THAT THE BUILDINGS ARE ENTIRELY WITHIN THE LOT LINES. I FURTHER
REPORT THAT THE PROPERTY IS NOT LOCATED IN A FLOOD PRONE AREA AS SHOWN ON FEDERAL INSURANCE MAPS FOR COMMUNITY
NUMBER Z 5 O 1
DATED: 11 - ) 8 -97 NOTE
THIS PLAT FOR MORTGAGE LOAN PURPOSES ONLY AND DOES
SURVEYOR: NOT CONSTITUTE A PROPERTY SURVEY.
MORTGAGE LOAN INSPECTION PLAT
ilk OF QORTHAM PTONJ MASS .
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i346p5 U I E L. A R Y A E 5 E M'E D I S O K
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SUit SCAL.E : lt1=40
Richard J.La Sr.,Registered Professional Land Surveyor
ng Street,Northampton, Massachusetts 01060
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0 1999
Fi 1 e No.jd Elec ;_.... ...._.
ZONING PERMIT APPLICATION (§10 . 2)- e:ns
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant. ( AlT j� ►�'{ 1 �(
Address: CR31 f7�1 t � E'd-C I-C � it Telephone: �,� Y `�` i��
2. Owner of Property: kAtt-
Address: '5A"e c Telephone:
3. Status of Applicant: Owner _Contract Purchaser Lessee
Other(explain):
4. Job Location: y��
Parcel Id: Zoning Map# 1° Parcel# District(s):
(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):
a X t$'_TnVC l rstltAC y �v
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 ocument#
Does the site contain a brook body of water d V
9, y er 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-1999-1084
APPLICANT/CONTACT PERSON LAMPIASI MATT&LISA
ADDRESS/PHONE 271 BROOKSIDE CIR 586-4421
PROPERTY LOCATION 271 BROOKSIDE CIR
MAP 36 PARCEL 127 ZONE URA
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Fi ed out
Fee Paid
Typeof Construction: CONSTRUCT 10 X 18 REAR PORCH
New Construction
Non Structural interior renovations
Addition to Existing
Accesso Structure
Building Plans Included:
Owner/Statement or License
3 sets of Plans/Plot Plan
THVDLLOWING 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:
y
Curb Cut from DPW Water Availability Sewer Availability
Septic Approval Board of Health Well Water Potability Board of Health
Permit from Conservation Commissio
-d
Signature of Building Official 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.
271 BROOKSIDE CIR BP-1999-1084
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map:Block:36- 127 CITY OF NORTHAMPTON
Lot: -001
Permit: Building
Category:alteration-addition BUILDING PERMIT
Permit# BP-1999-1084
Project# JS-1999-1809
Est.Cost:$1500.00
Fee: $40.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group:
Lot Size(sg.ft.): 26528.04 Owner: LAMPIASI MATT&LISA
Zoning:URA Applicant:_
AT• 271 BROOKSIDE CIR
Applicant Address: Phone: Insurance:
ISSUED ON:6/18/1999 0:00:00
TO PERFORM THE FOLLOWING WORK.-CONSTRUCT 10 X 18 REAR PORCH
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 6/18/1999 0:00:00 $40.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Building Commissioner-Anthony Patillo