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36-185 (7) a � >y or 3 Z m r- -t Z ...1 ^' m Zoning Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations a NORTHAMPTON, MASS. 9 Additions APPLICATION FOR PERMIT TO ALTER Repair Garage 1. Location �S C,I rb U ,(V)S P 1-7' (? Lot No.,1 c- 2. Owner's name W Qn Gael -1 P� ('�i Y ik591/�Address T c � b% �� 3. Builder's name Address A 3 1,3 (Pd. Mass.Construction Supervisor's License No. �•�thnR. 7�ft� Expiration Date 4. Addition n_ ` 5. Alteration Carw�N+� {t n 1..1 %,r J S '►.► 1, I Gt` rr- IM VC i)1 7. Is existing building to be demolished? °t� ^^ eb t`c. V-j i>1 S. Repair after the fire -'y ,. -(0' W t naj�,4 51. 9. Garage No.of cars Size 10. Method of heating (� 11. Distance to lot lines (�l-> �G�r ia�~►-� a0 12. Type of roof G U 41ck, 'i r6�,v� ��^�+ 11-A f'^ ►- W410 if 13. Siding house 14. Estimated cost S _n The undersigned certifies that the above statements ewe to he best of his. C Yt,01C knowledge and belief. A J-r I.JVQ1 S*\-\ `w '4�/ Signature of responsible app icant It Remarks"'Wd 10 b x 5 5't �V �(� G4j�"�wn� �rb,�S o�}1C�yL� _ �CA kt1; ) t, e�t, $y,y".►'f 1 - ct k 10— J'o j"Cd 4 j 1'�v �� 'l"1� �JLo,b�.t�l�rwW ' �JG JI" • " �Q,tFJ e,i/ O��tiAAfp�O � � . (riff of Y DEPARTMENT OF BUILDD\TG INSPECTIONS _ INSPECTOR , 212 Alain Street ' Municipal Building ' Northampton, Mass. 01060 ' HOI•IEOWNER LICENSE EXEbMTION ( Please Print ) DATE; S ) � 6I�j JOB LOCATION: b795( ISVJNM PIT ( Map) ( Parcel ) ( Subdivision ) HOMEOWNER: G r 1 i 6 ^ �' n- 'K eiA ( Name Address ) H1 51t 1-► so 66 66 --1-'5o J9 Ai 0 146 (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 , a State of Massachusetts General Laws Annotated. � HOMEOWNER SIGNATURE l� BUILDING PERMIT # 5 � � �xssarhnsrtia a _ 1. Grit of Xart4anlvtou w A'EU�-; 1 61999 ,DEPARTMENT OF BUILDING INSPECTIONS X212 Main Street ' Municipal Building Northampton, Mass. 01060 WORKER'S COMPENSATION INSURANCE AFFIDAVIT \Q' &-1-1-1 VwIn S (liven-serJPeruli ) with a principal place of business/residence at: (phone#) (streeilcity/statthz p) 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 Comparry/Policy Numbcr) (Expiration Date) (Name of Contractor) (Insurance Company/Policy Number) (Expiration Date) (Name of Contractor) (Insurance Compalry/Policy Number) (Expi.ration Daze) (Name of Contractor) (Insurance Company/Policy Number) (Expiration Date) (auarh additional slid if nocc=Uy to bch).&informatioa pertaining to all watrn r3) I am a home owner performing all the work myself. NOTE:please be aware that vihilo homcoxvm who amploy p=om to do= .eca cc coastru oa'at repair worts on a dwelling of not morn than throe units is which the hom owocr raids or oa the grounds appurtenant tb=w arc not generally oomdacd to be employers under the works':oompcn=4oa Act(GL152,s 1(S)),app da6on by a homeowncr for a ricctue a permii may evideooe the legsl status of an employer under the Workers Compmsatioa AcL I undmt=d that a oopy of this ruLcromt may be forwarded to the Dcpeutara2 of Indsu rial ADddm&Oboe of Iixunnoe for the oovaage verification and that failure to soiree cowmv under soctioa 25A of MOL 132 as lead to the'imposition of criminal pcaalfics comist mg of a fine of up to S1,300.00=&or k4xisoamait of tip to one year and Civil pcml6es is the form of a Stop Work Order and a firm of S 100.00 a day Inc For d tsao oily permit Nltmbet Lot# Si of Li ermitxee: 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 NOy IF YES,describe size,type and location: 11. ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE DENIED DUE TO LACK OF INFORMATION. This cclu= to be filled in by the Hcildiny Department 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 &Paved parkingi # of -Parking spaces f of Loading Docks Fill: (vol-ume--& location) 13 . Certification: I hereby certify that the i.nformatio contai here 'n is true and accurate to the best of my know l dge. DATE: �I �6/c,c\ APPLICANT's SIGNATURE NOTE: lamuanoe of a zoning permit does not relieve an applioarka bard n Yo comply wit"`all zoning requirements and obtain all required permits from the Board of Health, Conservation Commission, Department of Public Works and other applicable permit granting authorities. FILE # ,t Fi 1 e No. Poo ,.,Z0NXNG PERMIT APPLICATION (§10 . 2) PLEASE TYPE OR PRINT ALL INFORMATION 1. Name of Applicant: l� -rw� Address: �1 �y 4' S 0 C N �lA Telephone: 2. Owner of Property: 'v" °�wW4 �' 1J�aq— ��r`��3 ay-'% Address:.-1t-'5\ %- ddress--1t`1 %- 0"A S Q t� `��. Telephone:-- S 3. Status of Applicant: 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 C' 1 6. Description of Proposed Use�9rk/Project/Occupation: (Use addonal sheets if necessary): �.�.. d� '' (��,S-O E�� 4\ -�1 °J�-L 1L �ro,•�, �a�lL � �� Ste: 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 Pe mit/Vadance/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) File#BP-2000-0176 APPLICANT/CONTACT PERSON REYMOND WENDELIN&HEIDI ERIKSON ADDRESS/PHONE 898 BURTS PIT RD 584-5066 PROPERTY LOCATION 898 BURTS PIT RD MAP 36 PARCEL 185 ZONE SR THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Buildina Permit Filled out Fee Paid 27,5 Tvpeof Construction:_ENLARGE EXISTING WINDOWS&REMOVE EXISTING REAR DECK New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building_Plans Included: Owner/Statement or License 3 sets of Plans/Plot Plan THE OWING 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 Septic Approval Board of Health Well Water Potability Board of Health Permit from Conservation Co 'ssion Signature of Building OfKal 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. 898 BURTS PIT RD BP-2000-0176 GIS#: COMMONWEALTH OF MASSACHUSETTS t Map:Block:36- 185 CITY OF NORTHAMPTON Lot:-001 Permit: Building Category:renovation BUILDING PERMIT Permit# BP-2000-0176 Project# JS-2000-0274 Est.Cost: $4500.00 Fee:$50.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: Lot Size(sq.ft.): 31232.52 Owner: REYMOND WENDELIN&HEIDI ERIKSON Zoning: SR Applicant:_ AT.• 898 BURTS PIT RD Applicant Address. Phone: Insurance: ISSUED ON.•8/23/1999 o:oo:oo TO PERFORM THE FOLLOWING WORK.-ENLARGE EXISTING WINDOWS & REMOVE EXISTING REAR DECK 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: r 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 8/23/1999 0:00:00 $50.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Building Commissioner-Anthony Patillo ?g z. I .-F,xtr�a± -r: °F Y."�.�` "iE^x:'" PIT R n a i R5 049 of Whvin All MY 1211 Ann W or I WIN S. toot x s s STS E,` Co'blMONWEALTH1,10F MASSA ,EW- MV 185 , T � TON Lot:-tIO2 Permit; Suildino C�tenorv:ttttvation . PgMT.' PE"ISSION IS HEM Y GRANTED TO.- PrQie't# JS-�C1274 � __; Contruc©r: .License: 4�U'RE M maRMU N HED1 E1 QTt Ejulit's PIT Do lcAdres • Phone: �,arr,ice: M PEIt+ F0"- ?`)' rOLLO ING :' ILARt I: 9XISTING WINDOWS &COVE EXISTING FEAR MIK E Isa or atl r ,U tw'of*1ft9 b.P.W: Insv"r ofbo", Und� rd; Ice. iVteer F boom: =Fou�dtttioa; - Rough Ftro Gaa Uenartu ent F1rep1weXhh=q-. I au ►i : lmifttloH: TM� !. T Y BE RRYOXW BY THE CWY ORT A,11 ON UPON VIOLATION OF a 0 01 P Date P ' eck osa Building 943/1999(0:00:00 $50.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Y Building Commissioner-Anthony Patillo