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U Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No.
`3 J Alterations
NORTHAMPTON, MASS. V
�ek n 24 1911 Additions
Repair
' APPLICATION FOR PERMIT TO ALTER
Garage
1. Location twa^ �1 �,y�Y10 ql e6, ' 0/0(,2- Lot No.
2. Owner's name l 1M OTq-t1 615"p f Address 71 Wee S 2P rhA Aall) fe'tl
3. Builder's name Address
Mass.Construction Supervisor's License No. Expiration Date
4. Addition
5. Alteration 's
6. New Porch
7. Is existing building to be demolished? 0
8. Repair after the fire N 0
9. Garage ! No.of cars Z Size
10. Method of heating ;-"15 TGtce of
11. Distance to lot lines l
12. Type of roof
13. Siding house
14. Estimated cosL- ,
The undersigned certifies that the above statements are we to the best of his,
know! bel'
Signal of responsible app,ican!
Remarks
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u, . ARTMENT OF BUILDING INSPECTIONS
fif �� �•�z ' ;,T,J 2 Main Street Municipal Building
Northampton, Mass. 01060 '
WORKER'S C01Y1TENSATION INSURANCE AFFIDAVIT
(li ceri see/perms ttce}
with a principal place of business/residence at:
`71 "'04) Nh-ArfleD g, 11` 0/062 (phone#)
(stre�.i/city/statrJzip)
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 o win homeowner cle one) and have hired
the contractors listed below who have the follog wor er's compensation policies:
1'P111 1 �1 ke Af
(Name of Contractor) Rnslunce Company/Policy Number) (Expiration Date)
(Name of Contractor) (Insurance Company/Poticv Number) (Expiration Date)
(Name of Cont actor) (Insurance Con pauy/Poky Number) (Expiration Date)
(Name of Contractor) (Insurance; Company/Policy Number) (Expiration Date)
(attach additional sheet ifnaoesssry to inchide informs .pertaining w all c..bm ors)
O I am a sole proprietor and have no one working for me.
( } I am a home owner performing all the work myself.
NOTE:please be aware that while homcowvas who employ perzons w do maiutenane,oowtuctioa or repair work on a dwelling of
not mote than throe units is which the homoow acr resides or oa the grounds appurtenant thereto arc not gc oernlly ooasid-ed to be
employers under the%Ymicn"s oompenseioa Act(GLl52,s 1(5)),application by a homeowner for a license or permit may evidcnoe the
legal rtaiva of an employer under the Workers Compms►iion Act
I understand that x oopy of this uatcmau may be forwarded to tha Dcpnrimm2 of In&&u ial Accld=&O1fioc of InwJM oo for the
coverage unification and that failure to sinus covcrngo under soctiou 25A of MOIL 152 can lead to the imposition of criminal prnalties
oogn.,amg of a fine of up to S1,500.00 and/or irvr6o=x:3t of up to one yev and civil penalties in the form of a Stop Work Order and a
fine of 5100.00 a day against mc.
For dgmtm-►I use only
--- l permit Number
Lot.#
Si&aturt 6f LiccnseeJPerad
+8 s .f�assRrtp�artla ' .�
FFR 2 Q 19-CA
DEPARTMENT OF BUILDIXG INSPECTIONS
INSPECTOR " 212 Main Street ' Municipal Building
Northampton, Mass. 01060 "
HOMEOWNER LICENSE EXEMPTION
rr s
(Please Print)
DATE: �4 - 2�, �
JOB LOCATION-
(Ma ) (Parcel) (Subdivision)
HOMEOWNER: 'T I M 6 t1 " LS Orr
(Na e & Address)
1 W0'0v, r U%Y�a r1f62 4)3 °584-3<3q- 4r3-413 •?31 �
(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
r: for compliance with the State Building Code, City of Northampton
Ordinances, State and Local Zoning Laws, and State of Massachusetts
General Laws Annotate
HOMEOWNER SIGNATURE
BUILDING PERMIT _ s
10 Do any signs exist on the property? YES NO v
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 cols to be filled in
by the Building Departm nt
Required
Existing Proposed By Zoning
Lot size
Frontage
Setbacks
- side L: R: L: R:
- rear
Building height
Bldg Square footage
%Open Space:
(Lot area minus bldg
&paved parki_ngli
# of -Parking spaces
# fof Loading Docks
Fill:
-(volume--& location)
13 . Certification: I hereby certify that the information contained herein
G is true and accurate to the best of my knowl edge.
DATE: APPLICANT's SI GNATURE
NOTE: Issuance of a zoning permit does not relieve an applioant's buralelh to oomply vrit4_$11
zoning requirements and obtain all required permits from the Board of Health. Conservation
Commission. Department of Publio Works and other appliooble permit granting authorities,
FILE #
FEB 2 4 C
File No
r
ZONING PERMIT APPLICATION (§10 . 2)
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant: I N101'N"1 6)WP
Address: 71 Ind 0C/D 5 v _Telephone: 413 Z
2. Owner of Property:
Address: Telephone:
3. Status of Applicant: ✓Owner _Contract Purchaser Lessee
Other(explain):
4. Job Location: 5AT4-
Parcel Id: Zoning Map# Parcel# District(s):
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/Property
6. Description of/proposedt,U`se/Work/Project/Occupabon: (Use additional sheets if necessary):
Gtr A PP7 VAI U�� �' l ►Y-n k ?/ayorm
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.
S. Has a Special PermittVariance/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-1999-0724
APPLICANT/CONTACT PERSON BISHOP TIMOTHY M&ELIZABETH
ADDRESS/PHONE 71 WOODS RD
PROPERTY LOCATION 71 WOODS RD
MAP 36 PARCEL 277 ZONE SR
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out
Fee Paid
Typeof Construction: BASEMENT PLAYROOM --°
New Construction
Non Structural interior renovations
Addition to Existin¢
Accessory Structure
Buildi Included:
Q)ygqj-jStatement or License
3 sets of Plans/Plot Plan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION:
Approved as presentedibased 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
igv `$aard off ,j w' Well Water Potability Board of Health
Wi ♦ i�,� a y' Y�y\yf
Permit from Conservation mmission
Signature of Building ffficial 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.
f l
71 WOODS RD BP-1999-0724
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map:Block:36-277 CITY OF NORTHAMPTON
Lot:-001
Permit: Building
Category:Non structural interior renovations BUILDING PERMIT
Permit# BP-1999-0724
Project# JS-1999-1319
Est. Cost: $4000.00
Fee: $40.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group:
Lot Size(sg ft.): 51400 80 Owner: BISHOP TIMOTHY M&ELIZABETH
zoning: SR Applicant:_
AT: 71 WOODS RD
Applicant Address: Phone: Insurance:
ISSUED ON.•2/2a/99 0:00:00
TO PERFORM THE FOLLOWING WORK.-BASEMENT PLAYROOM
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 2/24/99 0:00:00 $40.00
212 Main Street,Phone(413)587-1240,Fax:(413)587-1272
Building Commissioner-Anthony Patillo
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71 WOODS RD BP-1999-0724
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map:Block:36-277 CITY OF NORTHAMPTON
Lot:-001
Permit: Building
Category:Non structural interior renovations BUILDING PERMIT
Permit# BP-1999-0724
Project# JS-1999-1319
Est.Cost: $4000.00
Fee:$40.00 PERMISSION IS HEREBY GRANTED TO
Const. Class: Contractor: License:
Use Group:
Lot Size(sq.8.)_ 51400.80 Owner: BISHOP TIMOTHY M&ELIZABETH
Zoning:SR Applicant:
AT., 71 WOODS RD
Applicant Address: Phone: Insurance:
ISSUED ON.•2124199 o:oo:o0
TO PERFORM THE FOLLOWING WORK.-BASEMENT PLAYROOM
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:
I Footings:
Rough: Rough: .2�.2 34 F 44.4 House# Foundation:
Final: Final: j 1411
Rough Frame:
Gas Fire Department Fireplace/Chimney: ( r
Rough: Oil: Insulation:
Final: Smoke: Final:
THIS PERMIT MAY BE REVOKED BY THE CIT F NORTHA 'TON UPON VIOLATION OF
ANY OF ITS RULES AND REGULATIONS.
Certificate of Occupancy
i at re•
Fee Type: Receipt No: Date Paid: Check No: Amount:
Building 2/24/99 0:00:00 $40.00
212 Main Street,Phone(413)587-1240,Fax:(413)587-1272
Building Commissioner-Anthony Patillo