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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. cc�yy���,, Alterations
a rNORTHAMPTON, MASS. ��� 19 Additions
Additions
APPLICATION FOR PERMIT TO ALTER Repair
Garage
1. Location o� Lot No.
2. Owner's name —Address—A -C>
3. Builder's name Address
Mass.Construction Supervisor's License No. Expiration Date
4. Addition r
5. Alteration_�` AfT w(�5f
6. New Porch
7. Is existing building to be demolished? 0c)
8. Repair after the fire �jd
9. Garage Q - No.of cars Size !4
0. Method of heating 96-0
11. Distance to lot lines
12. Type of roof
13. Siding house ka. QZ)CD
14. Estimated cost:-
q l � The undersigned certifies that the above statements are we to the best of his
knowle ge and belief.
Signature of responsible app icant
Remarks
Crzf� of 'Norf11all y f oil
s$ 1 SLins�xci�uteUe C7'
pEPT OF BUt'«'taG Izz;E IbNSDE ARTMENT OF BUILDING INSPECTIONS
P'.
x'12 Main Street ' Municipal Building '
INSPECT Northampton, Mass. 01060
HOMEOWNER LICENSE EXEMPTION
S/
q (Please Print)
DATE:
JOB LOCATION•
(map)- (Parcel) (Subdivision)
HOMEOWNER: —DOwt'a
IN (Name & Address) / r
37o-5'7a-7 .
(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 iYe Building
Official, on a form acceptable to the Building Official, . that he/she :
shall be responsible for all such work performed under, the ebuilding
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 PERMIT # �L
of �DZ#ljttllt�l�Qtt z
s +� � yn AEf ACtt llf CttE MAY 6 P
s" "'L>EPARTMENT OF BUILDING INSPECTIONS
212 Main Street • Municipal Building
' '>o
, •`,
Northampton, MA 01060
Applicant Information
Name— �,�b
Location
City-- 4L1r�",�"'4- --------------------
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 tvIGL 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 certi under Qthe fpairs nd penalties of perjury that the information provided above is true and correct.
Signature \ G— f Date C4 ( q 1
Print NameCJ��.it� \ ����Cy l Phone# Y Y01 (1-7
Official Use Only Do not write in this area to be completed by city or town official
City or Town PermitfLicense 0 ❑ HuMmcDept
E)Lrensing Hood
Check if immediate response is required
Contact Person El Selo'Dept.
Phone#
Heahh Dept.
10 Do any signs exist on the property? YES NO
M Z
IF YES, describe size,type and location:
Are there any proposed changes to or additions of signs intended for the property? YES NQ)O
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 Railding 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
&paged park.Lngl
# of -Parking spaces
# 'of 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 kn wledge.
DATE: �jCD- 1 APPLICANT s SIGNATURE
NOTE: Issunnoa of a zoning permit does not relieve an applioanYs burden to comply wit"-ell
zoning requiramants and obtain all required permits from the Board of Health. Conservtation
Commission, Department of Pubilo Works and other applloable permit granting authorities.
FILE #
MAY 6 �g
File No.
pEPT of 8tlrtnit�c fk 15f
a, e SPEIONS
ny r '''r0 ING PERMIT APPLICATION (§10 . 2)
PLEASE TYgqPE OR PRINT ALL INFORMATION
1. Name of Applicant:
Address: c'�U �U �l /T u�� � Telephone: 7 0. 0 8
2. Owner of Property: CGS-!—
Address: Telephone:
3. Status of Applicant: Owner —Contract Purchaser Lessee
Other(explain):
4. Job Location: f4t-e- r AUrcy ti &,wo t
Parcel Id: Zoning Map# 5(!- Parcel# 6 District(s):
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/Property
6. Description 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.
S. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO DON'T KNO:A./,� _ 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? Np 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)
26 DAY AVE BP-1999-0927
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 25C-068 CITY OF NORTHAMPTON
Lot: -001
Permit: Building
Category:roofing BUILDING PERMIT
Permit# BP-1999-0927
Project# JS-1999-1589
Est. Cost: $900.00
Fee:$20.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group:
Lot Size(sa.ft.): 8015.04 Owner: PINARDI DAVID&ELISE CHARKOUDIAN
Zoning:URB Applicant._
AT. 26 DAY AVE
Applicant Address: Phone: Insurance:
ISSUED ON:51611999 0:00:00
TO PERFORM THE FOLLOWING WORK.-STRIP & 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 5/6/1999 0:00:00 $20.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Building Commissioner-Anthony Patillo