25C-133 (7) 10/8/03 Steven Zucchino
70 Gleason Road
Northamton, MA 01060
584-3878
Scope of work at 44 Elizabeth Street-
Replace windows on two story side porch with vinyl replacement windows and
prep for vinyl siding(to be done by someone else ). Replace entry door with full lite fiberglass
door. Repair posts and railings on open front entry porch.
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212 'Main SUM blunic pY Buildjq
Northampton, 1,1ras. 07060
WOI:IU,R'S COMPENSATION INST.MAN(T AFFIDAVIT
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rove ale vciFic lion and It t fsil to c at:c wtt�n uc 3 r seetict 25A of MCI,152 cin Icad to tlxi i:n;»s:fic�"
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SECTION 8 -CONSTRUCTION SERVICES
8.1 Licensed Construction Supervisory: Not Applicable ❑
Name of License Holder :_ ��QM .V�-C-�1����__..._____ _ �»�--------
License Number
Rep
Addre s E on Date
gnature Telephone
a
9Regtster'ed HoMrrielrrip'r.'ove'rrient-Contractor .,.,.. HUN , ,„p,.d_b, f„ Not Applicable ❑
Company Name Registration Number
A/d�drress / C Expira ion Date
1_6 ��l��:5 �. n 019. Telephone�tf
SECTION 10- WORKERS' COMPENSATION INSURANCE AFFIDAVIT(M.G.L, c. 152, § 25C(6))
Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit
will result in the denial of the issuance of the building permit.
Signed Affidavit Attached Yes....... ❑ No...... ❑
{ll �H'ome0`vnerExemption
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
ns supervisor. CMR 780 Sixth Edition Section 108.3.5.1.
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 perforated 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 (IIiability 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 — _
SECTION 5- DESCRIPTION OF PROPOSED WORK(check all ap linable
New House ❑ Addition ❑ Replace ent Windows Alteration(s) [I Roofing 11 Or Doors
Accessory Bldg. ❑ Demolition[] New Signs [ Decks [ ] Siding [ ] Other [ ]
Brief Description of Proposed Work: t� _ ,H_, We -� ,ry
Alteration of existing bedroom ___-_____Yes No Adding new bedroom -Yes ----- No
Attached Narrative rI Renovating unfinished basement Yes No
Plans Attached Roll ❑ - Sheet ❑
6a."1f'New:1fou'se'and or addition to existing housing, complete the«followin_;
a. Use of building : One Family ?wo Family _Other
b. Number of rooms in each family unit . _ Number of Bathrooms--_
c. Is there a garage attached?
d. Proposed Square footage of new construction._ ___ _ Dimensions
e. Number of stories? _
f. Method of heating? Fireplaces or Woodstoves _ Number of each
g. Energy Conservation Compliance _- Mascheck Energy Compliance form attached?
h. Type of construction
i. Is construction within 100 ft. of wetlands? ___ Yes No. Is construction within 100 yr floodplain , _Yes_ -No
j. Depth of basement or cellar floor below finished grade
k. Will building conform to the Building and Zoning regulations? Yes No
I. Septic Tank City Sewer Private well ____ City water Supply
SECTION 7a - OWNER AUTHORIZATION - TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
I, __ '���vNc �— / _- ___ as Owner of t'�ne subject property
hereby authorize �1�U -�'� ✓rLC11, o to ac; or
my behalf, in.a_U matters rela ve to port, authorized by th s building pe mit application.
Signature of Owner Date -
I, _ k(/QA-\ ��'�� �1,11� __ as Owner/Authorized Agent
hereby declare that the statements and information on the foregoing application are true and accurate, to the best of my
knowledge and belief.
Sign nder the pains and p aloes of perjur /
--- --�Pr e
Signature of Owner/A t _ _a —__
Section 4.
ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE
DENIED DUE TO LACK OF INFORMATION
Existing Proposed Required by Zoning
This column to be filled in by
Building Department
Lot Size
Frontage
Setbacks Front
Side L: R: L: R:
Rear
Building Height
Bldg. Square Footage %
Open Space Footage %
(Lot area minus bldg&paved
parking)
# of Parking Spaces
Fill:
volume&Location
A. 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 Document #
B. Does the site contain a brook, body of water or wetlands? NO bON'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:
C. Do any signs exist on the property? YES NO
IF YES, describe size, type and location:
D. Are there any proposed changes to or additions of signs intended for the property ?YES _
No
IF YES, describe size, type and location:
r-- - - ---- - -- � Depatrpentsusonlytt 4
r City of Northampton Status of er
Pmit ��
JIM
Building l); partment Curb Cut/Driveway - rmlt .
i 212_ Mein Street Sewer/,SepticAv labi(Ity r ��f g '
Room 100 Water%Well Avaalablllty f���� ��t��� ��r� t �';
t $ Nt
Nor thamipton, MA 01 _)60 Two-Sets"6 Structural P,Jarts �W ..,a
IilJil(? l�l �i 12t0 Fax 1!358/ - , .' PIQ ��I:e �II � �
Oth6t t x ,
_
APPLICATION TO CONSTRUCT ALTER .REPAIR, RENOVATE OR-DEMOL,I ISH AtON;E O_R �WO�E Q
M J IL Y pVVELLING
(r+~fit ,_.II
J
SECTION 1 SITE INFORMATION L
1.1 Property Address:
This section to be completed by office
1`4ap- - Lot Unit---
Zone Overlay District
_ _ Elm SA, District_ CB District____—
SECTION 2 PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
Nlame
l
gn tt r
-- - - ----
2.2 Authorized_Agertt: r�� /�
7 r+
eh"? r -
SECTION_3 ES_ ATED CONSTRUCTION COSTS
Item � estimated Cost (Dollars) to b, Offici,a! Use Only
I t p opGca it
rr, �� _ ed v errs it a, --
J(
(al lN — - -- - ----.—.
E3uilding Permit Fee
Total Cost c`
-,� Est action from (6)
- -------------
3. t 'ut��bir g Building Permit Fee
�.
Fire -rote ton � —
6 ]ota� Check Number
This Section For Official Use Onl
Building Permit Number: _ Cate Issued: __
Signature:
Building Commissioner/inspector of B rnldings Date
L ETH S BP-2004-0411
GIS# COMMONWEALTH OF MASSACHUSETTS
t;I CITY OF NORTHAMPTON
Lot: -001
Permit: Building
Category: BUILDING PERMIT
Permit# BP-2004-0411
Project# JS-2004-0597
Est. Cost: $5600.00
Fee: $25.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: Steven Zucchino 100199
Lot Size(sa. ft.): 7056.72 Owner: LEE TERRENCE J
Zoning:URB Applicant: Steven Zucchino
AT. 44 ELIZABETH ST
Applicant Address: Phone: Insurance:
70 Gleason Road (413) 584-3878
NORTHAMPTON MAO 1060 ISSUED ON:10 110103 0:00:00
TO PERFORM THE FOLLOWING WORK.INSTALL PORCH REPLACEMENT WINDOWS
POST THIS CARD SO IT IS VISIBLE FROM THE STREET
Inspector of Plumbing Inspector of Wiring D.P.W. Building Inspector
Underground: Service: Meter:
Footings:
Rough: Rough: House# Foundation:
Driveway Final:
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:
FeeType• Receipt No: Date Paid: Check No: Amount:
Building 10/10/03 0:00:00 445 $25.00
212 Main Street,Phone(413) 587-1240,Fax: (413)587-1272
Building Commissioner-Anthony Patillo