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25C-188 (3) ,o v b o• � ,$ 3 c o V) .. •, � zm x C: t C, Lon Z rn O Z o •• C7 Zoning Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. �'� 7 7 Alterations NORTHAMPTON, MASS. � 19 Additions - � APPLICATION FOR PERMIT TO ALTER Repair Garage 1. Location (' ` Lot No. 2. Owner's name C,C, - Address I k c4 I a.n tJ r4' 1-� 3. Builder's name (:�La i I is r Address Mass.Construction Supervisor's License No. Expiration Date 4. Addition t I 5. Alteration t h S Gib Gn/� C� f r0C.L �--Q 'uIbf-S 6. New Porch 7. Is existing building to be demolished? 8. Repair after the fire 9. Garage No.of cars / Size- L/ Q� 10. Method of heating 11. Distance to lot lines 12. Type of roof 13. Siding house 14. Estimated cost:- (am r av The undersigned certifies that the above statements are we to the best of his, her knowledge and belief. Signature of responsible app,icant Remarks O O g= °� GZf-2 al 'art4a11ipfoll Z 3 �`� �asaxchnsctta FEB I f 1998 m DEPARTMENT OF BUIt,DrNG INSPECTIONS 212 Main Street ' Municipal Building Northampton, Mass. 01060 ' WO RICE, COMPENSATZON TNSUIRANCE AFFIDAVTr I, (h otusccjpc rmi ttee) with a principal place of busines- /residence at: (phone#) (st v;t Uci ty/statdzi p) do hereby certify, under the pains and penalties of perjury, that: ( ) I am an employer providing the following workers compensation coverage for my emptoye-es working on this job: (Insurance Company) (Policy Number) (Expiration Dare) 1 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) (Insurancc Comparly/Policy Number) (Expiration Date) 6—a(_ e- s° Mme of Contractor) (Insurance Company/Poticy Number} (Expiratioa Date) (Name of Contractor) (Instrancti Compauy/Poticy Nuulber) (Expiration Date) (Name of Contractor) (Insivance Company/Policy Number) (Expiration Date) (anadi a&bcai!thx�Lfnt=rnuy to inc}uc}c infvrnvtion pcstn.iuing to all o�c:trad ) ,( I am a sole proprietor and have no one working for me. I am a home owner performing all the work myself. NOTE:pieaac be aware that wtn]o h«aoowncr3 woo employ perzow w do naxiEdxiiazkor,ccc:sln ctioa or repair work on a dwelling of oot morn than thrno units in which the homoowacr r=dcs«oa the grcunrh appurtenant,,Scrx D arc oot gencraily oomidacd w tx cwloyrr-a undo'the wteiccr13 c=pcmatica Act(GL152,s 1(5)�applira6aa by a homeowner for a liccwe oc permit may cvidcocc the legal etatrrs of an omployee under the Woikcez Compe xtion Act I undaTtAnd that a ocpy of this cEaicmcnt may bo forwnrdnd W tbo Dcpartrnczat of TndusGial A.ocidmte OfIioo of Sor tbn oovaage vaifiaatioa and that failure to scaue covccago under soc;doa 25A of MOL 152 can Icad to tbo"impovtioa of airninal Pcnsltics omIL'ting of a&nc'of up to 51,500.00 andloc imprisotmocsit of up to onc year abd civil panitics in the form of a Stop Work Ordcr and a find ofS100.00 a day ag&inst mc_ Signed this , day of Y_.►, 199f For&putrr�t=u-coly Permit Number C Mag# —Lot# Si tcxn.>celPctmit#cc OQ"�ttM!pip «, Grif� of 'Nart4ally tell $ FEB I I {9981$send1usrtts DEPARTMENT OF BUILDING INSPECTIONS INSPECT 212 Main Street ` Municipal Building ' Northampton, Mass. 01060 HOMEOWNER LICENSE EXEMPTION DATE• (Please Print) ��(��X JOB LOCATION: -7 J�^�J /YS — (Ma (Parcel) (Subdivision) HOMEOWNER: L` d (Name & Address ) (� O / - 2J2 "' /` OJ (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, and State of Massachusetts General Laws Annotated. HOMEOWNER SIGNATURE BUILDING PERMIT # 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 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 colu= to be filled in by the Building Zkpnrtment 1 Required 1 Existing Proposed By Zoning I Lot size Frontage Setbacks - front - side L: R: L: R: - rear --�� Building height Bldg Square footage %Open Space: (Lot area minus bldg &paged parking i # of -Parking Spaces # (of Loading Docks Fill: volume-& location) 13 . Certification: I hereby certify that the information contained herein .a is true and accurate to the best of my knowledge. DATE: - APPLICANT's SIGNATURE NOTE: Issunnoo of a zoning permit does not relieve an applioant's burden to oompty mgth'all zoning requlremonts and obtain all required permits from the Board of Health, Consery tatio n +Commisslon. Department of Publio Works and other applioable permit granting authorities. FILE # FEB I 1 1998 , File 963 c� ' .� ... �. ZONING PERMIT APPLICATION (§10 . 2) PLEASE TYPE OR PRINT ALL INFORMATION 1. Name of Applicant: V � ci= Address: 31 -A"2 Jt I(A �� Telephone: 2. Owner of Property: Address: j 1 �` r - Telephone: 3. Status of Applicant: Owner _Contract Purchaser lessee Other(explain): 4. Job Location: — 5'1 Parcel Id: Zoning Map# Parcel# Z6 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): 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: as the permit recorded at the Registry of Deeds? NO Y 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 # � FEB I I APPLICANT/CQNT?ACT PERSON: ADDRESS/I'HtOIE: PROPERTY LOCATION: C)9 " MAP �(2� PARCEL: /9 ZONE THIS SECTION FOR-OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONTNG FORM M OUT Fpp Paid 1Ri6l(jin2 Permit Filled nut t� Fee Pnid TvnP of Cnnstnictinn- Netiv Arrect_nry�trurtiirt- THE IN OLLOWG ACTION HAS BEEN TAKEN ON THIS APPLICATION- ,,,F, 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 I/ 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-Bd of Health Well Water Potability-Bd Health !Permit from Conservatio ommiss'ion Signature of Building or Date NOTE:issuanoe of a zoning permit does not relieve an appiloant's burden to oomply with all _ zoning requirements and obtain call required permits from the Board of Health, Conservation Commission, Department of Public), Works and other applioable permit granting authorities. lift, � a , p�°�°� . City of Northampton REQUIRED INSPECTIONS DING DEPARTMENT 1. Footings and Walls 0 ! BUIL 2. Structural Components in Place* 4 3. Complete Building* Office of the Building Inspector No. 1282 Date 2/13/98 Fee $40.00- (deck# 566 Zoning Form No. 963210 Page, 25C Parcel 188 ,Zone uRC Section 127 ❑ Yes ❑ No P 71 Buln-LDING *Plumbing and Electrical Inspections required THIS CERTIFIES THAT Gai' Paddock before Building Inspections has permission to insulate & sr ;etrock upstairs garage Inspection on Site—Foundations situated on 29-31 Highland`ve Inspection of Plumbing—Rough provided that the person acceptint this permit shall in every respect Inspection of Plumbing—Finish conform to the terms of the applic n on file in this office,and to the Gas Inspection provisions of the Statutes and the ances relating to the Construction, Inspection of Wiring—Rough Maintenance and Inspection of Buildings in the City of Northampton. Any violation of any of the terms a noted is an immediate revocation Inspection of Wiring—Finish of this permit Expires six months. ,m date of issuance,if not started. Building Inspection—Rough Note:A certificate of occupancy 3e issued by this office upon return Insulation Inspection of this card signed by the Plumb Wiring and building Inspectors. Building Inspection—Finish Smoke Detectors(Fire Department) Other ,c --- THIS CARD MUST BFF 'TISPLAYED IN A CONSPICUOUS PLACE ON TWPREMISES Certificate of Occupancy Building Inspector