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31B-035 (6) T > 2 < n F � T '9 v ^► Z rn rn Cn Z c ` O rrir, 0 Zoning Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations 1 NORTHAMPTON, MASS. 19 Additions APPLICATION FOR PERMIT TO ALTER Repair Garage A —1. Location r� rti,1 rLL J T'- ^.t r,2'f A�tr,�to:.i Lot No. --2. Owner's name J."'i Ye j,-,3 -Address IL 01 Y A-R.L YT- 3. Builder's name Address Mass.Construction Supervisor's License No. Expiration Date v4' Addition s niter= a E e I�(,- / 5. Alteration 6. New Porch Q -- Is existing building to be demolished? f j — T �,�i �r c K- 8. X / Repair after the fire 9. Garage No.of cars Size 10. Method of heating 11. Distance to lot lines 12. Type of roof 13. Siding house L-14. Estimated cost- o c C? -- The undersigned certifies that the above statements are true to the best of his, her knowledge and belief. c,1 ugnailWof responsible appicant Remarks i i i �� $ � � � �lasasrituartta Grif� Of Nart4amptoll MAY ( 9X997 DEPARTMENT OF BUILDING INSPECTIONS = , INSPECTOR 212 Main Street ' Municipal Building c ;Of Northampton, Mass. 01060 HOMEOWNER LICENSE EXEMPTION / (Please Print) DATE: �/ It L-7 7 JOB LOCATION: 3i t3 44 3S (Map) (Parcel) ( Subdivision) HOMEOWNER: i-I is 0 Au C (Name & Address ) 1 myn-,t.t S'r- ,JL47LA.4 .,nr6 .1 (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 # _, � p�u7 7 ru i I I i I r ° Gx ' r an #1 M MA 997 • �iasaachtrsctfa ?T u'� DEPARTMENT OF BUILDING INSPECTIONS ' 212 Main Street ' Municipal Building ' Northampton, Mass. 01060 WORKER'S COMPENSATION INSURANCE AFFIDAVIT (lio se&permittee) with a principal place of business/residence at: i� ►MYnT`� sT— AJoAT-4,-nata,J ✓ham...- (phone#) (strcef/city/st d2ip) 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 Dale) ( ) 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 Company/Policy Number) (Expiration Date) (Name of Contractor) (Insurance Company/Policy Number) (Expiration Date) (Name of Contractor) (Insurance Company/Policy Number) (Expiration Date) (Name of Contractor) (Insurance Company/Policy Number) (Expiration Date) (attach additicml shed ifnecenary to include infwwafion pertaining to all oorrtradors) ( ) 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 homoownem who employ pe mm to do mai*+t____c_a_� consuuction or tcpair work on a dwelling of not mote than throe unite m which the homeowner resides or on the gmxh g7irtenvt thereto are not gearalty considered to be employers under the worket's compensation Ad(GL152,ss 1(5)),application by a homeowner for a license or permit may evidence the legal status of an employer under the Worker's Compensation Act. I understand that a copy of this statement may be faweuded to the Depnctarmt of I itrial Acm w&Office of 1=wnu ce for the coverage verification and that failure to secure coverage utxiar section 25A of MGL 152 can lead to the imposition of criminal penalties oomistiug of a fine of up to S 1,500.00 and/or imprisonment of up to one year and civil penalties in the form of a Stop Work Order and a f=of 5100.00 a day against t>x v; Signed this ti day of 199 7 For dgmtm w use only Permit Number Lei# Mao Li ren4t Si of I I I l l I l I I I I !ilr�( j � idyl (j o . TPT OF H! 1 � 1 / i J r* f Y l i ;; 1f Dec I� 1FP�� 20 e )34 1.5Fr/B 15 y: 1.SFr 1 28 17 SFr/B OFP 5 5 _ J 7 10 5 OFP 4 { r U 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?YYES 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 columa to be filled in by the Building Department 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 parking) :pf -Parking Spaces f rof Loading Docks Fill: '4vol-ume--& location) 13 . Certification: I hereby certify that the informatic'n contained herein is true and accurate to the best of my knowledge. DATE: -5ii�rS APPLICANT's SIGNATURE ' NOTE: issuanoe of a zonin g permit does not relieve an lioant's buioUs&to comply wltlx,,A"ll- zoning requirements and obtain all required permits t 6A the Bomr4f of Health. Conservation Commission. Department of Publio Works and other applionble permit granting authorities:;.. FILE # AY 9 1997 Fi 1 e No. ��'IFPT O WkING PERMIT APPLICATION (§10 . 2) PLEASE TYPE OR PRINT ALL INFORMATION 1. Name of Applicant: �i �^1 �Q V "G Address: l r'"Y;i7t_t` 3'7_ NclTu.4.mP ­J Telephone: 2. Owner of Property: Address: Telephone: 3. Status of Applicant: _Owner Contract Purchaser Lessee Other(explain): 4. Job Location: /G r" Y,1-'L s` Parcel ld: Zoning Map# J Parcel# District(s): (TO BE FILLED IN BY THE BUILDING DEPARTMENT) 5. Existing Use of Structure/Property L fT"^7( `'/°`"L 6. Description of Proposed Use/Work/Project/Occupation: (Use additional eets if necessary): 4�:te a e U7 64 K, /® X c , 7. Attached Plans: X 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: 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) r�,r` i I FILE # NAY 1 999, P CT PERSON: DE. t!. ��kESSRIIONE. /G PROPERTY LOCATION: _ MAP �I/ B PARCEL: L `� ZONX eC, THIS SECTION FOR-OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM VELLED OUT 1RniIfjin2 Permit Filled plit Fee Paid C;lt ►/ G Type of Cnnqtriirtinn- y)(q New Ccingtriirtinn f THE LOWING 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-Bd of Health Well Water Potability-Bd Health Permit from Conservatio mmiss'o Signature of Building InV r e NOTE:Issuance of at zoning permit does not relieve an appiioant's burden to oompty with all zoning requirements and obtain all required permits from the Board of Health, Conservation Commission, Department of Public Works and other applicable permit granting authoritles. II I II i I I� III �,. _ I sREQUIRED City of Northampton INSPECTIONS e 1. Footings and Walls BUILDING DEPARTMENT 2. Structural Components in Place* o 3. Complete Building* Office of the Building Inspector No. ai 2 Date 5/20/97 Fee $40.00 Aleck# 720 Zoning Form No. 962269 F°aSe, 31B Parcel 35 ,Zone URC Section 127 ❑ Yes © No BUI]LDINGPERNM * Plumbing and Electrical Inspections required THIS CERTIFIES THAT Jim Young before Building Inspections has permission to replace 8' X 9' deck w 110' X 12' deck Inspection on Site—Foundations situated on 16 Myrtle St Inspection of Plumbing—Rough provided that the person accepting this permit shall in every respect Inspection of Plumbing—Finish conform to the terms of the application on file in this office, and to the Gas Inspection provisions of the Statutes and the Ordinances 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 above noted is an immediate revocation Inspection of Wiring—Finish of this permit.Expires six months from date of issuance,if not started. Building Inspection—Rough Note:A certificate of occupancy will be issued by this office upon return Insulation Inspection of this card signed by the Plumbing,Wiring and Building Inspectors. Building Inspection—Finish Smoke Detectors(Fire Department) Other THIS CARD MUST BE DISPLAYED IN A CONSPICUOUS PLACE ON PREMISES Certificate of Occupancy Bu' ding Inspector