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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations
40 NORTHAMPTON, MASS. _ -e 19 qp Additions
APPLICATION FOR PERMIT TO ALTER Repair_ 2,,o;1,2
Garage
1. Location :3 5 5 "1// 1CZdg22nC a A-a Lot No.
2. Owner's name 54e jer\, [A th,-s Address sc+.,. -f
3. Builder's name Address :i Y RRA 341.,40mo Q0l Ht.6da/C
Mass.Construction Supervisor's License No. Expiration Date
4. Addition
5. Alteration
6. New Porch
7. Is existing building to be demolished?
S. 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
14. Estimated cost:-
The undersigned certifies that the above statcmcn are the best of his, her
know ledge lief
Gurs r sponsible oppucont
Remarks 2e eac- n
Crz#�r zr" z#17�i1 }�foriY
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DEPARTMENT OF BVILDrNG INSPECTIONS
INSPECTOR 212 Main Street ' Municipal Building
Northampton, Muss. 01060
HOMEOWNER LICENSE EXEMPTION
(Please Print)
DATE:
JOB LOCATION : 3'5 SkgAwbpaa ,ll /=o,2A•1cC, All q s$
(map) (Parcel ) ( Subdivision)
HOMEOWNER: _S-f e✓e n M'w U 1z4*"e_
(Name & Address )
3S S�-swba�
Hill Fly k-L"
(Home Phone ) (Work Phone)
The current exemption for "homeowners" was extended to include
Owner-occupied Dwellings of one ( 1 )or two (2) fami 1 ies. 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 Uerformed under the buildinq
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 . a "
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 S I GNA=6:
BUILDING PERMIT #
SRC ti/J f P'0 ((rr
g 6 Alasxctilnsctta
DEPARTMENT OF BUILDING INSPECTIONS '
212 Main Street ' Municipal Building
Northampton, Mass. 01060
wo xw,S CoMeENSATION INSUT- NCE A�ITDAVE '
(11 CCIlSGLI pCrID)ttcc)
vnth a principal place of b"1SlIICSSJrCSIdencc at:
N
., (stmt/citylstalcJzip)
CIO hereby certifjr, under the pains aad penalties of PC * lf'f, that
( ) 1 2111 Lilt employer prOvldllw the [ollo\vIn \'JOt�SCi�S C.O[?lp`� S2 OI) COVC-IMOe for my
CtuDl0ye(�s wor ing On t11 is job_
(Izv-uzzic Ccri sf) (Poticr Nu :i:r) ( tivu [ion Dat-)
( I am P. Sole proDPetor, �gCner2] GOnt1,-CCOr Or L',OMCO 11DCr (Ci(-,iC one) and baVe tired
the contractors listed below Vrho gave e p pol0 -,�g - icies:
(l:CllllC of Cop.rT-'Ci(-C) (InSiL3ilC �,G[il J G�/��Ot1C{ NULaCCi) - �`:'��L C10R Datc)
-----------
(\LII1C 0I L011u1iC10O (ISL'Z�1L7C C.OL D,tll)'IPol1Cf NLl!.t"1.-r) Ap cLOCI D2te)
(Name of Con-u-actor) (Lnsziranct Company[Polief Nurnl-,-j) Date)
(Mamie of Contactor) (InsLuaucc. ConlpzslyfPoEcf i tuinLx-r) (I :'pira6on Date)
-fc�tioc:
O I arci a sole propnetor anti have no one worming for me.
( ) I am a home owner- performing all the work myself.
NOTL plczsc be awl,r dirt wtsilo hoo��wncn vt�o employ pc'-o 'w&mxiutmsnrX d.Tlling oC
`_--__—J oomidacd do be
nod moan than limo units is dcfrich the boQwos�vcr redo«oa tho p oundr xppurtcnad Ibc d4+-rc ood E�'tIy ma cvidcmc the
cmployrrs undo tbo wockc�`s oompnis:iim Au(GL132,n t(S)�appliation by a hommwncr for x liccnx a P� y -
IcSxI rW •of an cmployw under dbo Work e,Cooapo 11l- Aet
I uudmaa a thst a copy of this mtcmcat may bo forwardod to Lb.D p_t_d of Inb s is Anodmry pf5oo of lawn+o0o for tin
covaxgc vzrificidion and t hat Eiltmc to cxurc coves, undcr sanion 23A of MOL I52 as11d 10 tho'imponntoa of crimm'1 pmslhn
°O iiCt;Sme oCvp l0
S1500.00 cnd/or ([tip to.orse year end an7 pcv?lies w the form oC a Stop Woilc Oidcr.ind a
Tiro oCS 100:00'ti dxy igAdnst trig � -
u"o
,Pcrmit;2lumbcr
: `.:... .. .Sl jcclPcmu. -
rA1a
10. Do any signs exist on the property? YES NO X
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 —.I— 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]
# of -Parking Spaces
t %f Loading Docks
Fill:
Avol-ume--& location)
13 . Certification: I hereby certify that the information contained herein
is true and accurate to the best of my
knowl
DATE, PPICAT'S SINAUR� CI
"' —
NOTE: ss�a 1 an6e of a zoning permit does not relieve an aknwtV6ant-a--b%nf6`d- en & oom witl�atl
zoning requiramenta and obtain all required permits from the Board of Health, Conservation
Commission, Department of Publio Works and other appliomble permit granting authorities.
FILE #
File No. L3 i
ZONING PERMIT APPLICATION (§10 . 2)
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant:
�a
Address: _Telephone:
2. Owner of Property:
Address: Telephone:
3. Status of Applicant: _Owner Contract Purchaser Lessee
Other(explain):
4. Job Location: S 4 [�1hEf2R�/ /J �`—lv�2r�rice /W.
Parcel Id: Zoning Map# 1:20— Parcel# District(s):
(TO 8E-FILLED IN BY THE BUILDING DEPARTMENT) �s
5. Existing Use of Structure/P rope rty _//i-,e /
6. Description of Pro pos d 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: 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 X 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 # 907 U 1 �
UN
APPLICANT%CONTACT PERSON:
ADDRESS/PHONE:
PROPERTY LOCATION:
MAP PARCEL: ,j ZONE
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FH,T,FD OITT
Fee Pnid
Rnilding Permit Filled Mit
FpePnid
✓"
./
TvnP of Conctrurtinn-
New.Cnnstmirtion 01
Rerrind
Addition to a
v LIU 96
Arcyccnry Strnrture _
pffildiriv,
icr #
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS AP ICATION:
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 Conservation Commission
Signature of Building Inspector Date
NOTE:Issuanoe of a 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 Pubiio Works and other applioable permit granting authorities.
Department: Reference No: BP-1998-0074
----------------------------------
Building, Electrical & Mechanical Permits
... ..............................................•---•--------------...-----------......
Fee Type: Receipt No:
Roofing REC-1998-000082
Paid By: Paid in Full On:
Steven Hinks Fri Jun 26,1998
.......................•----........................-----....................---........
......................................
Received By: Check No:
Linda Lapointe 920
..................................•-•-•-•-.............•--••-•---........................
......................................
DEPARTMENT'S COPY Amount: $20.00
...........................
DEPARTMENT FILE COPY 35 STRAWBERRY HILL
CITY OF NORTHAMPTON
BUILDING PERMIT
Owner's pulling their own permits or dealing with unregistered contractors for applicable work do
not have access to Guaranty Fund(MGL 142A)
Issued: Permit No: Inspector: Tracking No.: Fee:
26 Jun, 1998 BP-1998-0074 963707 963707 $20.00
GIS #: Map Block: Lot: Address: Zoning: Use Group: Lot Size:
1685 17C 050 001 35 STRAWBERRY HILL URA 19645.56
Contractor: License Type: Insurance:
Homeowner as Contractor
Address: License No.: Insurance No.:
City: State: Zip Code: Phone:
Project No: Category of Work: Const. Class: Cost Estimate:
JS-1998-0078 $4,000.00
Description of Work:
strip & shingle roof
GeoTMS401997 Des Lauriers&Associates.Inc.