17A-060 (2) F'
MAR 3 0 1999
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Zoning
Miscellaneous Additions,Repairs,Alterations,etc.
Tel.No. �O 7&-fl Alterations
NORTHAMPTON, MASS. 1 q Additions
a APPLICATION FOR PERMIT TO ALTER Repair
Garage
1. Location 205 N✓v*'�i /l/tU!e-, 010(a2 Lot No.
2. Owners name S C�Df+- cl vt d JT V1 L-L t ! C I'V i 6Z,44 Address 1J, M UU
3. Builder's name Address S a"
Mass.Construction Supervisor's License No. Expiration Date
4. Addition V\14
5. Alteration �-?Vt is ti d
6. New Porch Pl I a
7. Is existing building to be demolished? 'Yi-o
8. Repair after the fire -h /a
9. Garag No.of cars Z Size 2 �'�'►�
10. Method of heating ru G;'i?u 9z-v5
11. Distance to lot lines -tA a Vtn ct4aAA yC
12. Type of roof S �
13. Siding house wl�Cad I
14. Estimated cost:- /
The undersigned certifies that the above statements are true to the best of his
knowledge and belief.
Cj aAA
Signature of rtsponsible appicant
Remarks
4�ttAMP�.
O 0
alass Itch asrtts
MAR 3 019% DEPARTMENT OF BUILDrNG INSPECTIONS
212 :Main Street ' Municipal Building '
Northampton, Mass. 01060
WORKER'S Coi�ENvSATION I NSY RA-NCE A. I AVIT
3Co+I 0-0d �ICVIj f CirVJ'"
(li censer/permi flee}
with a principal place of business/residence at:
2-00, N )6,4J4 /vlc,� Sf-, Flo-utivtc- N3A CtO&Z_ (phone#) 996o-7W
(stre:,f/ci ty/statrla p)
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 worlang on this job:
(Insurance Company) (Policy Number) (F-cpiration Date)
( ) 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/Pohu Number) (Expiration Date)
(Name of Contractor) (Insurance Comparry/Policy Number) (Expiration Date)
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(attach ad&tioml short ifneccvary to kwh3 a inform ca paining to all 0f-3)
O I am a sole proprietor and have no one worlang for me.
(t)'I am a home owner performing all the work myself.
NOTE:please be aware this wbilo homco%mcm who carploy persons to do mx^iM•^e.cooarruction'ar rcpair work on a dwelling of
not more than throe units is which the bomoow ner sides or on the grounds appurtenant iherdo arc oot generally oo=dcrcd to be
employers under the worker`s campeasation Act(GL152,ss 1(5)),application by a homeowner for a license or permit may evidence the
legit m-, of an employer under the Woriroes CooV*cn&ion Ad.
I understand that a copy of this ssatcmcat may be forwarded to tho Depwtnrcd of Lxh=tria!Aeddcn&OfSoo of ImurLOm for dw
oovemge verification and that failure to sewn covaago under section 25A of MGL 152 can lad to tbd impasiiioa of criminal penalties
oous'tstatg of a fine of up to S1,500.00 and/or i> prisoc m of up to one yar and ci prnatties in the form of n Stop Work Order and a ,
firm of sloo.00 a day agaitsst tnG
For departW,-utal use 0011!
permit Numba
3 17,q
MEe
Sigaahtre&L�iaensee/Permit3x
04K�pT0 l �
$ �� ' - �aaaxrltuartla
� R
rif� of 'Nart1jamp toll
' DEPARTMENT OF BUILDING INSPECTIONS
INSPECTOR *R 3 U 212 Main Street ' Municipal Building
Northampton, Mass. 01060 "
HOMEOWNER LICENSE EXEMPTION
(Please Print)
DATE:—3- 2q ° GI GI
JOB LOCATION: 2-05
(Map) (Parcel) (Subdivision)
HOMEOWNER: S coif cx,L-qa S'�1 civ1OA4
, (Name & Addres )
Zy5 N• /�/l a Sf• (r t -Vtc� , M/k U tole 2 59& - 794-( _�4S-2, Z I
(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 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.
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
r 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 PFAU4IT ( :1s
s
10. Do any signs exist on the property? YES NO V
IF YES, describe size,type and location:
Are there any proposed changes to or additions of signs intended for the property?YES NO t/
IF YES,describe size,type and location:
11. ALL INFORMATION MOST BE COMPLETED, or PERMIT CAN BE DENIED DUE TO
LACK OF INFORMATION.
This coIu to be filled in
by the Building Department
1 Required 1
Existing Proposed By Zoning
Lot size ,,d/
b
Frontage
Setbacks - frnnt
- side L: R: L: R:
- rear
Building height
Bldg Square footage
%Open Space:
(Lotarea minus bldg
&paved parking}
# of -Parking spaces
# 'of Loading Docks 1 �.0-Z,ie_,
Fill:
_(volume -& location)
13 . Certification: I hereby certify that the information contained herein
G is true and accurate to the best of my knowledge.
DATE: APPLICANT's SIGNATURE C,4 l/j d A^
NOTE: lasuanoa of a zoning permit does not relieve an appli ao nt's burden to oomply v✓ith all
zoning requirements and obtain all required permits from the Board of Health, Conservation
Commission, Department of Publio Works and other applloable permit granting authorities.
FILE #
l _
MAR 3 01999
File No. t
2
f
to
ZONING PERMIT APPLICATION (.§10 . 2)
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant: S C o¢k Cam d C 0 6✓!4 I CIVI,( I
Address: 2057 tl NIG I%Ia��yt4 ,A/1/k Telephone: 9(a- ?941
2. Owner of Property: S tl✓yt�i
�
Address: ZOO ►U. NIa L' F 1 cu�V c%AAA. 010(v2- Telephone: �jgb- 78/t I
3. Status of Applicant: ,Owner Contract Purchaser Lessee
Other(explain):
4. Job Location: 205 Nz?v1�/i Mf�/2.��. S �C� Flc—, U-06=. ,tilA
Parcel Id: Zoning Map# Parcel# District(s):
O– D IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/Property KC'S CLfy"[ 7 _
6. Description of Proposed Use/Work/Project/Occupation: (Use additi t sheets if necessary):
I VI I'S Ut .0 X(, vi 0 d i m -Q- I(Vi vt a Cel < I c
► � CL4
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 V YES
IF YES: enter Book Page and/or Document#
9. Does the site contain a brook, body of water or wetlands? NO t/ 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#BP-1999-0797
APPLICANT/CONTACT PERSON CIVJAN SCOTT&SHERYL
ADDRESS/PHONE 205 NORTH MAPLE ST 586-7841
PROPERTY LOCATION 205 NORTH MAPLE ST
MAP 17A PARCEL 060 ZONE URB
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit illed out
Fe_e_ Paid Zgo
Typeof Construction: FINISH EXISTING ATTIC SPACE FOR MUSIC ROOM/OFFICE
New Construction
Non Structural interior renovations
Addition to Existing_
Accessory Structure
Building Plans Included:
Owner/Statement or License
3 sets of Plans/Plot Plan
THE OLLOWING 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 Board of Health Well Water Potability Board of Health
Permit from Conservation Comm' io '
Signature o uilding Official Da
Note:Issuance of a Zoning permit does not relieve a applicant's burden to comply with all zoning
requirements and obtain all required permits from Board of Health,Conservation Commission,Department
of public works and other applicable permit granting authorities.
I :
205 NORTH MAPLE ST BP-1999-0797
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 17A-060 CITY OF NORTHAMPTON
Lot:-001
Permit: Building
Category Non structural interior renovations BUILDING PERMIT
Permit# BP-1999-0797
Project# JS-1999-0787
Est.Cost:
Fee:$40.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: 6A" .
Lot Size(sa.ft.): 11979.00 Owner: A-RET M '
Zoning:URB Applicant:_ 01 Utr
AL. 205 NORTH MAPLE ST
Applicant Address: Phone: Insurance:
ISSUED ON.41611999 0:00:00
TO PERFORM THE FOLLOWING WORK.-FINISH EXISTING ATTIC SPACE FOR MUSIC
ROOM/OFFICE
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 4/5/1999 0:00:00 $40.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Building Commissioner-Anthony Patillo