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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No.5S /�' Alterations
a NORTHAMPTON, MASS. K�,Y (a 191 Additions
APPLICATION FOR PERMIT TO ALTER Repair
Garage
1. Location �.S i��V, j T Lot No.
2. Owner's name /`1t1✓�7�1/,�' t Sc��✓SU/1 ����2 Address '925/!ZZ
3. Builder's name Address
Mass.Construction Supervisor's License No. Expiration Date
4. Addition lN5'7sGLL 16/ XdO16 Gk041410 A9OL ;,t2
5. Alteration /
6. New Porch
7. Is existing building to be demolished?
8. 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:-`%,5'"OO U�
The undersigned certifies that the above statements are true to the best of his, her
knowledge and belief. {a
,i Signature of responsible applicant
Remarksj-
PRfIyN��Sy/P
0 0
City of Nart1jampfu7Y
8 ,�sseacltuuetts y
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DEPARTMENT OF BUILDING INSPECTIONS
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PECTOR 212 Main Street ' Municipal Building `M�
INS Nlorthampton, Mass. 01060
AS A HOMEOWNER I UNDERSTAND THAT I MAY APPLY FOR AND RECEIVE
A BUILDING PERMIT FOR A HOME OR ADDITION I INTEND TO LIVE IN.
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I ALSO UNDERSTAND THAT I AM RESPONSIBLE FOR KNOWING THE STATE
BUILDING CODE AND ZONING ORDINANCE OF THE CITY OF NORTHAMPTON. '
BEING A HOMEOWNER AND NOT A PROFESSIONAL CONTRACTOR IN NO WAY
ABSOLVES ME OF ANY RESPONSIBILITY TO INSURE THAT ALL FACETS
OF THE RULES AND REGULATIONS ARE COMPLIED WITH.
ignature & Date
t
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Date Filed File No.
ZONING PERMIT APPLICATION (510.2)
I. Name of Applicant: llgk-7 ,� �5 6'4A11L�
Address:4 s'/,�-/y/ � Lnr� ..Fu Telephone:E'9 y-76 :fO
2 . Owner of Property:
Address: T lephon - " 6
3 . Status of Applicant: f✓Owner Contract Purchaser
Lessee Other (explain: )
4 . Parcel Identification: Zoning Map Sheet# Parcel# �
Zoning District(s) (include overlays) Lti/2
Street Address
Required
5. Existina Proposed by Zoning
Use of Structure/Property
(if project is only interior work, skip to #6)
Building height
%B1dg.Coverage (Footprint)
Setbacks _ - front --
side l +
rear
Lot size
Frontage
Floor Area Ratio
%Open Space (Lot area minus
building and parking)
Parking Spaces
Loading
signs
Fill (volume & location)
6. Narrative Description of Proposed Work/Project: (Use additional sheets
if necessary) i�J
6- im ov
7. Attached Plans: Sketch Plan Site Plan
8 . Certification: I hereby certify that the information contained herein
is true and accurate to the best of my knowledge.
Date: 05'-�M- 57,2. Applicant's Signature•
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
THIS SECTION FOR OFFICIAL USE ONLY:
Approved as presented/based on information presented
Denied as presented
aeon for nial:
Signa r u: it ldin pector at
NOTE: Issuance of a zoning does not relieve an applicant's burden to comply 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 authorities.
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City of Northampton REQUIRED INSPECTIONS
1 . Footings and Walls
BUILDING DEPARTMENT 2 - Placetural Components in
}�
3 . Complete Building
No. 249 Office of the Building Inspector
Date May 6, 1992 1
B U1 DING P RMIT
THIS MAY CERTIFY THAT Martha Senser-Blair Insp. on Site — Foundations
has permission to - Install an above ground pool 18' in diameter Insp. of Plumbing — Rough
situated on 45 Lilly street Insp. of Plumbing — Finish
provided that the person accepting this permit shall in every re- Insp. of Wiring — Rough
spect conform to the terms of the application on file in this office,
and to the provisions of the Statutes and the Ordinances relating Insp. of Wiring — Finish
to the Construction, Maintenance and Inspection of Buildings in Insp. of Health (Septic Tanks)
the City of Northampton. Any violation of any of the terms above
noted is an immediate revocation of this permit. Expires six Building Insp. — Rough
months from date of issuance, if not started. Building Insp. — Finish
Note:A certificate of occupancy will be issued by this office upon
return of this card signed by the Plumbing,Wiring and Building Smoke Detectors (Fire Dept.)
Inspectors. Gas Inspection
THIS CARD MUST BE DISPLAYED IN A CONSP UOU RLACE ON THE PREMISES
r Certificate of Occupancy
Bu nspector
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4
' Page No. of Pages.
—'''THE JUBB CO., INC.d.b.a.
LARRY JUBB'S
1111111111W IMPROVE-A-HOME PROPOSAL
7 Devens Street 18 North Hatfield Road
P.O.Box 429 Hatfield,MA 01038
Greenfield,MA 01302-0429 MA Registration 100001
(413)7A 013 7 Northampton,MA MA Cons. Sup. Lic. 055333
(413)584-3716 _
PHONE DATE
> Jackson Karen 5135-0239 12/06/00 _
45 Lilly St,r.eet. JOB NAME/LOCATION
Florence , Ma . 01062 REPLACF_ME_NT WINDOWS
45 Lilly Street
E'-lorence , Ma . 01062
JOB NUMBER JOB PHONE
f �
hereby submit specifications and estimates for: j
- SUPPL'f & INSTALS_ ALCOA/MASTIC TRULOK Pt._.US 4750 VINYL REPLACEMENT WINDOWS--
-1/2 screens . ( double hung only ) - titanium dioxide .
-locking screens . ( double hung only ) *-welded sashes .
-tilt in sashes . ( double hung only ) *- welded master frame . ii
-hi -tech intercept glass system . -7/8 thermo pain .
-block & tackle balances . ( double hung only ) --insul [-),,'added
-Sun Shield vinyl compound . ( Alcoa exclusive ) --virgin vinyl
-double locks & sash limit, latches on all doublc hang windows over 32" wide . I
-Lifetime transferable manufactures guarantee on vinyl window frame .
20 year manufactures guarantee on glass agai-itst seal failure .
abo - guarantee as required by MA ,VT ,NH cont:.rac.tor regu.l.ations .
')R= _,__,_,_,linen white , ---bright white , ( almond , brown [extra charge] )
I .. fAL UNITS REPLACED" 03 double hung to living roorrf .
RIDS = none . ( beveled_-._.__. or fl.at_.�.__)
_OW "E" GLASS ." yes .
HERMO BREAK SPACER: yes . Hi--tech intercept glass . ( best thermo glass made )
INSULATION= as needed . ( into weight pockets )
ALUMINUM CLAD EXTERIOR CASINGS; no . ( ____full , _ partial )
NORM WINDOW REMOVAL : yes . r \j lu ` `k
3THER = L.
SERVICE FEE : $125 .00 ( includes permit & disposal of all job related refuse . )
[service fee not included in total at bottom & is to be billed as separate .]
WE I�IPmP DOS hereby to furnish material and labor—complete in accordance with the above specifications,for the sum of:
Seven Hundred Twenty and 00/100 Dollars dollars($ 720 .00 �.
Payment to be made as follows:
1/3 DEPOSIT UPON ACCEPTANCE , balance in full upon completion . An interest
�--ha.rge of 20 per month ( 24% per annum ) on past due balances , plus all costs ,
including reasonable attorney 's fees , incurred in collecting any sums owed .
All material is guaranteed to be as specified. All work to be completed in a professional
manner according to standard practices. Any alteration or deviation from above specifica- Authorized
tions involving extra costs will be executed only upon written orders, and will become an Signature
extra charge over and above the estimate. All agreements contingent upon strikes,accidents or
delays beyond our control. Owner to carry fire,tornado,and other necessary insurance.Our Note:This proposal may be
`OOWs are fully covered by Worker's Compensation Insurance. withdrawn by us if not accepted within 30 days. .
Ac maptaffica ®T 1PII'(1)jp®Z1111 —The above prices, specifications
and conditions are satisfactory and are hereby accepted. You are authorized signature
to do the work as specified. Payment will be made as outlined above.
` Signature
Date of Acceptance:
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OQ.'C�MpTO
9 6 �assacllnsctta'
DEPARTMENT OF BUILDDIG INSPECTIONS
212 Main Street ' Municipal Building '
Northampton, Mass. 01060
WORKER'S COMPENSATION INSURANCE AFFIDAVIT
(Iicroseelpeimittee)
with a principal place of business/residence at:
(phone#)
(street/city/statd2ip)
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:
:5(Hi:xY,
(Insurance Company) (Policy Number) (Expiration 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/Poficy Number) (Expiration Date)
+r.
(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 additional sheet ifneoessmyto include iafwmatioa pataiaing to all ooatxactots)
( ) 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 homeowners who cmpley pa-sons to do muiatwauce,ooa9ru ion or repair work on a dwelling of
not morn than three units in which the homeowner resides or on the grounds appurtenant thereto arc not generally considered to be
employers under the wcxice� oornpeasal ioa Act(OL152,ss 1(5)�application by a homeow=for a license or permit may evidence the
legal status of an employer under the Worms compensation Ant.
I uaderttsad that a copy of this statement may be fmvvncded to the Depwt w&of Industrial Am idm&Office of LuAwLnce for the
coverage verification and that failure to seatre covetngo under section 25A of MOL 152 can lead to the imposition of criminal penalties
consisting of a fine of up to S1,500.00 andlor imprison of up to one year and civil penattia in the form of a Stop Work Order and a
fine of 5100.00 a day against me.
For dgmtm :.w use only
permit Number
Mao Lot#
Signature of Licensee/Permittce
V
P
CTItiN''$-C�JNSTRUC'tIC)W SERVICES
_.1 Licensed Construction Supervisor: Not Applicable ❑
Name of License Holder -e n(L- t) J 55
License Number
PCB EYQ-�, L+L3,q or-3c,2- - a-/ _0 C:�-
Address p Expiration Date
,:��- � as)(/ —�
Signature Telephone
Not Applicable ❑
/ aaob l
Company Name Registration Number
Add es/s\ � Expiration Date
( J )Q X �a '/ Telephone
013C-'Z
SECTION 141-WORKERS'.COMP'ENSATIQN INSURANCE AFFIDAVIT(M.G.L. c. 152,§-26C(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 th ding permit.
gned Affidavit Attached Yes....... No...... ❑
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.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 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
J F is ie
New House ❑ Addition ❑ Replacement ows Alteration(s) ❑ Roofing ❑
Or Doors
Accessory Bldg. ❑ Demolition❑ New Signs [ ] jj��Decks [ ] Siding[ ] Other [ ]
Brief Description of Proposed Work: T-'�-+�SrLct l� �3 r�l�l4CC�rnP ��✓1 L<_;-S
Alteration of existing bedroom Yes No Adding new bedroom Yes No
Attached Narrative❑ Renovating unfinished basement Yes No
Plans Attached Roll 0 - Sheet❑
°yYk
a. Use of building : One Family Two 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?
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 7.a-OWNER AUTHE)RIZATION -TO°HE COMPLETED WHEN
OWNEFt5 AG.. 1�T OR.COWTRACTO�t APPLIES FOR BUILDING PERMIT
as Owner of the subject property
hereby authorize to act on
my behalf, in all matters relative to work authorized by this building permit application.
Signature of Owner Date
J Q/b ./ as Owner/Authorized Agent
hereby cleclar0that the statements and information on the foregoing application are true and accurate, to the best of my
knowledge and belief.
Signed under the pains and penalties of erjury.
r _
,�' 1 ✓ /� k�v f'n[
Print Name USignature of Owner gent t Date
4
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
arkin
#of Parking Spaces
Fill:
volume&Location
A. Has a Special Permit/Variance/Finding er 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 DON'T KNOW 1/
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:
E CL9 E hampton
Buildi partment
FEB � 2012 Street
R om 100
ton MA 01060
OEAI�dt�fPfl �p I 240 Fax 413-587-1272
APPLICATION TO CONSTRUCT,ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTION I-SITE INFORMATION.
1.1 Property Address: Y vs v
u
N 14 6 40
SECTION 2- PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
ame(Print) Current Mailing Address:
Telephone
Signature
2.2 Authorized Agent:
Po &-x -eya 9 �('Ic� )lv /�
Name(Print) Current Mailing Address:
Signature Telephone
ECTIO EST{iVfATEO CONSTRUCTION et15TS
Item Estimated Cost(Dollars)to be Official Use Only
com feted by ermit applicant
1. Building (a)Bui#ding Permit'Fee
2. Electrical (b)Estimated Total Cast of.
Construction from 6
3. Plumbing Building Permit Fee
4. Mechanical(HVAC)
5. Fire Protection
6. Total =(1 + 2 + 3 +4 + 5) '`lad Check Number
This Section For Official Use Only
Building Permit Number: Date Issued:
Signature:
Date
Building Corn missloner/lnsp ctor of Buildings
45 LILLY ST BP-2001-0679
GIs#: COMMONWEALTH OF MASSACHUSETTS
MR.-Block: 17C-270 CITY OF NORTHAMPTON
Lot:-001
Permit: Building
Category:windows replaced BUILDING PERMIT
Permit# BP-2001-0679
Project# JS-2001-1230
Est.Cost:$720.00
Fee: $25.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: THE JUBB CO INC 100001
Lot Size(sg.ft.): 7753.68 Owner: JACKSON KAREN
Zoning-:URB Applicant: THE J U BB CO INC
AT. 45 LILLY ST
Applicant Address: Phone: Insurance:
P O Box 429 (413) 772-6217 Workers
Compensation
GREENFIELDMA01302 ISSUED ON:217101 0:00:00
TO PERFORM THE FOLLOWING WORK.-INSTALL REPLACEMENT WINDOWS
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 2/7/010:00:00 4684 $25.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Building Commissioner-Anthony Patillo