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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations
NORTHAMPTON, MASS. 19— Additions
APPLICATION FOR PERMIT TO ALTER Repair
a Garage
v
- Lot No.
Location ,,
(,4. Owner's name 66�L 6 122 4,0(- CF —kddress
3. Builder's name —Address
Mass.Construction Supervisor's License No. Expiration Date
4. Addition
L-15' Alteration tLZ'd
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
U,14• Estimated COSL�,/,a_o
�e undersigned certifies that the above statcmcnts are true to the best of his
knowledge and belief.
Signature of responsible app,icant
Remarks
�o�inn�rPTO
g $ Crier >af 'Nadl-U11rpfa1T
� 8 �insencittirctts
67
DEPARTMENT OF DUILDD,�G INSPECTIONS
INSPECTOR 312 \4nin Street ' Municipal Building '
Northnmpton, Mass. 01060 "
HOKEOWNER LICENSE EXEMPTION
( Please Print )
DATE: ��El
JOB LOCATION:— -- � �--"
(lap) ( Parcel ) ( Subdivision )
3OME OWN ER 4 uc c l N,•FrA��''�' lEA
(Name & Address )
//i��10'LNil1 LLP A// aio�i o"t6� 2613
I (Home Pho e) (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 bui-ldinq
permit.
As acting Construction Supervisor your presence on the', job site
will be required from time to time, during and upon completip" nto'f 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. PLA2MIT ## :Aq
9 IL of Nort4ampton
4 ! p 81999 . :,ac,�ttsrl:,
TMENT OF BUILDrNG INSPECTIONS
DEPT Of BUILtNGINSP
�,;PRJ 3f !k �.' YA"' z ,,,Vain Street ' Municipal Building '
Northampton, Mass.' 01060
WORKER'S C01ITENSATION INSURANCE AAF'FIDAVIT
UC
(li censeelpe�noni ttee)
with a principal place of business/residence at: �t c
(Phone#),,2 97`763)
(strectici ty/stalcJri 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 working on this job:
(Insurance Company) (PoE.cy Number) (Expiration Date)
�Iam a sole proprietor, general contractor or homeowner(circle one) and have hired
the contractors listed below who have the following worker's compensation policies:
J�_k
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(Name of Contractor) (Insurance Compauy/Policy Number) (Expiration Date)
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(attach additionA sheet ifneonsary to be udc information pataining te.all cos r.d )
( ) I am a sole proprietor and have no one working for me.
O I am a home owner performing all the work myself.
NOTE:plea--be avrare tbA whir-homcoKmcra%k o employ persons to do nom •, coodnu oa or rcpalr Vora[oa a d.+ttling of
not mom than throo trnitt is wb"the bomoawncr rude=or oa the prouadt zppurteawi thasto errs not gwer&Uy considered to be
employors trader tba%%vd='s compcasatron Ad(GL152,a 1(5))�,application by a homcown r for a Sow-a permit may evidcoco the
legal&I—aa of as employer under the Wocicees CooVeosdioa AcL
I underaland toad a copy of this—cmmt may be forwarded to tba Depot neat of Indumial A,64a e!offioe of Iawnoea for tha
coverage verificatioa and that failure to secure oovaabro under sectioa 25A of MOL 152 an lad to the impos—of rimiw penal8a
ooaustiaa of a$ne brup to 51,500100 aadlor i gx6oarxsII of tip to one yar and Civil penzWes is the foam of a Stop Wart order and a
Sao of 3imoo s day apbnt tae
[For q=th eatal tier°ea1Y
9 mitNtunber
1 siguahireofL.i«msctlPeimi�tx Uate
R
10. Do any signs ebst on the property? YES NO
p
IF YES,describe size,type and location:
Are there any proposed changes to or additions of signs intended for the property?YES NO X
IF YES,describe size,type and location:
11. ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE DENIED DUE TO
LACK OF INFORMATION.
This cola= to be filled is
by the Bcilding DiepartX nt
Required
Existing Proposed By Zoning
Lot size
Frontage
Setbacks - frnnt
- side L• R: L: R:
- rear
Building height
Bldg Square footage
%Open Space:
(Lot area minus bldg
&paved parking)
# of "Parking Spaces
f of Loading Docks
Fill:
{vol-ume--& location)
13 . Certification: I hereby certify that the information contained herein
is true and accurate o the best of my knowledge.
E / LICANT's SIGNATURE
NOTE: Issuance of a zonin rmit does not reiieve an applloant's burden to oomply w117 OR
zoning requirements and obtain all required permits from the Board of Health, Conservation
Commission, Department of Publio Works and other applioable permit granting authorities.
FILE #
SEP 8 W
DEPT OF BUILD"�tG 14�SPECTIONS File No
Ivy 1'tl^fin, �'l
ZONING PERMIT APPLICATION (§10 . 2)
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant: GZ7 g�&D, t,) L—U C
f�A,-tOe+vv�LL,a' v1-
✓Address:�G N I'"/4Kn^5 fz y MA Telephone:
L,-2" Owner of Property: ,: a,a,// L
Address: _Telephone:
3. Status of Applicant: _Owner Contract Purchaser Lessee
Other(explain): y�
Job Location: G � '/���1Z L
Parcel Id: Zoning Map#.,, 17e . Parcel# District(s):
(TO BE FILLED IN BY THE BUILDI G DEPARTMEN
5. Existing Use of Structure/Property
6. Description of Proposed UseMlork/Project/Occupation: (Use additional sheets if necessary):
7. Attached Plans: Sketch Plan Site Plan Engineered/Surveyed Plans
Answers to the following 1 questions may be obtained by checking with the Building Dept or Planning Department Files.
8. Has a Special PermitA/adance/Finding ever been issued for/on the site?
NO DON'T KNOAI V 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)
68 NORTH MAIN ST BP-2000-0258
GIs#: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 17C-259 CITY OF NORTHAMPTON
Lot:-001
Permit: Building
Categ_or:windows replaced BUILDING PERMIT
Permit# BP-2000-0258
Proiect# JS-2000-0402
Est.Cost: $1200.00
Fee: $25.00 PERMISSION IS h1EREB Y GRANTED TO:
Const.Class: Contractor: License:
Use Group: John Corbett 104000
Lot Size(sq ft.): 15333.12 Owner: LUCE GORDON R&KATHLEEN
Zoning.URB Applicant: John Corbett
AL-SaN93TH MAIN ST
Applicant Address: Phone: Insurance:
56 Dimock St (413) 584-5807
LEEDS 01053 ISSUED ON:91811999 o:oo:oo
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 _airnature:
Fee Type: Receipt No: Date Paid: Check No: Amount:
Building 9/8/1999 0:00:00 $25.00
212 Main Street,Phone(413)587-1240,Fax:(413)587-1272
Building Commissioner-Anthony Patillo