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17C-310 (4) ..„! T rte► E > X Z Ct'1 G ...1 3 7' w I � i Zoning Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. t-52 -5685- Alterations NORTHAMPTON, MASS.• J y``f `� 19 � Additions APPLICATION FOR PERMIT TO ALTER Repair o Garage 1. Location,. `q I 0 2A-) �� , V�— 0/C)60 Lot No. 2. Owner's name' ^��4 o��.. Address Z-�Oct l�'wy (�b� Coen 3. Builder's name Address Mass.Construction Supervisor's License No. Expiration Date 4. Addition p /` (1 5. Alteration. `�-2�s4A (5� Uwa .tSkiP . 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 X14) EstimatedcosL- I4N”-Q- ;-S Avo C- r-5- The undersigned certifies that the above statements are true to the best of his, her knowledge and6 elief. V�Jp� p�-,�'��` S�-�J� �✓'"a°T— .�-q1 '`__—`.:_,.' �' tf Sig a re oJresponsible app,ican! Remarks n �� `--} ► Lj JLL 6 � .ccC�r u� . � s^ t:2 ������� DEFT i3f `i.�"/.,cr.�'°`•:.k�da�.��iF�r�c�"`"""�' � Ors a,�c� .J��� 4 William F. Wei Lovernur Kentaro Tsut.`tumi `�, .�tac �e+► '7$1�� Chairmen (617) 727-32(X7 Charles J. I)inexio SOLID FUEL BURNING PEI-Lr-T STOVE AFFIDAVIT Administrator FOR PE2�7 STOVES SATISFYING -NEGATl'VE PRESSURE NG (FA.I.L [.n L`%v1NTER i991 IlEATING SEASON) To the State Board of Sutlding Rcrulmions and S12ndUrai: Datc J un s 9 19 92 L Jess Baldwin ,t Eastern Region Manager oab2trsif6f The Earth Strivo, Inc. a=nufaeturcr of solid fuci burning pellet stavcsnccalerslfire place inscu(drdc appropriate p Ucts)• bereby certify shat the following pellet heating appliances,by trpilclt nt ldcntlGcello ; modd(a): EP60, TP40, WP50,�MP40, HP4 ., MP250, MPZ 0 have baca tented,or trncdAmed (dr lr,appropriatc infomuuon)pc-the ac-;ativc p=urt trst rnjuirtmCnis of dthcx MC$42-IiL-7iA Sundard B366.: or via methodslrequircmcnts of simttar nationally gnbmd namdards,and found to =idy the apptiobie criteria of ULC S627/CSA Sundard 83661 or othc nauonaliv r_gnited s dartlr additionally,burnback did not oattr either dudo;normal or abnormal'nc;ative pt=um' rating.. M NUFACMRa�]L. The Earth Stove, Inc- SIGNED.— TYPED op,PRIA"r1;A-MEAzovF—. Jesn Baldwin TtYtF—. Eastern Region Manager ~� On this _ -- day of t.< 19�2 mat p'-=nally appcmm berorr mc,the ab7ft named yttllllU ,•., ` -d ctadc GatA that a abtn'C stlLeisi 17 !rr himrAtr.arc w� 'OT.iRY,h1Y8Lic NY CLIMM�SrSION aypror69tt /r��/11!l11I111y• `"'` I Past;of 7 0 4�{V YY ^4\ a� JUL I big j Gift of Warf1j&ntpfun 9 •�` �a5sachnrclta g T Of ;DEPARTMENT OP BUILDING INSPECTIONS 212 Main Street ' Municipal Building ' Northampton, Mass. 01060 WORT ER`S COMPENSATION INSURANCE AFMAVrr a! a- Lo ' 2 (licenses/permiticc) with a principal place of businesslresidence at: L4 © S4• y r-l-)!Renc.R fP,va WOCC - (phoneO / -s73 -yyS-S6hS do hereby certify, under the pains and pen,,Aties of perjury, Thai: O I am an employer providing the following v.,0rKer's compensation cove abe for my employees wor)dng on this job- (Inu=re, Conpaay) (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) Zastuance Company/Poky Number) (E pimtion Date) (Name of Coutrzcior) (In_nlrancz- Company/PoLicy Number) (Expiration Date) (Name of Contractor) (Instrranct Compare},(Policy Number) (Expiration Date) (Name of Contractor) (Insurance Compauy/Poky Number) (Expiration Date) (atlaeh additiooal sboe4 ifntt, s to i,,k info .,,pabiaing to all matracton) (�am a sole proprietor and have no one wonting for me. ( I am a-home owner performing all the work myself. NOTE:please be aw-a=that wbilo bomcowo=wbo anplay parom to do mnintc = mnsuuctioo'or rcpa r work an a dv,cWG of not mote tban tbroo unit.in wfnch the homoowocr rcid=or oa the goods Tpurtenaut tb=to arc cot prnanlly coasidcrcd w be employ—uoder the--kcts.c0mpeasatioa Act(GL1523s 1(5)�application by a homeowner for a 6cco=cc perrdd may evidence the legal r-bu of an employee under the Worir ,compomation Act: I understand thzt x copy of this cam may be forwarded to tbo Departmccd of Inditrsi al Aoddca&Of6 of Iasvraeao for tba oovcrage verification and that faawc to snore covcmco unda sccdoa 25A of Mot,152 can Icad to tbd imposition of criminal penalties oogn3t mg of a-fine bf up to S 1,500.00-cVockqx6o=xntorup to o=year and dva panitia in the form of a Stop W ork Orda and a find o(5100.00 a day agnin5t ax. h Sign this q-, of y 1 1997 For d al u"oaty ` Pcrmit Number Map4 Lot i! grab=of Li crtn>t3cc �Ot�AlPT ^�-«- 4 , c a ? �asexcliaurtJa " f 67 % DEPARTMENT OF BUILDING INSPECTIONS INSPE T(DE'T OF 212 Main Street ' Municipal Building '�H Northampton, Mass. 01060 HOMEOWNER LICENSE EXEMPTION (Please Print) DATE � � /`�-°I q JOB LOCATION: /7c/7 ,3)0 (Map) ( Parcel ) ( subdivision) HOMEOWNER:,, Li".)CA o Ca y ! 04 L�� f?22 � �- IOIG�tnC Q V�, A01 UG,0 (Name & Address ) 1-5 73-gvS-5 6FS ( 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 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 SIGNA BUILDING PERMIT ## 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 pro rty?YES NO IF YES type describe size, and location: 77 11. ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE DENIED DUE TO LACK OF INFORMATION. T2da column to be filled in by the Building Department Required Existing Proposed By Zoning Lot size a Frontage Setbacks - 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-rime--& location) 13 . Certification: I hereby certify that the information contained herein is true and accurate to the best of my knowle e. _1 D?II"E: 7"_/'�1 APPLICANT's SIGNATURE, NOTE: Issunnoe of a zoning permit does not relieve an imWplloanrnbdcOfin to oomply wlt4-all- z9ning requirements and obtain all required permits from the Board of Health. Conservation Commission. Department of Publio Works and other applioabia permit granting authorities. FILE # � p 6W Fi 1 e No. IL DEFT QF FF . —�ZONING PERMIT APPLICATION (§10 . 2) C J PLEASE TYPE OR PRINT ALL INFORMATION ' 1. Name of Applicant: /--r^ �- L h 2 Address: L09 PO4=1 ;6, C- Co/oMbja N10 A 2o3Telephone: 5"9- 2. Owner`of Property: �� d �-0 2 Address:-7--4-09 tAti►,5. C4, C-ol�w 5 N+, 6�ZDS Telephone: S } 3 -4yr-sties 3. Status of Applicant: Owner Contract Purchaser Lessee Other(explain): 4. Job Location: 7 F/ /- A-A-- Q NG LD Parcel Id: Zoning Map#—/J(�-- Parcel# District(s): / (TO BE FILLED IN BY THE BUILDING DEPARTMENT 5. Existing Use of Structure/Property 6. Description of Proposed Use/VVork/Project/Occupabon: (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/Vadance/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 Regi 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 1lj 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) 4 FILE # f'T/CONTACT PERSON: �7jy� Cow DEPT OF !,'A Dw1J,'�6NE: PROPERTY LOCATION: &ale _ MAP C P CEL: ZO THIS SECTION FOR-OFFICIAL USE ONLY: PERNUT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM M.I.ED OUT Fee PAid l9_6 Accessory 'Strurture THE FALLOWING 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 P k fro onsa ' C _ n Signature of Building Ingiketor ate NOTE:Issuance of es zoning permit does not relieve an applioant's burden to comply with all zoning requirements and obtain ail required permits from the Board of Health, Conservation Commisalon, Department of Publio Works and other applicable permit granting authoritles. City of Northampton REQUIRED INSPECTIONS 1- Footings and BUILDING DEPARTMENT 2. Structural Components in Place* P 3. Complete Building* No. 672 Office of the Building Inspector Zoning Form No. 962549 Date 7/4/97 Fee $20.00 Check# 3514 Page, 17C Parcel 310 ,Zone URB Section 127 ❑ Yes 0 No BUI]LDINGPERMIT * Plumbing and Electrical Inspections required THIS CERTIFIES THAT Linda Lohr before Building Inspections has permission to install wood stove Inspection on Site—Foundations situated on 49 Oak St - Florence 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 .�,!�7-�7 1 - 17. ** Install per Manufacturer's information: windows,vinyl siding,roofs and woodstoves Smoke Detectors(Fire Department) Other THIS CARD MUST DI CONSPICUOUS PL4CE _ SES Certificate of Occupancy Building Inspector