32C-201 (4) $q St BP-2003-0313
GIS#: COMMONWEALTH OF MASSACHUSETTS
tflC-2D11 CITY OF NORTHAMPTON
Lot: -001
Permit: Building
Category:Non structural interior renovations BUILDING PERMIT
Permit# BP-2003-0313
Protect JS-2003-0531
Est. Cost:$8000.00
Fee: $50.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
use Grono: Homeowner as Contractor_
Lot Size(sn. ft.): 3789.72 Owner: LAMONDE JASON&KIRSTIN
Zoning:URC Applicant: LAMONDE JASON & KIRSTIN
AT: 89 WILLIAMS ST
Applicant Address: Phone: Insurance:
49 WALNUT ST (413) 587-3104 0
N O RTHAM PTON MA01060 ISSUED ON:9/27/02 0:00:00
TO PERFORM THE FOLLOWING WORK:SHINGLE ROOF, MISC INTERIOR RENO
(WIDEN DOORWAY, HARDWOOD, TILE FLOORING)
POST THIS CARD SO IT IS VISIBLE FROM THE STREET
Inspector of Plumbing Inspector of Wiring D.P.W. Building Inspector
Underground: Service: Meter:
Footings:
Rough: Rough: House# Foundation:
Driveway Final:
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 9/27/02 0:00:00 329 $50.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Building Commissioner-Anthony Patillo
File#BP-2003-0313
APPLICANT/CONTACT PERSON LAMONDE JASON&KIRSTIN 4t Coe_fr 7)
ADDRESS/PHONE 49 WALNUT ST (413)587-3104 Q
PROPERTY LOCATION 89 WILLIAMS ST
MAP 32C PARCEL 201 001 ZONE URC
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out
Fee Paid To,SSD—
Tvpeof Construction: SHINGLE ROOF,MISC INTERIOR RENO(WIDEN DOORWAY,HARDWOOD,TILE
FLOORING)
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 FO LOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INFO ATION PRESENTED:
Approved Additional permits required(see below)
7
PLANNING BOARD PERMIT REQUIRED UNDER:§
Intermediate Project: Site Plan AND/OR Special Permit With Site Plan
Major Project: Site Plan AND/OR Special Permit With Site Plan
ZONING BOARD PERMIT REQUIRED UNDER: §
Finding Special Permit Variance*
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 Commission Permit from CB Architecture Committee
Permit from Elm Street Co ion
Signature /9/7/H2C2---
of Building Official Date
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.
*Variances are granted only to those applicants who meet the strict standards of MGL 40A. Contact Office of
Planning&Development for more information.
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of Northampton 'S,»Yy+ %dXa ,-1ta; „p
too +IngDepartmen# .,mss
Lys, C—"-----11 2 Main Street to niai�.7-in ‘iiiym ict, .ii
Room 100 ra1nieile vriikiiiiii -
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58 1244 Fax 413-587-1272 Nair Ntb r w
DEP Of eJii lNC laSPECISNS
• •• ATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTION 1-SITE INFORMATION
;,This section to be completed by office
1.1 Property Address:
'2R VV i I11a ns S4. Map io 9{ unit
No-d-v CunP{ao A Zone t )+++OiterlayDlstrict
EIm,.6t.District ':CB D)strlet. _. „__
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
:Rani .t -1` Vtand2 49 Walnut4 34. Ncri acne-tn
e Pr t) Curret Maili08d1resas:
tbS-
, /L et_ Telephone
Signa re
2.2 Authorized Aeent
Name(Pont) Current Mailing Address:
Signature Telephone ,1
SECTION 3•ESTIMATED CONSTRUCTION COSTS: 16 .y,-gj K= $40 i 50 In.n, maim
Item Estimated Cost(Dollars)to be Official Use Only
completed by permit applicant
1. Building i CJ rjaoC> 00 (a) Building Permit Fee
2. Electrical (b)Estimated Tota!Cost of
Construction from(6)
3. Plumbing Building Permit Fee
4, Mechanical(HVAC)
5, Fire Protection o
6, Total =(1 + 2 +3 +4+5) 3 s. 0� Check Number OOp'/ {/.J43`—
This Section For Official Use Only - - -
Building Permit Number Date Issued:
, - - = _.
Y
Signature: - t. -
Building Commissioner/Inspector of Buildings Date
Section 4,
ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE
DENIED DUE TO LACK OF INFORMATION
Il wtrrk -o be done w�i1 exlsfiincV • '- rcApnv,AT
Existing Proposed Required by Zoning
This column to be filled in by
Building Department
Lot Siz-
Frontage
Setbacks Front
Side L: R: L: R:
Rear
Building Height
Bldg.Square Footage
Open Space Footage
(Lot arca minus bldg&paved
parkin)
p of Parking Spaces
Fill:
(volume&Location)
A. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO DONT KNOW X 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 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:_
C. Do any signs exist on the property? YES NO r`
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:
r
•
. 'O.CTION 5•DESCRIPTION OF PROPOSED WORK(check all applicable)
New House 0 Addition ❑ Replacement Windows Alteration(s))gt Roofing X
Or Doors ❑
Accessory Bldg. Cl Demolition❑ New Signs [ j Decks [ ] Siding[ ] Other( ]
Brief Description of Proposed Work: a00t ID be co5hIn5led Mrsc retro' chcns(llt)id2n{.ir {Citorwa.
Alteration of existing bedroom Yes }4. No Adding new bedroom Yes X No 11e/PJ " "" Sicort "
AttachedtNarrative❑ Renovating unfinished basement Yes /' No
Plans Attached Roll❑ • Sheet❑
61jf(te 'muse ;lig". din caoe plow- • I . rr e.e:i efof .:IRE:
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?
t. Method of heating? FireM s or Woodstoves Number of each__
g. Energy Conservation Compliance. Mascheck Energy Compliance form attached?
Type of construction
i. Is construction within 100 ft.of .nds? Yes No. Is construction within 200 yr. floodplain Yes No
j. Depth of basement or - ar floor below finished grade
k. Will building orm to the Building and Zoning regulations? Yes No .
i. c Tank City Sewer Private well City water Supply
SECTION 7a-OWNER AUTHORIZATION-TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
I, _, 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 1 Date
I, t'�i T`71t'R 1.0.0C Y.ie, , as Own•r Authorized Agent
hereby declare that 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 perjury.
4<tcc kiv7 U- eJ-R-
Print -me
SA Apo_ * ( q Z, o'Z
Sig ature of Owner/Agent Date
iSECTION 8-CONSTRUCTION SERVICES
Li -n e•. •nstru '.r Su•ervis. : Not Applicable 0
Name of I'cense Holder
License Number
Address Expiration Date
Signature Telephone
2h1ice'Nome-"no'• 'ern' ''Coift kor_. ;t"" 1 ;';^'t 77, T Not Applicable 0
¢omoany Name Registration Number
Address Expiration Date
Telephone
SECTION 10-WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L c.152,§25C(6))
Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide the affidavit
will result in the denial of the issuance of the building permit
Signed Affidavit Attached Yes ❑ No 0
askiiiner w If t I I
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 shalt 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.
A t.-71/11E447.24-2
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Homeowner Signature , Y ,^rr
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