22D-115 (5) 46 AVIS CIRCLE BP-2003.0063
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 22D- 115 CITY OF NORTHAMPTON
Lot: -001
Permit: Building
Category: BUILDING PERMIT
Permit# BP-2003-0063
Project# JS-2003-0147
Est.Cost:$14800.00
Fee: $50.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: KENNETH LYNDS 0013668
Lot Size(sq.ft.): 26658.72 Owner: MARROCCO MARLENE
Zoning: URA Applicant: KENNETH LYNDS
AT: 46 AVIS CIRCLE
Applicant Address: Phone: Insurance:
P 0 BOX 448 (413) 584-9282
LEEDSMA01053 ISSUED ON:
TO PERFORM THE FOLLOWING WORK:ROOF OVER & SCREEN EXIST 12 X 12 & ADD
12 X 22 & ADD 22 X 6 TO FRONT PORCH ,00-, P,,, Plumbing ] Building .1 Electrical J
•*' ;II Cityof Northampton
POST THIS CARD SO IT IS VISIBLE FROM THE c vo - P
Inspector of Plumbing Inspector of Wiring D.P.W. BUILDING INSPECTION LABEL
Underground: Service: Meter: H o LG APPROVED
Footing
Rough: Rough: ��/ House }� (i3
Inspector
Drivewa
Final: Fina . /2," Date -7" / q - C 2
xougn r ramex �y
at D --/9-/9-0 9-,
Gas: Fire Department Fireplace/Chimney:
Rough: Oil: Insulation:
Final: Smoke: Final:17A fp- c./..1?_144.,
} 4r.
THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF
ANY OF ITS RULES AND REGULATIONS.
Certificate of Occupanc =-/. ." Signature:
-?...;?.&ae'
Fee Type: Receipt No: Date Paid: Check No: 4, Amount:
Building 7/17/02 0:00:00 2170 $50.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Building Commissioner-Anthony Patillo
BP-2003-0063
GIS#: COMMONWEALTH OF MASSACHUSETTS
CITY OF NORTHAMPTON
Lot:-001
Permit: Building
Category: BUILDING PERMIT
Permit ft BP-2003-0063
Project it JS-20030147
Est.Cost:$14800.00
Fee:$sa.0o PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: KENNETH LYNDS 01013668
Lot Size(sg,R.): 26658.72 Owner: MARROCCO MARLENE
Zonine: URA Applicant: KENNETH LYNDS
AT: 46 AVIS CIRCLE
Applicant Address: Phone: Insurance:
P 0 BOX 448 (413) 584-9282
LEEDSMA01053 ISSUED ON:
TO PERFORM THE FOLLOWINGWORK:ROOF OVER & SCREEN EXIST 12 X 12 & ADD
12 X 22 & ADD 22 X 6 TO FRONT PORCH
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 sianature:
Fee Type: Receipt No: Date Paid: Check No: Amount:
Building 7/17/02 0:00:00 2170 $50.00
212 Main Street,Phone(413) 587-1240,Fax: (413)587-1272
Building Commissioner-Anthony Patiilo
File#BP-2003-0063
APPLICANT/CONTACT PERSON KENNETH LYNDS
ADDRESS/PHONF,P O BOX 448 (413)584-9282
PROPERTY LOCATION 46 AVIS CIRCLE
MAP 22D PARCEL. 115 001 ZONE URA
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DA IE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out �77
Fee Paid IW1O d a-
Tvoeof C nstruction; ROOF OVER&SCREEN EXIST 12 X 12&ADD 12 X 22&ADD 22 X 6 TO FRONT
PORCH
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/Statement or License 0013668
3 sets of PlansPlot Plan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INFO ATION PRESENTED:
Approved Additional permits required(see below)
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 -mien
94/2a72"---
Signature of Building • ticial 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 40k Contact Office of
Planning&Development for more information.
•
u e g ' bXt. i
r.- Gy of Northampton S sofa
Building DepartmentC apC;' En. gFtts .
12 Main Street Se "` jil( ._ j ! •
1 Room 100altrAk. -7,--,..-1.,4_- t'f:c.''
ort mpton, MA 01060 T etso r lk 'cdi - ` 2 r
1 pho+te3 5 71240 Fax 413.587.1272 P1%VSite:tla " k .-- e 1;'
ono
APPLICATION 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 /� i� Lot "
4G ,wr's Q Map' 6�I� /� " Unit
/ofGwe.(_ / , L- 0/UG "— Zoned OOverlay District
Elm St. District CB District
SECTION 2- PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 er of Record:
OwC /�`
Y 'Ora qc kJ Cr7cc./ r tkcc7 ,ud. 0/04
Na e( � Current Mailing Address'.
µv Telephone
Sign rure
2.2 Autho ized A e t: ��e
en p). 41 (A 01- z) Pa, t'/ f(icr eedf / ,W' , O/0s3
Name(Priv Current Mailing Address:
d 4//3 ". 51- 9z 8 2.--
Sign Telephone
SECTION 3 - ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollars)to be Official Use Only
completed by permit applicant
1. BuildingJy/JyGn (a) Building Permit Fee
2. Electrical (b) Estimated Total Cost of
Construction from(6)
3. Plumbing Building Permit Fee
4. Mechanical (HVAC) 2.--_
5. Fire Protection
6 Total =(1 + 2 + 3 + 4 + 5) I /V, rea ,----- Check Number CP70 co8
This Section For Official Use Only
Building Permit Number: -3() �{D ; --/_ 3 Date Issued:
Signature:
Building Commissioner/Inspector of Buildings Date
. .
•
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
drl '1 h Building Department
Lot Size / b i fi Yphh•
Frontage 8'5- ' SS' r /5
Setbacks Front 2,0 SM,7�' - lot /WAYS' — 3 d' 3 O
Da
Side Iv L: R: L. R: 15 /0
&f23' — 26' (, t'1j'_ to' /
Rear 'Lp So 2C) /
Building Heightr 'hamar
Zup r.,,ap _S y --
Bldg. Square Footage 141
L.t I0, % 4/0 9
Open Space Footage 9r % // '�'v875,
57(Lot area minus bldg&paved 4 pc. / „Q
parking) 1+— lJL/
ft of Park spaces
Filt: '
(volume&Location)
A. Has a Sp ial 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 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
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:
•
SECTION 5- DESCRIPTION OF.PROPOSED WORK(check all aoolicable)
New House 0 Addition 0 Replacement Windows Alteration(s) 0 Roofing 0
Or Doors 0
Accessory Bld Demolition - New Sian- [ l . Decks N Siding[ ] Other[ )
��7Q�1G1K I/+� ��,,ImoI ..%i�it / !: //
Brief Description of Proposed Work: U w. )C.7ue Jdcza b€-' 1n " ik.FVWt f ow_ r'n..lkc�e y.-! asµq-r•-
Vexc:JJ,ky Dtic4e
Alteration of existing bedroom Yes No Adding new bedroom Yes ✓ No
Attached Narrative ❑ pBenovati�g}int in h basement Yes .,/ No
Plans Attached Roll o - Sheet 0d/'/�_9.yv{` (o X
5p>If-Netlt&i antflbraddition to existine bOlisiii ecompleteTthe fdlloWinti
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?
h. 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 7a-OWNER AUTHORIZATION -TO BE COMPLETED WHEN
OWNERS AGENT'/ OR CONTRACTOR APPLIES FOR:BUILDING PERMIT
I. M gy/UrGCA a1rsc / H/°'s,/ / ,( , as Owner of the subject property
hereby auths efilika 6)' % CA -a- z) to act on
my beha, I matters relative to work author ed by this building permit application.
Signatur::f i.,,ww�ner / Date
�G'
I, nh 4) .2-rt + (A -a2- Z , as plrstr/Authorized Agent
hereby declare that the statements and information on the foregoer] application are true and accurate, to the best of my
knowledge and belief.
Signed under a pains a penalties of perjury. /'
LAn W, 417/4 LA •2 - a
Print Name
Signal YE fj>wwer/Agent Date
SECTION 8 -CONSTRUCTION SERVICES
8.1 Licensed Construction Super isor: ( Not Applicable ❑ /609
Name of License Holder : e. b W. ` �S CS a/3G
//JJ / License Number
7/ KQS eI'✓u_iK /(2 / LeC d4/ Aft, o/D,}'J -7 -LY - Lona
Address Expiration Date
Sign e
0944-- Telephone
93Re¢isleredNolneiliThi'remeiit Contracfdr: ;^,'• µ'" E2 -'_,e„ „ Not Applicable ❑
Company 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 this affidavit
will result in the denial of the issuance of the building permit.
Signed Affidavit Attached Yes ❑ No 0
111
.. Om IA 0 '-fighWri o,`•
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
•
Q^lfpp .
09-e `qp
. (rtofdortamton
.QU!t.....0.&.•t. te .alneitchnsetn'
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DEPARTMENT OP BUIIDriyG INSPECTIONS J=
212 Main Street •e Municipal Budding /
Northampton, Mass. 01060 as s
WORKERS COMPENSATION INSURANCE AnIDAVI'T'
Iz <eh4% _ r� N "_ ...
ipermittee) ......
with a principal place
ofbusiness/residence at:
d'.1°3)6 S4``Ygf (A4da• t bli D(b-t-3 :....._ (phone#) V�1'17l f 'L
(strl/city/staltlap)
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:
•
Qnsurance Cottkr.. (Policy Number) (Expiration Date)
I am : sole propriet.-, general contractor or homeowner (circle one) and have hired
tt}te contra • i .ell below who have the following worker's compensation policies:
(Natxte of Contractor) (Insurance Company/Policy Number) (Fxpimtion Date)
t.
(Name of Canna-tor) —(3sntance C oto anviPotima Number) (Eaviratioc Date)
(Name of Conn-actor) (Insurance Company/Poky Numher) (F_xpiradon Date)
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(attach aM1*c I ztia ifncmusm include toe.im gcu:or<s tc all kation)
I am a sole proprietor and have no one working for me.
I am a home owner performing all the work myself
•
NOTE:ptuve be amt=thzwhile hcmvwun oh=m bay peat=todo rnsSraae:stt-ta.oven orffiffith one=oh a ANS of
bee ate=Wee tMrn tots in wl¢cb the hoouixrrmL>err m the Pn a.t apgoteffiaEhcae tee ns h_essilyactidat to be
caploycenskr the aawkda mpeaatim An(GL152aa 1(5)),epylinrie=by n hmmaoweer fora Comae cc permit way..i a ., the
legal nauw of an asploya'under t o hffickeffi Coop®.tion Act
I'lads"tEn a copy of t4ffi aatment may be font:reef to tto Department of, , .d A44=AS Office of lmuwm for the
covaagtAtifazioa=tithe teinnctouuue coverage=odes sot 254 etMOL in a¢Iwlta the nine;m MWCat4 rte-+
nwidmg of*fineotpto S1500.000a Sroriuynssot year tof up to ore yayd+tt p®JGe inthc t ofastev St-44c tad a ..
cum 4C5100.00 a day pine me
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