24A-209 (2) 24ADAREPL BP-2001-0163
GISJt: COMMONWEALTH OF MASSACHUSETTS
Map:Block:24A-209 CITY OF NORTHAMPTON
Lot:-001
Permit Building
Category:Deck Addition BUILDING PERMIT
permit# BP-2001-0163
ProjectJS-2O01-0272
Est.Cost: $4500 00
Fee:$50.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: NICHOLAS JONES 066878
Lot siu(sa. 5619.24 Owner MITCHELL IAN iIc JACQUELINE
Zoning: URB Applicant: NICHOLAS JONES
AT: 24 ADARE PL
Applicant Address: Phone: Insurance:
P O BOX 515 (413) 665-7927
W HATELYMAO 1093 ISSUED ON:8123/00 0:00:00
TO PERFORM THE FOLLOWING WORK CONSTRUCT 5 X 8 DECK, ADD STORM DOOR
TO PORCH & REPLACE EXISTING PORCH FOOTINGS
POST THIS CARD SO IT IS VISIBLE FROM THE STREET
Inspector of Plumbing Inspector f Wiring D.P.W. Inspector of Buildings
Underground: Service: Meter:
Footings:
Rough: Rough: House It 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 8/231000:00:00 4304 $50.00
212 Main Sweet,Phone(413)587-1240,Fax: (413)587-1272
Building Commissioner-Anthony Patitlo
Fite#BP-2001-0t63
APPLICANT/CONTACT PERSON NICHOLAS JONES
ADDRESS/PHONE P O BOX 515 (413)665-7927
PROPERTY LOCATION 24 ADARE PL
MAP 24ASBL 209 ZONE URB
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Fe Paid Permit Filled out
13� ,r X25r
Fee Paid Y- Ldi O
Typeof Construction: CONST _ :T 5 X 8 D^ .K ADD STORM DOOR TO PORCH&REPLACE EXISTING
PORCH FOOTINGS
New Construction
Non Structural interior renovations
Addition to _xistin_
Accessory Snpeture
Building Plans Included:
Owner/Statement or License 066878
3 sets of Plans t Plot Plan
THE 50/LLO WING ACTION HAS BEEN TAKEN ON THIS APPLICATION:
//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 Board of Health Well Water Potability Board of Health
Permit
from Conservation Comm' n Permit from CB Architecture Committee
Signature of Building Official Date
is. 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.
I_ City of Northampton
Building Department
212 Main Street
Room 100
Northampton, MA 01060
phone 413-587 1240 Fax 413-587-1272
APPLICATION TO CONSTRUCT,ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTION 1-SITE INFORMATION
1-11/rAggthi Address: a. -
}k �
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT
2,1 Owner of Record:1 J
11644 / 10.1G1W t cc , Litz
4 c1e 9.4'C 14&�su,,e S {s Sl Natal.
ro[lame(Print) Current Mailing Address'
"" Ai!! r , Telephone /r1 y,,r)
c o7
Signature �'(� v
22 AuthorizedqAgent:
I cite , 3-0 NES _— P.0 Dox 5Lg�L
15 . ' ,j „YYIo,, otOcl3
Name(Pr' t) Current Mailing Address:
` 5--74X7
Signature Telephone
ill • ' n . w1f ' Iu<t'1I=
Item Estimated Cost(Dollars)to be , Official Use Only
completed by permit applicant
1. Building 4500 (a)Building Permit
2, Electrical (b)Estimated Tota1','.(tsst of
Constructionk ^t6)
3. Plumbing Building Permit Fee
4. Mechanical (HVAC)
5. Fire Protection �L
6. Total=(1 + 2+3+4+ 5) 11{sav Cheek+Nt+mber �T %\s-c.) "'�
tl This Section For Official Use:Only
Buildiffot Permit Number: ?Pt/ /( bate Issued: ,.
eyi din Commibsioner/lns actor of Burl
eftgnafii#sT . . . ..
P .
Section 4.
r ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE
DENIED DUE TO LACK OF INFORMATION
Existing Proposed Required by Zoning
This column to be tined in by
{- Building Department
Lot Size Sj &erD 5-Aerc
Frontage v
Setbacks Front o?,�'r ap
Side L: it: i.: // Rta7
017/ d
Building Height
Bldg.Square Footage Rfg %
Open Space Footage l /
(Lot arca minus bldg&paved
parking)
#of Parking Spaces
Fill:
(volume&Location)
A. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO K 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 _,.. DC DONT 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 p( —
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:
MMIi-OE 1TSN'OF PROPOSED,!9Fkeh . ..'', apuncable)
New House 0 Addition 0 Replacement Windows Alteration(s)$. Roofing 0
Or Doors 0
Accessory Bldg. ❑ Demolition❑ New Signs [ ] Decks Ti(,] Siding[ ] Other[ ] 77"�
Brief Description of Proposed Work:A1.. •rn ; �,1axe.. - as- 4e,A; 5 l�. Sr 1 t esti.
Alteration of existing bedroom Yes y No Adding new bedroom Yes Pe No
Attached Narrative C Renovating unfinished basement Yes _ _No
Plans Attached Roll❑- Sheet❑
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,_
SECTIONla.OWNER AUTHORIZATION:- :BE COMPLETED WHEN
OWNERSS(/AGENT OR.CONTRAD OR{APPMESP�{{1OR BUILD
PERMIT
i+""/1 G4A.4.)437 1/ "L"` 7 - / , as Owner of the subject property
hereby authorize 14.c\oLS .3e.it A 1 _to act on
my behalf,in Il matters re ,tive to w.r ^i, . l &Iildln: permit applicati
T ce
Signature ofOwnerDate
Ajtthla5 a+t-5 ,as Owner/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.
elin,Signed under the pains andpenalties of perjury.
tc . 5 TeALS
Print Na
Owner/
g 0 eeoo
Signature of Owner/ Date
•
sokECFON:S-CONSTRUCTION SERVICES
1 Licensed Construction Supervisor: Not Applicable 0
Borne of License Holder: 7,rcIsol0.5 g Td, C66V7?
License Number
P , Q� Sts { t-01A .11 MA. p(ac3 S/t7/ot
Address Expiration Date
A Telephone
5-7r2^1
Si nature Telephone
Not Applicable 0
,e14,2,5 13 re nts 121.481
Company Name Registration Number
l-Ur O°- ¶15 wtt44.�.1 mq, 5-bo jet
Address I (�� Expiration Date
... ._Telephone T_/ 3 "IOC`7127
SECTION 10.WORKERS'COMPENSATION INSURANCE AFFIDAVIT(MAI.c. 152,$2$C(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 pt No 0
The current exemption for"homeowners"was extended to include Owner-occupied Dwellines 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.
pefinition of Homeowner:Person(s)who own a parcel of land on which he/she resides or intends to reside,on which there
is,oris 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
,nsible for all suchwor,. 'erforme t nder the , il in, term'.
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 perfonn 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
p.
tr-
OOtVJ(P�..
et:� vsjajipe
(iifii of Northampton
b"`L DEPARTMENT OP BUILDING INSPECTIONS
212 Maio Street ' Municipal Duiidinp
Northampton, Kass. 01060 r.".>
WORICf:R'S COiWFENSATION U4SURANCE .AbI EWA.V1•1'
4a•5_
(heenscclperri«ce)
with a principal place of business/residence at:
ns- (Les4tPLtn R. . trAudilimt t o9) (phood)4i3-6S-7427
(stn Udtylstalclep)
do hereby certify, under the pains and penalties of perjury, Thal
( ) I am an employer providing the following worker's compcnsenon coverage for illy
employees working on this job.
—.... Qasurana Conway) (Pchcr Nunlrr) (ixpiruoc Dan)
() I am a sole proprietor, general coon-actor or homeowner(circle one) and have hired
the contractors bste4 below who have the following worker's compensation pehcies:
(Name of Coin.ctor) (Insurance Company/lobes' Number) 0-spiration Date)
U.
.. (Name of Con-actor) _.... (Inruranc CompaayrPolicy Numtcr) (Expiration D.se)
(Name or Coonator) ('Insurance Company/Policy Number) (Expucuon Date)
(Name of Contractor) ...- (Insurance Company/Policy Numbs) (Expiration Date)
tons)4odr.xsi.t.e a'oacap.mel.ckvd,''ol too pcn+in=s tow oa::ofll
p( I am a sole proprietor and have no one working for me
( ) I am a home owner performing all the work myself
NOTE.Plea Le oma W.:xraabananaanao0 comloy p..ono tea SD -..M,croaao na+v 'cao,I daal i.2s of
ma more.da 11ro:lmia a wind the oo oc.aids.or co the goers ,puteusst tbpae +o'x pappoty mo:Ybd to tc
opoptoyon e,c Pataa c,um ua(eus2.n1(S))Application by.boomam fel a ec-cx o<Ig,m n<r c';emx iLe
14.0 axiom of to my-Ioyx wider Poo Wo*on Compma.tiw Ad.
I imdtrn.n4 tpn a wpy of Una mtmay moy b.farwSsd ta Na Dcp.nmem of loo6 viu noodrmf OOP an or is 000 ra
a,vaogt voificatioo M thel feline o acurc ooveayc nada action 13A of MCL 151 m ladw WM ^^Ynnm of cattail pdniltia
oocsi z g of a fox of .lu S I}oo oo valor i.normazanocat of up to aro ycv cod anti remhv iz b.(of a Slop W oA(Woo M.
(Ima(SIo000 da ypinu03C
TOC dNuun:.=y u.c vuY
Permit Number
1C?/111.�7/. ktop LAI.1Signature of lln iu¢ _ ..
IAN & ,IAVE MATCHETT PAGE 02
08/12,2000 12:03 413-584-8413
11 1 � � "� ..
,..7 , , \
"--.7 Ft
v
41-- -
Lc- 20 {*=7
s..a toF
�+ K 1,.<
Y/
t ti-
L -I
-740
voir
C ?_ Nrn1t;y 1.0v,o
41 I L
1 y`y�-,
S� ��f Sro \"ps \ m Ou
Care
'r ,v-92 v too A b
pl i r ,'Lt £9OC li j
s*t t p 5_V w;)
I i �
11.3-1. 33
1ahz � dda v.,.,.d h� im � „ia L„•Pe-13