23D-151 (8) 147 HINCKLEY ST BP-2000-0569
GIS#: COMMONWEALTH OF MASSACHUSETTS
lap:Block:23D- 151 CITY OF NORTHAMPTON
Lot: -001
Permit: Building
Category:woodstove BUILDING PERMIT
Permit# BP-2000-0569
Project# JS-2000-1010
Est.Cost: $100.00
Fee: $25.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group:
Lot Size(sq.ft.): 18513.00 Owner: GIBBS PATRICIA CANDEE&
Zoning:URB Applicant:
AT: 147 HINCKLEY ST
Applicant Address: Phone: Insurance:
ISSUED ON:12/3/99 0:00:00
TO PERFORM THE FOLLOWING WORK:INSTALL WOODSTOVE IN SHOP/GARAGE
POST THIS CARD SO IT IS VISIBLE FROM THE STREET
Inspector of Plumbing Inspector of Wiring D.P.W. Inspector of Buildings
fnderground: 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 Signature:
Fee Type: Receipt No: Date Paid: Check No: Amount:
3uilding 12/3/99 0:00:00 $25.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Building Commissioner-Anthony Patillo
i_ A' G i
�u
DEC 3
pEPT OF BUILDING INSPECTIONS Fi 1 e No.
NORTHAMPTON Ng 01G6u
ZONING PERMIT APPLICATION (§10 . 2)
PLEASE TYPE OR PRINT ALL INFORMATION
✓ 1. Name of Applicant: ' ` oI���J�x jo8.3
Address: / 41 l i74Y\ d( 3/- Telephone:
Owner of Property: i0-alJ%�,�
Address: Telephone:
3. Status of Applicant: Owner Contract Purchaser Lessee
Other(explain):
LA<Job Location: /y 7 i-Xrtett34
Parcel Id: Zoning Map# Parcel# District(s):
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/Propert (7? 7--
y
p- /sue
6. Description of Proposed Use/Wor —roje Occupation: (Use additional sheets if necessary):
1 () CL -zSU42. > (1q)( -_Qcy.S __
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 PermitNariance/Finding ever been ' ed for/on the site?
NO DON'T KNOWS 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 cument#
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)
,
10. Do any signs ebst 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 property?YES NO
IF YES,describe size,type and location:
11. ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE DENIED DUE TO
LACK OF INFORMATION.
This column to be filled in
by the Building Department
Required 1
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
&paced parking)
# of -Parking Spaces
# of Loading Docks
Fill:
vol-ume -& location)
13 . Certification: I hereby certify that the information contained herein
is true andg accurate to the best of my knowledge.
,DATE. s- ( APPL 'CANT's SIGNATURE .jel4F .
: Issuanoe of zoning •er It does not relieve an appli tr.
bur• - o oom with
zoningPIY hall
requirements and obte n all required permits from th •and of Health. Conservation
Commission, Department of Publio Works and other applioab - •ermit granting authorities.
FILE I
,3' Th
C ,
p,d < . •
.,, Crzi4 of NITi;iljtunpf aii _,-__--=1
Qw` `,-t.3 �1k1/kC411(t��/ .(itr!„.-_
DEC JJZPARTMENT OP BUILDING INSPECTIONS i'_1 = _
INSPECT ►R Ct� 12 Main Street ' Municipal Building l��^
Northampton, Mass. 01060 Irmo"
DEPT OF BUILDING INSPECTIONS
NORiH ,E,`,'rC'J,MA 01660
HOMEOWNER LICENSE EXEMPTION
( Please Print)
DATE; (2- :2 T (4 1
JOB LOCATION:
,(//M���a��p, ) Parcel ) ( Subdivision )
IEOWNER: .�' ' \LAC �C 00
(Name & ddres ,�
/ u-Z llr li\e k Kc7,12 cQ -07E37
' (Home Phone) (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. CMR760 Section 109. 1 . 1
DEFINITION 'OF . HOMEOWNER: Person(s) who own a parcel of land on
which'_he/she residers 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 buildiriq
permit: . .
As acting Construction Supervisor your presence on the. j:ob 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 . Northarnptor
Ordinances, State and Local Zoning Laws , and State of Massachusetts
General Laws Annotated
c
OMEOWNER SIGNATURE g .
. CBUILDING. PERMITii ��`
•h
'...iitl , _!...--ft,
9�Y�`� . .",01 DEC `] 1999 jaassactlasctts ::• ,_
Vir� 's al•/ J 1�77J �1
-"' D PARTMENT OF BUILDING INSPECTIONS _ `=
vy DEPT Of SUIID!PdG INSPECTION` —
r,. . ONs 12 Main Street ' Municipal Building '
••— Northampton, Mass. 01060
WORKER'S COMPENSATION INSURANCE AFFIDAVIT
Rs caNda_c_ 6t(e .s
(li ccnsee/permi tree)
with a principal place of business/residence at: / --
Z / LI c1 l�7(to 5 (phone#) 5 eZ v `S5
city/stair/zip)
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:
s.
(Insurance Company) (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) (Insurance Company/Policy Number) (Expiration Date)
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(Name of Contractor) (Insurance Company/Poticy Number) (Expiration Date)
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(attach additional sheet if -scary to include information pertaining to all ooa7ndon)
(L<AM a sole proprietor and have no one working for me.
( a home owner performing all the work myself.
•
NOTE:pewee be aware that while homeowners who«Z.pl ay paroau to do reainte-tanre corsruaioo or repair work on a dwelling of
not mere than three units in which the homeowner resides or ea the ground,appurtenant thereto are not generally°on/i.d:red to be
employes under the w od tt's cnrp- ion Act(GL152s3 1(5)),application by a homeowner for a liana or permit may cvid-on-the
legal atatua of an employer under the Waimea Compemaiioe AC(-
1 understand that a copy of this etitemmt may be forwarded to tbo Department of Industrial Accident,'OfSoo of Inausnoe for the
coverage verification and that failure to secure coverage under section 25A of MGL 132 can lead to the imposition of criminal penalties
oomi.sting of a fine of up to S 1,300.00 and/or imprisoomeat of up to one year and civil penalties in the form of a Stop Work Order and a
fine of S 100.00 a day against me.
a For departmental use only
/ C� Permit Number
V ( "� ( Map# Lot#
Sigma icensee/Permittee late
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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations
�%�� NORTHAMPTON, MASS. 19 Additions
;;• • ; Repair
•. -I APPLICATION FOR PERMIT TO ALTER
g t� , f - / Garage
. Location l LI 1 L [+i Jqi
---7 1 Lot Noo..
L7 Owner's name ? eai 88 Address, I ? �)f� r J
3. Builder's name Address
s.Construction Supervisor's License No. „ Expiration Date
. Addition LOb61).--In VC I ts . /5qP9-042..
5. Alteration
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
. Estimated cost:-
4If1.00oe'
e undersigned certifies that the above statements are true to the best of hi,
knowledge d belief.
Sig ure of responsible appicani
Remarks