32A-205 (2) 36 BUTLER PL BP-1999-1091
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map:Bloc CITY OF NORTHAMPTON
Lot: -001
Permit: Building
Category: chimney rebuild BUILDING PERMIT
Permit# BP-1999-1091
Project# JS-1999-1820
Est.Cost: $5400.00
Fee: $20.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group:
Lot Size(sq. ft): 6011.28 Owner: GREGORY PATRICK BOLTON&JUSTI
Zoning:URC Applicant:_
AT: 36 BUTLER PL
Applicant Address: Phone: Insurance:
ISSUED ON:6/15/1999 0:00:00
TO PERFORM THE FOLLOWING WORK:REBUILD CHIMNEY TOP FROM ROOF LINE UP
POST THIS CARD SO IT IS VISIBLE FROM THE STREET
Inspector of Plumbing Inspector of Wiring D.P.W. Inspector of Buildings
Underground: 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 giEnature:
Fee Type: Receipt No: Date Paid: Check No: Amount:
Building 6/15/1999 0:00:00 $20.00
212 Main Street,Phone(413)587-1240,Fax:(413)587-1272
Building Commissioner-Anthony Patillo
File No. 5 9 �to/
ECTIO
DE NORTHAMPTON MA IMP
ZONING PERMIT APPLICATION (§10 . 2)
PLEASE TYPE OR PRINT ALL INFORMATION
x 1. Name of Applicant: PctrcL 61 r
� � r k/
Address: 3 Le f 0JO elephone: `JV lX /
2. Owner of Property: ) -�CSC- Crr r
Address: {Q 1hL.tfleL PICICL Telephone5g L( Li ) I
3. Status of Applicant: V Owner Contract Purchaser Lessee
Other(explain):
4. Job Location: [� ���.CJ�-�L...•f r"'
Parcel Id: Zoning Map# _3?-4 Parcel# OC�S District(s):
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/Property 14
7, 6. D s p io Pr Fe
U e ork/Prgje t/Occu ar ti (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 PermitNariance/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#
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 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 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
Existing Proposed By Zoning
Lot size
Frontage
Setbacks - frnnt
- side L: R: L: R:
- rear
•
Building height
Bldg Square footage
w
%Open Space:
(Lot area minus bldg
&paved parking)
# of -Parking Spaces
# of Loading Docks
Fill:
-(vol-ume -& location)
13 . Certification: I hereby certify that the information contained herein
G is true an accurate to the best of my knowledge.
)(NDATE: 44 __L APPLICANT's SIGNATUREat
NOTE: les ano o a zoning permit does not relieve an appiioanrs burden to m with 011
zo+trfng requirements and obtain all required permits from the Board of Heelt . Conservation
Commission, Department of Publlo Works and other applicable permit granting authorities.
FILE #
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Aissssc4asctis
EPARTMENT OP BUILDING INSPECTIONS
DE�TO�T �� iA 0106NPECTION5 212 Main Street ' Municipal Building '
Northampton, Mass. 01060 '
WORKER'S COMPENSATION INSURANCE AFFIDAVIT
I, QAnmiwe , P15
(iipermittee)
with a principalal place of business/residence at:
55 c�I L/ti lnt G kLi met- octie(phone#) 5 2r 1-l`1�
ct/city/stair/rip)
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:
(Insurance Company) (Policy Number) (Expiration Date)
( ) I am a sole proprietor, general contractor o homeownje i'(circle one) and have hired
the contractors listed below who havethe following worker's compensation policies:
J3f1 ,,S Cam• 1 F&1.O5r373 rjioloo
(Name of Contractor) cc Company/Policy Number) atioDate)
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(enacts additional short ifn ,.ry to include information pertaining to all contractors)
( ) I am a sole proprietor and have no one working for me.
XI am a home owner performing all the work myself.
NOTE:please be aware that while homeowners who airplay persons to do mainsm.nn construction or repair work on a dwelling of
not more than throe units in which the homeowner resides or oa the grounds appurtenant thereto are got gmrrally ooasidcrcd to be
employers under tha worker's a .ration Act(GL152,s1 1(5)),application by a homeowner for a license or permit may cvidcaoe the
legal atsale of an employer under the Workola Compensation Act
I understand that a copy of this etatema t may be forwarded to abo Deportment of Industrial Aooideote Oflioo of Inxrr.noo for the
coverage verification and that failure to secure coverage tinder section 25A of MOL 152 an lad to the"imposition of criminal penalties
consisting of a fine of up to S 1,500.00 and/or im n priso of up to one ytar and civil pc oaltics in the form of a Stop Work Order aad a :1
/� fuse of
5100.00 a day against me.(ev IN/ i ^k l .-1 i Foe dgaatmr� se al u oat)
�/-' Permit Number
kJt weep# Lot 4
C` Teti Signature t crruitiec
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� pp J�i ►; .� I a � yuASIIACI,AIIfIIII ��v = :
D PARTMENT OF BUILDING INSPECTIONS
DEPT NN MA 01060
BUILDING
ORTHAMPTO
INSPECTo, 12 Main Street Municipal Building
Northampton, Mass. 01060 '" r
/� HOMEOWNER LICENSE EXEMPTION
If! � II ( Please Print)
DATE;
JOB LOCATION: 5?-f- 5— Gth. C
X HOMEOWNER: Ritr ( P�r el �f �C(JS�u�b
O Mare' Noty1rpt
f
N me Add ess)
(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. 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 completipn 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 L
Cry
BUILDING PERMIT #
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`C 86 - t4& / / Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No 3< / /, Alterations
NORTHAMPTON, MASS. 4//5 / y 19 Additions
" A' APPLICATION FOR PERMIT TO ALTER Repair
Garage
1. Location a& But IC r P I aCJL 1 Igor th Lot No.
Rib- _ y 3b tler Pkc� lIc
2. Owner's name � �� Address
i
3. Builder's name .-5 Address . LA( Q)(t" "j aI�f J_
Mass.Construction Supervisor's License No. f Expiration Date
4. Addition
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
14. Estimated cost: 740 . G zy
The undersigned certifies that the above statements are true to the best of h
knowledge and belief.
PC If\Lik a
Si fur o sponsible app.icant
Remarks V` P Cti. /1 CiP n,%rrl ¢ V roe 'Pf/.✓i Cnof 1. z t°. 0 er . QS IS',
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