Loading...
17A-142 (3) / r C .k.•�a ®.a. A'14.1.4L.•ax • ka i ®:s ;.! ..c.'��w .. a��._ .! ®.• <i.:e'.a <a -: New House ❑ Addition ❑ Replacement Windows Alteration(s) g Roofing n Or Doors Fi Accessory Bldg. ❑ Demolition ® New Signs [❑] Decks [E) Siding [❑] Other [❑] Brief Description of Proposed Work: REP, ACE SE'vE RAt. Wi,JDOWS REpcg v(ZAt. Do REPLACE 6PeA6E Doo,Z RtFsNrSH FLoc Alteration of existing bedroom Yes X No Adding new bedroom Yes 1 No Attached Narrative Renovating unfinished basement Yes 74 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. Masscheck 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 - QTR AUTHORIZATION - TO BE COMPLETER WHEN OWN S AGENT CONTRACTOR APPLIES FOR [ PERMIT IT 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 Date I, ANN A. M o (S R /..f , as Owner /Authorized Agent hereby d 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. 7 ?n /ivy A. MoR.ers Print Name Am ill /1 07 21Z Signature of • - . = Date ► # Section 4. ZONING All Information Must Be Completed. Permit Can Be Denied Due To Incomplete Information Existing Proposed Required by Zoning This column to be filled in by Building Department Lot Size Frontage Setbacks Front Side L: L: R: Rear Building Height / I Bldg. Square Footage Open Space Footage % (Lot area 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 ® DONT KNOW 0 YES 0 IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO 0 DON'T KNOW (7 YES 0 IF YES: enter Book Page, and /or Document # B. Does the site contain a brook, body of water or wetlands? NO �' DONT KNOW 0 YES Q IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained 0 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 ob IF YES, describe size, type and location: E. Will the construction activity disturb (clearing, grading, excavation, or filling) over 1 acre or is it part of a common plan that will disturb over 1 acre? YES Q NO ® IF YES, then a Northampton Storm Water Management Permit from the DPW is required. ■ ti City of Northampton: k(� 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 [r(--;,' 1.1 Property Address: ' r I rl 1� r `c; 'ice ' 201 CHESTNUT Sr , -- FLORENCE, Mt Q104 o 2 JUL 2 2 2009 civaNitst SECTION 2 - PROPERTY OtlHIPllAc 2.1 Owner of Record: SuSnN DBivNy MaRR/s 6 9 LAuREI.- PARK IJoRi,IMPTDJ 01040 Name (jr t Current Mailing Address: 1 - . 70? Telephone Signature 2.2 Authorized Agent: Name (Print) Current Mailing Address: Signature Telephone Item Estimated Cost (Dollars) to be Official Use Only com leted by permit applicant 1. Building 00 O (a) Building Pit Fe+e 2. Electrical (b) Estimated Total Cost of Construdtion frc {6) 3. Plumbing etlikartE Permit Fee 4. Mechanical (HVAC) 5. Fire Protection 6. Total= (1 +2 +3 +4 +5) 6 0 Cft cNumber ,1� t 53 This Section For Otf iai Use only Building Permit Number: Issued: Signature: Building Commissionerllnspector of Buildings Date � s X BP- 2010 -0110 GIS #: COMMONWEALTH OF MASSACHUSETTS , v 1 5t ' 141 ` CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: BUILDING PERMIT Permit # BP- 2010 -0110 Project # JS- 2010- 000126 Est. Cost: $6000.00 Fee: $55.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: Homeowner as Contractor Lot Size(sq. ft.): 25482.60 Owner: MORRIS SUSAN Zoning: URA(1001/ Applicant: MORRIS SUSAN AT: 201 CHESTNUT ST Applicant Address: Phone: Insurance: 69 LAUREL PARK (413) 303 -0330 0 NORTHAMPTONMA01060 ISSUED ON ::7/29/2009 0:00:00 TO PERFORM THE FOLLOWING WORK: INSTALL REPLACEMENT WINDOWS,DOORS,GARAGE DOOR & REFINISH FLOORS 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: FeeType: Date Paid: Amount: Building 7/29/2009 0:00:00 $55.00 212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272 Building Commissioner - Anthony Patillo