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36-046 ' o z a .. r .� Z n .. eD � Z z -1 m I r° -s Zoning Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. aLf''�� Alterations NORTHAMPTON, MASS. 194S_ Additions APPLICATION FOR PERMIT TO ALTER Repair Garage 1. Location / (, :n LJt es&,- /err l !?Vt°i�z.E� /��� Lot No. 2. Owner's name Al in R"I,4,"', r 1r Address_ 3. Builder's name ii rot e�r �,>S Address 71 Aj;Lj.�z,'- �7 Mass.Construction Supervisor's License No. Expiration Date 4. Addition tic 5. Alteration pi 1J 6. New Porch N(; 7. Is existing building to be demolished? Al a. 8. Repair after the fire 9. Garage Yr-3 No.of cars Size �V K P ` 10. Method of heating � n 1l. Distance to lot lines 1`,,6jif ,'ar- g TYkr V11 FfpIJ 12. Type of roof NEI I e 13. Siding house 14. Estimated cosL- The undersigned certifies that the above statements are true to the best of his, her knowledge and belief. Signature of responsible app!cant Remarks p 8 Coif oaf 'Hart aillpfan � � .�iasaachuaetta DEPARTMENT OF BUILDING INSPECTIONS INSPECTOR 212 Main Street ' Municipal Building ' Northampton, Mass. 01060 ` HOMEOWNER LICENSE EXEMP`T'ION (Please Print) DATE: JOB LOCATION: Map) (parcel) (Subdivision) HOMEOWNER: (Name & Wdress) _ J (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 resided 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 m_ ay be' liable for persons) 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 AND SHALL BE ON THE JOB AS SUPERVISOR. HOMEOWNER SIGNATURE BUILDING PERMIT # 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 Existin-g Proposed Bv Zoninci Lot size /00, X /00' 16)0' Frontage /D /00 ' Setbacks - front - side L: R: L: R• - rear Building height r� /y, Bldg Square footage 7V' a 75 , %Open Space: (Lot area minus bldg &paved parking) # of Parking Spaces # of Loading Docks Fill: (volume & location) ] 13 . Certification: I hereby certify that the information contained herein is true and accurate to the best of my knowledge. Date: 1- < Applicant's Signature: NOTE: Issuance of a zoning permit does not relieve an applicant's burden to comply with all zoning requirements and obtain all required permits from the Board of Health,Conservation Commission, Department of Public Works and other applicable permit granting authorities. File No. K7� ZONING PERMIT APPLICATION (§10. 2) PLEASE TYPE OR PRINT ALL INFORMATION 1. Name of Applicant: j�& Q M qg.7' A iiei t q. mss Address: J w 7 �ioiexTe(^ T-eeF- Telephone: -5-Y"9= 1 �� 2. Owner of Property: K ahls e'TA l si el H e ts.s.S Address:-///G�L�G�%���u%� L, . v 2 Telephone: -5$ 3. Status of Applicant: Owner *�` Contract Purchaser Lessee Other (explain): 4. Street Address: Parcel Id: Zoning Map# Parcel# District(s): (TO BE FILLED IN BY THE BUILDING DEPARTMENT) r 5. Existing Use of Structure/Property 4 Lr t ':r,.1 .10 s r^ q �. J 6. Description of roposed Use/Work/Projec ccupation: (Use additional sheets if necessary): / r � /-'O CX1i4Av6,(F 70 �oo��if/iyl 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 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 # 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) FILL $ APPLICANT/CONTACT PERSON: ADDRESS/PHONE: PROPERTY LOCATION: MAP PARCEL: �� ZONE THIS SECTION FOR OFFICIAL USE ONLY: — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out �� Fee Paid I/I Type of Construction: New Construction Remodeling Interior / Addition to Existing r Accessory Structure Building Plans Included: Owner/Occupant Statement or License $ 3 Sets of Plans / Plot Plan THE FO OWING ACTION HAS BEEN TAKEN ON THIS ZONING 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 from DPW Permit from Consery tion Commission _ Sign u e of BUfldlng Inspector Date NOTE:Issuance of a zoning permit does.not relieve an applicant's burden to comply with all zoning requirements and obtain all required permits from the Board of Health,Conservation Commission,Department of Public Works and other applicable permit granting authorities. e I'� �E 0 lzr O U ono ® 0-4 E � Qc� 3 V a °� ao o wo a'cb o ° A arpq ° a a a °' w COO bA bA ►� bo Ln �y w cd v' a A, ° ° to 14-4 S o o ° o o W ONO gz O � c z C� wo 4 riir U4 O O V ` Q O 3 v w ti � V .� � •� pq Q A rc) (a U O w 3 Q ° ° 9 vs 1 tn r-, rs. W o � 000 Q � x w `° ° a � o Zo � �o b4 k Z tQ a O 4-(IUU'fP�0 e g6 1 :ssrtchnsctta' m DEPARTMENT OF BUILDDA G INSPECTIONS 212 Main Street ' Municipal Building ' Northampton, Mass. 01060 WORKER'S COMPENSATION INSURANCE A TIMAVIT (li censee/pertni ttec} with a principal place of business/residence at: � 4A tSl e� � , 'c•,� �� Ic_��� . (phone#) r,')1 (st-ccucity/sta 2e p) do hereby certify, under the pains and penalties of penury, that: ( ) I am an employer providing the following worker's compensation coverage for my employees working on this job: (jnsurance Company) (Policy Number) (Expiration Date) O I am a sole proprietor, general contractor or homeowner (circle one) and have hired the contractors fisted below who have the following worket's compensation policies: (Name of Contractor) (Insurance Cornpany/Policy Number) (Expimbon Date) (Name of Contractor) (Insurance Company/PoLcy Number) (Expiration Date) (Name of Contractor) (Inswant CompanyiPolicy Numbu) (Expiration Date) (Name of Contractor) (Insu=ce Company/Policy Number) (Expiration Date) (attach additional s_hcci ifnto icy to iaformitioa patnining to'H mdraciors) i I am a sole proprietor and have no one working for me. ( ) I am a home owner performing all the work myself. NOTE:please be aware that whi]c hocxnwncta who cmplay pczt n to(10 repair wovk on a dµttling of not mere than throe units in kfrich the hoar- —acr rctides a oo the gvin i,appurtecLU t th�tto I ax g'ncr-tUY coes;' a1 to be catploycrs under the Ve0ek is cernpcnzatim Act(GL152,"1(5)),application by a honicowna for a Lcc—a pcflnil may evidrno`the legal�txtus of an employes under the Workcet Compamation AcL I un&=e-,nd that a copy of this Kt rc,cL may be lbrwwded to the Bcpa in of rn&utrial Aocidas&Offroo of Inziu.ncn for'ho covaiage verification and that failure to seauc coverago undx sccuoa 25A of MOL 152 can Icad to thti itnposirion of criminal penalties ooasiatin of a fine of up to S1,500.00 and/of imprisoamcat of up to one year and civil penattia in dl[I'M of a Stop War'Ord--and a find of S 100.00 a day against me 7 Fof dc¢uRir 'I isle°°ty Permit Number t Lot 4 v Signature of Liccnse Crmittce e SECTION 8-CONSTRUCTION SERVICES' 8.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder License Number Address Expiration Date 1 4— Signature Z4 Telephone Reel"�tered Hom`"zImprovement'Contractor:. .��" �,,,, E,•� ^ {f.... Not Applicable [I Company Name Registration Number Address Expiration Date Telephone SECTION 10-WORKERS';COMPENSATION INSURANCE AFFIDAVIT(M.GL.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...... ❑ Owner Exein i n The current exemption for"homeowners"was extended to include Owner-occupied Dwellinp_s 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, J to a d Local Zoning Laws and State of Massachusetts General Laws Annotated. r Homeowner Signaturet SECTION 5- DESCRIPTION=OF PROPOSED WORK(check all applicable) New House ❑ Addition ❑ ReplacemenyWindows Alterations) ❑ Roofing ❑ Or Doors Q7 Accessory Bldg. ❑ Demolition❑ New Signs [ J Decks [ ] Siding[ ] Other [ ] Brief Description of Proposed Work: 'Rt 04 x. Alteration of existing bedroom Yes No Adding new bedroom Yes No Attached Narrative ❑ Renovating unfinished basement Yes No Plans Attached Roll ❑ - Sheet❑ sa:If°Nevit!t Ouse=and orad`dition'to"existing'.liou"sing com'pletb'Ahe:foll' wine: 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? In. 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 _�&, 1 J/ �! " f a, Y , as Owner of the subject property hereby authorize �C c/i /�n to act on my alf,,in all matters r tive to work auth,: ized by this building permit application. Signature of Owner Date _ 1 E as Owner/Authorized Agent hereby declare that the tatements 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. ,)"A L� 6 . +;J fi Print Name Signature of Owner/ gent 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 Building Department Lot Size Frontage Setbacks Front Side L: R: L: R: Rear Building Height Bldg. Square Footage % Open Space Footage % (Lot area minus bldg&paved parking) #of Parkina Spaces Fill: volume&Location A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO DON'T KNOW 1% 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: of Northampton 5 atu #P tu, t1 V l5 i ding Department 2 Main Street Se er%Sepc ab ;` , { yy( Room 100 Wa erWeil ' v iii 1 JUN 2 2002 N rtha pton, MA 01060 Turo Sets oSt c bra . a s -58 -1240 Fax 413-587-1272 PI Site�Pans f � ,¢ DEP10f BU'l DING INSPECT104S Other�Specify����� Twm,EQN.M� 01060 APPLICATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 -SITE INFORMATION 1.1 Property Address: This section to;be completed by office Map Lot Unit ` Zone= �Z• Overlay�D�strict Elm St. District CB'District SECTION 2 -?PROPERTY OWNERSHIP/AUTHORIZED AGENT 4ae,( r f Record: ng Current Ma i,J{ng Telephone Sig a ure _ 2.2 Authorized Agent: Name Print) Current Mailing Address: w ' It �f..�-•a= �-� Y ��lL�ai�� Signature Telephone SECTION 3 -ESTIMATED CONSTRUCTION COSTS Item Estimated Cost (Dollars)to be Official Use Only completed by ermit appiic ant 1. Building C'i (a) Building Permit Fee r�'` 2. Electrical (b) Estimated Total Cost of Construction from 6 3. Plumbing Building Permit Fee 4. Mechanical (HVAC) 5. Fire Protection 6. Total =(1 + 2 + 3 + 4 + 5) Check Number This Section For Official Use Only Building Permit Number: Date Issued: Signature: Building Commissioner/Inspector of Buildings Date tl TM BP-2002-1140 GIS#: COMMONWEALTH OF MASSACHUSETTS CITY OF NORTHAMPTON Lot:-001 Permit: B u i I d i nib Category: windows replaced BUILDING PERMIT Permit# BP-2002-1140 Project# JS-2002-1835 Est.Cost: $2800.00 Fee: $25.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: EDWARD QUINN 055499 Lot Size s(sq. ft.): 10018.80 Owner: LEARY RUSSELL J& Zoning.URA Applicant: EDWARD QUINN AT. 12 WINCHESTER TERR Applicant Address: Phone: Insurance: 126 EAST ST (413) 527-9408 EASTHAMPTONMA01027 ISSUED ON:6121102 0:00:00 TO PERFORM THE FOLLOWING WORK.-INSTALL REPLACEMENT WINDOWS 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: Fee Type: Receipt No: Date Paid: Check No: Amount: Building 6/21/02 0:00:00 115 $25.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo