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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. L-T-e1.No. 4,6 Alterations
Ser S 4 lf67 -3441-7 (,:eabj
NORTHAMPTON, MASS✓/ 19 Additions
APPLICATION FOR PERMIT TO ALTER Repair
Garage
Location V-3 FA,rt S /79ZT /y4 _ Lot No.
c,2'Owners name AiJOA lt-ba rzjm< Address Lts F,4,1?
3. Builder's name Address
Mass.Construction Supervisor's License No. Expiration Date
4. Addition
Alteration-J H><e.1.-C:t•1 a,n RA I-t P
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:- . -,r 00
L,- ate undersigned certifies that the above statements are we to the best of his,
knowledge and belief.
�
Sigtiure of responsible app,ican!`
Remarks u ti A ) a'D C.L IBS i S /d 1 A 00& A cR
I' n A In f go-V C, L, N-S /4A gimy 467—
Qri11� oaf 'darillaillpfall
I�recachautl.
NOV 2 3 IM EPARTMENT OF BUILDI?\G INSPECTIONS `^
INSPEC oP
_ 212 lNfnin Strcct • Municipal Building
DEFT Of BUILIP,°IG INSPECTILtIa Northnmpton, Mass. 01060 • ••,
HOKEOWNER LICENSE EXE11PTION
( Please Print )
✓DATE; / C _
JOB LOCATION:
(map) ( Parcel ) ( Subdivision )
fOMEOWNER: A k]oA IAC,nA cjry; 4•'3 i
(Name & Address)
�,,��,� _ 7 (Home Phone) (Work Phone)
Sc�� r=�� f7e��G c;�5 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 i-s, 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 . pekiod shall- not be
considered a -homeowner. - Such "homeowner" shall submit to the Building
Official, on a form acceptable to the Building Official, Oi-at he/she
shall. be responsible for all such work performed under: the' buildiriq
permit.
As acting Construction Supervisor your presence on th- e,• 3ob 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. n
t OMEOWNER SIGNATURE � ✓vnGt ���'d �,2 "
BUILDING. PEf2MIT ( li
—.. .. `?iK::�:�.v:� ... . ..'vin•e,
VMA64P��
NOV 2
$ �lasaachnsrtta
31%9 PARTMENT OF BUILDING INSPECTIONS
D .____�� 12 Main Street a Municipal Building S��S
EPT OF$UIo nzlar�,S"FfT,; Northampton, Mass. 01060
WORKER'S COMPENSATION INSURANCE AFFIDAVIT
(lldpermittee)
with a principal place of bresidence at:
4-5 66,1Z 57- a!Z TiI��M 7 ,1.1 //4 (phone#) ✓ru 4-i26q1,,,
(StrCeVdty/sta&2ip)
do hereby certify, under the pains and penalties of perjury, that:
( ) I am an employer providing the following worker's compensation coverage for my
employees working on this job:
(Insurance Company) (Policy Number) (Expiration Date)
I am a sole proprietor, general contractor o o�wore circle one) and have hired
the contractors listed below who have the following ompensati on policies:
(Name of Contractor / (Insurancee Company/Policy Number) (Expiration Date)
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(attach additioml shoot if necessary to include information perulning to all ooatraotora)
( ) I am a sole proprietor and have no one working for me.
( ) I am a homeowner performing all the work myself.
NOTE:please be aware that while homeowners who employ persons to do m— M a oomtnutioa or repair work on a dwelling of
not more than three units in which the homeow=resides or an the grounds appurtenant tbado are not ec many considered to be
employers under the worker's compensation Ad(01,152,=I(5)),application by a homeoww far a Gceuse or p-mit may evidence tho
legal status of an employer under the Worker's Compensation Ad
I understand that a copy of this statement may be forwarded to the Depwtmx of In&Lstrial Aoddeot>'Office of Imwwoe for the
coverage verification and that failure to$=In coverago under section 25A of MOL 152 can lead to tbo imQOSdion of mminai penalties
consisting of a fine of up to$1,500.00 andlor imprisonment of up to one year and civil penalties in the form of s Slop Work Order and a
fim of$100.00 a day against tne.
For dgmt n=W use only
-� Permit Number
Date✓ a � Map# Lot#
} Sipahue of Licensee/Pirmittee
NON23W9
DEPT Of SUIt(11NG INSPECTION,) �
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CoNCRETE P��R
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NOV23 � y
DEPT OF BUILC"S19G INSPECT!" >
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A
WfJeI EL CHtly9 R16LMP Fag
Ff�l� ST,
10. Do any signs east on the property? YES NO l/
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 Cohn= to be filled in
by the Baildiag Depart—at
Required I
Existing Proposed By Zoning
Lot size
Frontage
Setbacks - front
- side L• R: L: R:
- rear
Building height
Bldg Square footage
%Open Space:
(Lot area minus bldg
&paved parking)
# of Parking Spaces
e 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: / APPLICANT's SIGNATURE A � - zg
NOTE: lmw6an646 of la zoning permit does not relieve an applioant's burdeh to oomply with-ail
zoning requirements and obtain all required permits from the Board of Health. Conservation
Commission. Department of Publio Works and other applloable permit granting authoritios.
FILE if
n � M
U
NOSY 2 3 I�8
File
DEPT Of SUlln!FIG iNSPECTt��;:
N1NG PERMIT APPLICATION (§10 . 2)
PLEASE TYPE OR PRINT ALL INFORMATION
✓1. Name of Applicant: u QA uC;Z, K.iAa
Address: +S 76t 2 S7— c qtr Hfi~i+rn sue' A4 Telephone: S<. 5 's
3�y7
✓
2. Owner of Property: A MkI A dc 4.�. &'k
Address: iG 'FP rS2 5') �c f �rFr�t cal Telephone: 'S6 4 -26 516 __ v
3. Status of Applicant: Owner Contract Purchaser Lessee
/ Other(explain):
l/d. Job Location: ,f 3 F,,4l R 5',ate C 2 rl r'rcyr� IVA
Parcel Id: Zoning Map# 3a Parcel#_ District(s):
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/Property
,,6! Description of roposed Us E roject/Occupation: (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 Permit/Vadance/Finding ever been issued for/on the site?
NO DON'T KNOA1 `' 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 KNOIt! 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)
a
File#BP-2000-0539
APPLICANT/CONTACT PERSON HODGKINS ANNA M
ADDRESS/PHONE 43 FAIR ST
PROPERTY LOCATION 43 FAIR ST
MAP 32A PARCEL 248 ZONE URA
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building,Permit Filled out
Fee Paid 131 3
Typeof Construction: CONSTRUCT WHEELCHAIR RAMP
New Construction
Non Structural interior renovations
Addition to Existin¢
Accessoa Structure
Building Plans Included:
Owner/Statement or License
3 sets of Plans/Plot Plan
THE F LLOWING 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 Co Sion
Signature of Building Official Date
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.
43 FAIR ST BP-2000-0539
GIs#: �. COMMONWEALTH OF MASSACHUSETTS
Map:Block: 32A-248 , m CITY OF NORTHAMPTON
Lot: -001
Permit: Building
Category:Non structural interior renovations BUILDING PERMIT
Permit# BP-2000-0539
Project# JS-2000-0936
Est.Cost: $2300.00
Fee: $50.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group:
Lot Size(sq. ft.): 21 605.76 Owner: HODGKINS ANNA M
Zoning URA Applicant.
AT. 43 FAIR ST
Applicant Address: Phone: Insurance:
ISSUED ON:11124199 0:00:00
TO PERFORM THE FOLLOWING WORK:CONSTRUCT WHEELCHAIR RAMP
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 Signature:
Fee Type: Receipt No: Date Paid: Check No: Amount:
Building 11/24/99 0:00:00 $50.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Building Commissioner-Anthony Patillo