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17C-104 (2) a Elf c� .: 70 D m O CA G 3 Z m ft �j > O a Zoning Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. S tO -y 8 G 2— Alterations NORTHAMPTON, MASS. 19 Additions APPLICATION FOR PERMIT TO ALTER Repair c Garage 1. Location I-3 .577 L S 6 � 4 v,�� L o Xc--fir✓ Lot No. 2. Owner's name L `/ P1 Address 7i' 7 �d 4-l-f YC�,L-U . 3. Builder's name Address Mass.Construction Supervisor's License No. Expiration Date 4. Addition / 5. Alteration 0 " 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 o4 G 11. Distance to lot lines � 12. Type of roof f l�*�� 13. Siding house 14. Estimated cost:- f DU The undersigned certifies that the above statements are we to the best of his, her knowledge lief. Signature of responsible app icanl Remarks O�(1tA1!p� _C \ O r Griff Ulf 'Narf11a11Tptoll a � "°.�y �esertcl�uactle UL LT oll 8 1 ( DEPAR TMENT OF BUILDING INSPECTIONS - INSPECTOR 212. Main Strcct ' Municipal Building ' DEPT;F,�0U Northampton, Mass. 01060 HOMEOWNER LICENSE EXEMPTION ( Please Print ) DATE: JOB LOCATION: (Map) ( Parcel ) (Subdivision ) HOMEOWNER: 61 L L- (I*�J i'7 d C--6A:!! Q fz, (Name Address )& ( Home Phone ) (Work Phone ) The current exemption for "homeowners" was extended to include Owner-occupied Dwellings of one ( 1 )or t%.,o (2) fami 1 i es 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 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, State and Local Zoning Laws , and State of Massachusetts General Laws Annotated . HOMEOWNER SIGNATURE BUILDING PERMIT r `� of wort 4aillptoll _ �e a /,n�/_/D/y� � �7I3DACh IIDtItD � I997 DERARTMENT OF BUILDING INSPECTIONS t DEPT 212 Main Street a Municipal Building ' Northampton, Mass. 01060 WORKER'S COMPENSATION INSURANCE AFFIDAVIT (liccnserJpermittee) with a principal place of businesshesidence at: C�/v( Z 3 S 7l t S°o N &� . F1- S�6�9G z-- �(phone#) (sticWcity/stateJrip) 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 wonting on this job: (Insurance Company) (Policy Number) (Expiration Date) ( ) I am a sole proprietor, general contractor-or homeowner ircle one) and have hired the contractors listed below who have the following rer's compensation policies: (Name of Contractor) (Insurance Company/Policy Number) (Expiration Date) (Name of Contractor) (Insurance Company/Policy Number) (Expiration Date) (Name of Contractor) (Insuranc,. Company/policy Number) (Expiration Date) (Name of Contractor) (Insurance Company/Policy Number) (Expiration Date) (attach additional sheet Yneecni y to include informltioa pertaining to all cc rtraeion) O I am a sole proprietor and have no one working for me. ( a home owner performing all the work'myself. NOTE:please be aware that whilo hoc3cowom who employ pcssons to do�,, •r ., m�ruction or repair work on a dwelling of not mero than three units in which the hotnoow ocr resides or oa the gtcc tt appurtemnt thereto arc not generady oocside ed to be ""Ploy—ut der the workers c anon Act(GL152,s 1(5)x,application by a homeowner for a license or permit may evidmoe tbo Iegal status Of an amployoc under the Workel6 Compc..tioR Act I undcrstaad that a copy of thin cratcmcut may bo fory nudi i to tho Dcpartmcnt of Industrial Accid,=&Offioo of L=umnoe for the coverage vaificstioc and that failure to&==covcrago under scaiou 25A of MOL 152 can[cad to tba imposition of criminal penalties consisting of a fine of up to S1,500.00 andlor imprisoj�of up to one year and Ci pcnal6es in the form of a Stop Work Order aad a firm of S 100,00 a dry tg&inst Me. ` Signed this r/ da o ® - 1997 For&patmrtalusecoly Permit Number _ ✓°- Map# Lot# Signature of LiccnScc/PCrmittCr- 10. Do any signs exist on the property? YES NO V t:V 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. Thin column to be filled in by the Building TJvpartment Required 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 &paved parking) # of Parking spaces # '6f Loading Docks Fill: -(volume -& location) 13 . Certification: I hereby certify that the information contained herein G is true and accurate to the best of my knowled . DATE: �a �' 7 APPLICANT's SIGNATURE "v✓� NOTE: Issuanoe of a zoning permit does not relieve an applioant*s burden to oomply wit" all zoning requirements and obtain all required permits from the Board of Health. Conservtation Commission. Department of Publio Works and other applionble permit granting authorities. FILE # t M 1 a+(smn`no� x File No. �`d np J .,F Y J�S E 1 .m� NING PERMIT APP LI C,ATION (§10 . 2) PLEASE TYPE OR PRINT ALL INFORMATION 1. Name of Applicant: (Z//-LL / 1/ ,OV7 - P &-/t. Address: / 3 ST LS'© Al & F�0'�phone: 2-- 2 Owner of Property: X11-- L / �L p ✓j Address: 13 S -q L-S'o 14 � Telephone: & 6 96 Z 3. Status of Applicant: Owner Contract Purchaser Lessee Other(explain): 4. Job Location: 13 577(-f 67 Al" Q '�r F--L on CF7rt�c-c Parcel Id: Zoning Map#_ j7e. Parcel#_/6 District(s):. (TO BE FILLED IN BY THE BUILDING DEPARTMENT) 5. Existing Use of Structure/Property 4e mc- 6. Description of Proposed Use/Work/Project/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/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) F FILE # 3 MT $ 1997 APPLICANT/CONTACT PERSON: © P /PHONE: PRO PE RTY LOCATION: PARCEL: 1-6-54 ZONE . �- THIS SECTION FOR-OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING IRORM Vff.T.F.D OUT Fee paid ]Ruildin2 Permit Filled nut, -Fee Pnifi Rernndelin2 Interior Cep �1 f Accessary Strnrtnre THE LLOWING ACTION HAS BEEN TAKEN ON THIS AP ICATION' ?' 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-Bd of Health Well Water Potability-Bd Health _Permit from Conservatio ommission Signa e //0 o r Date NOTE:la-suanoe o a zoning permit does not relieve an applicant's burden to comply with ail zoning requirementa and obtain all required permits from the Board of Health, Conservation Commisalon, Department of Public Works and other applicable permit granting authoritles. ���"-g City of Northampton REQUIRED INSPECTIONS BUMDING DEPARTMENT 2. Footings and Walls Pl aural Components in ace 3. Complete Building* No. 974 Office of the Building Inspector Zoning Form No. 962878 Date 10/10/97 Fee$20.00 Check# 4986 Page, 17C Parcel 104 Zone URB Section 127 ❑ Yes Q No BUI]LDING PERTVHT * Plumbing and Electrical Inspections required THIS CERTIFIES THAT William olander before Building Inspections has permission to strip & shingle roof Inspection on Site—Foundations situated on 13 Stilson Ave Inspection of Plumbing—Rough provided that the person accepting this permit shall in every respect Inspection of Plumbing—Finish conform to the terms of the application on file in this office, and to the Gas Inspection provisions of the Statutes and the Ordinances relating to the Construction, Inspection of Wiring—Rough Maintenance and Inspection of Buildings in the City of Northampton. Any violation of any of the terms above noted is an immediate revocation Inspection of Wiring—Finish of this permit.Expires six months from date of issuance,if not started. Building Inspection—Rough Note:A certificate of occupancy will be issued by this office upon return Insulation Inspection of this card signed by the Plumbing,Wiring and Building Inspectors. Building Inspection—Finish ** Install per Manufacturer's information: windows, vinyl siding,roofs Smoke Detectors(Fire Department) and woodstoves Other THIS CARD MUST BE DISPLAYED IN A CONSPICUOUS PLACE ON WE P MISES Certificate of Occupancy Building Inspector l City of Northampton REQUIRED INSPECTIONS ' I. Footings and Walls BUILDING DEPARTMENT 2. Structural Components in Place* 3. Complete Building* No. 974 Office of the Building Inspector Zoning Form No. 962878 Date 10/10/97 Fee$20.00 Check# 4986 Page, 17C Parcel 104 ,Zone URB Section 127 ❑ Yes 0 No BU11-, D1NG J PERT * Plumbing and Electrical Inspections required THIS CERTIFIES THAT William olander before Building Inspections has permission to strip & shingle roof Inspection on Site—Foundations situated on 13 Stilson Ave Inspection of Plumbing—Rough provided that the person accepting this permit shall in every respect Inspection of Plumbing—Finish conform to the terms of the application on file in this office,and to the Gas Inspection provisions of the Statutes and the Ordinances relating to the Construction, Inspection of Wiring—Rough Maintenance and Inspection of Buildings in the City of Northampton. Any violation of any of the terms above noted is an immediate revocation Inspecton of Wiring—Finish of this permit.Expires six months from da to of issuance,if not started. Building Inspection—Rough _ Note:A certificate of occupancy will be issued by this office upon return Insulation Inspection of this card signed by the Plumbing,Wiring and Building Inspectors. Building Inspection—Finish 6 tr 3-!4-q 9, ** Install per Manufacturer's information: windows,vinyl siding,roofs and woodstoves Smoke Detectors(Fire Department) Other THIS CARD M JST FLAYED IN A CONSPICUOUS PLACE ON WE P MISES Certificate of Occupancy Building Inspector