Loading...
03-014 (3) > o r` v -o o• � OZm C.3 °° 70 c Z cn O Z �• -� C7C _a Zoning Miscellaneous Additions,Repairs,Alterations,etc. / Tel.No. 1; 3 1 � Alterations NORTHAMPTON, MASS. /©Z20 19 Additions APPLICa ATION FOR PERMIT TO ALTER Repair Garage 1. Location 2 �c 1 �J Lot No. 2. Owner's name t/U 4N /77 C C" y Address 4 ". v t, 3. Builder's name ��n Address Mass.Construction Supervisor's License No. ::!'Z/? Expiration Date 4. Addition /11 c= 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:- The undersigned certifies that the above statements are we to the best of his, her know led belief. Signature of responsi app icant Remarks (✓ S 7`� a� 7`� i /j s�t ct �✓ ti �� . e Crz of Nazf[Talu ifall _ � • J�RSescfluacUe � `m DEPARTMENT OF BUILDING INSPECTIONS _ S III 1.�; ii INSPECTOR 212. Main Strcct ' Municipal Building Northampton, Mass. 01060 �m 3197 LIQI�W,l wrw.0 t!I f HOMEOWNER LICENSE EXEMPTION ----- / DATE: ri i 9 -7 ( Please Print ) � JOB LOCATION: (Map) ( Parcel ) ( Subdivision) HOMEOWNER: J& A . ^ e (�70 y - (Name & Add)(ess ) ( Home Phone ) (work Phone ) The current exemption for "homeowners" was extended to include Owner-occupied Dwellings of one ( 1 )or tl•ro (2) fami 1 ies 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 wAch .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 Annotate HOMEOWNER SIGNATURE BUILDING PERMIT goo o - a a OGC 3 0199 r e • �lassarhnsetta DEPARTMENT OF BUILDrNG INSPECTIONS 212 Main Street ' Municipal Building 'a Northampton, Mass. 01060 'v,y WORKER'S COMPENSATION INSURANCE AFFIDAVIT permitLee} with a principal place of re busine sid er at: 7 % � X" A.< a'A /-J (phone-9) (streeUci ty/stalf/a p) 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 or homeowner (circle one) and have hired the contractors listed below who have the following worker's compensation policies: (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) (Name of Contractor) (Insurance Company/Policy Number) (Expiration Date) (attach additioml sheet ifneocruay to inchsdo information pmuining to all 000tr Born) ( ) I am a sole proprietor and have no one working for me. YV I am a home owner performing all the work myself. NOTE:please be aware that wbilo homeowners wno employ pc som to do mainzcaancy construction or repair work on a dwelling of not more than droa units m which the homeowner resides or on tha grounds appurtenant thatito are not generally considered to be employes under the wortce's ootnQcas 4cu Arl(GL152.ss l(5)�application by a homeowner for a liccwe or pmad may evidence the legal status of an employer under tha Workees C,ompemation Act I undasiand that a copy of this statement may be forwarded to the Dq.,tm of Industrial Accident,'0ffioo of insurance for the coverage verification and that failure to s==coverage under section 2SA of MOL 152 can lead to the imposition of criminal penalties comisting of a fine of up to S1,500.00 anNor im� of tip to one year and civil pcnLWes in the form of a Stop W orlc order and a fines of S 100.00 a day against me. Signed this \-?O day Of 19 91 For drat use ooly Permit Number Map# Lot# Si of Licensee/Permitt 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 COMPLE'T'ED, or PERMIT CAN BE DENIED DUE TO LACK OF INFORMATION. This cola to be filled in by the Building Department Required Existing Proposed By Zoning Lot size Frontage Setbacks - side L: R: L: R: - rear _- Building height Bldg Square footage %Open Space: (LOtarea minus bldg &paced parking) # of -Parking Spaces # of Loading Docks Fill: Avolume -& location) 13 . Certification: I hereby certify that the information contained herein G is true and accurate to the best of my knowledge. DATE: 3 f 7 APPLICANT's SIGNATURE NOTE: lasuanoe of a zoning permit does not relieve an ap ant's burden to 00 ty Wit4_+.11 zoning requirements and obtain all required permits from the Board of Health. Con ration Commission, Department of Publio Works and other applicable permit granting authorities. FILE # Y Fi l e No. Af ZONING PERMIT APPLICATION (§10 . 2) PLEASE TYPE OR PRINT ALL INFORMATION 1. Name of Applicant: Address: �'1'4 �X s 10e,,,9 <:;/2 -/ /Z-pTelephone: 2. Owner of Property: JJ 4-0— Address: Telephone: 3. Status of Applicant: __Owner Contract Purchaser Lessee Other(explain): A 4. Job Location: - }t. et fc:�-o Parcel Id: Zoning Map# Parcel# District(s): 3 (CO BE FILLED IN BY T BUIL tNG DEPARTMENT) 5, Existing Use of Structure/Property 6. Description o �osedsork/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/Vadance/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) ��' `�� � OCT 3 01997 FILE # 0!�l APPLICANT/CONTACT PERSON: ADDRESSIPHONE: PROPERTY LOCATION: J �? � EZt• MAP 16 PARCEL: ZONE THIS SECTION FOR-OFFICIAL USE ONLY: PERK UT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM MLED MIT Fee Pni(i Hiii1ding Permit Filled mit THE FALLOWING ACTION HAS BEEN TAKEN ON THIS AP ICATION: Approved as presented based on information presented Denied as presented: Special Permit andlor 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 Conservation mission Signature of Building Insp or Da e NOTE:Issuanoa of a zoning permit does not relieve an applioant's burden to oompty with all Zoning requirements and obtain all required permits from the Board of Health, Conservation Commission, Department of Publio Works and other applioable permit granting authorities. City o Northampton REQUIRED INSPECTIONS BUILDING DEPARTMENT I. Fo otings and Walls 2. Structural Components in Place 3. Complete Building* No. 1051 Office of the Building Inspector Zoning Form No. 962977 Date 11/4/97 Fee$20.00 Check# 1467 Page, 3 Parcel 14 ,Zone RR/WSP/WP Section 127 ❑ Yes No BUI]LDINGPERMIT * Plumbing and Electrical Inspections required THIS CERTIFIES THAT John McCoy before Building Inspections has permission to install woodstove Inspection on Site—Foundations situated on 472 Coles Meadow Rd 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 o�k- 11-5 -q��, ** Install per Manufacturer's information: windows,vinyl siding,roofs and woodstoves Smoke Detectors(Fire Department) Other THIS CARD MUST BE DISPLAXtD A CONSPICUOUS PLACE ON PREMISES 17' -7,4 Certificate of Occupancy Buil ing Inspector