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23D-016 (2) ?0 �411Veti"•" City of Northampton REQUIRED INSPECTIONS } � !^ 1. Footings and Walls • .�:. BUILDING DEPARTMENT 2. Structural Components in Place* 3. Complete Building* No. 511 Office of the Building Inspector Zoning Form No. 962316 Date 6/16/97 Fee$20.00 Check# 475 Page, 23D parcel 16 ,Zone URB/WP Section 127 ❑ Yes 0 No BUILDING PERIVI1T * Plumbing and Electrical Inspections required THIS CERTIFIES THAT Tina & Drew Quinlan before Building Inspections has permission to strip & reshingle roof & shed dormer rolled roof Inspection on Site—Foundations situated on 554 Elm St 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 P C 0,z I ISES Certificate of Occupancy ,/-� 4 Building Inspector FILE I 9 6 ?31 G jln� APPLICANT/CONTACT PERSON: 4e r L et4f2 ADDRESS/PHONE: PROPERTY LOCATION: MAP ,93-D PARCEL: /f ZONE THIS SECTION FOR-OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILT,F,T) OPT •� T/�7'97 Fee Pad Rnilrling Permit Filled mit 1� Fee Paid `- TyPe of Cnn_sjr•nirtion• New C'nnctrnnrtinn Remodeling Interior i Addition to Fzicting X JAI Accessory Strnrtnre Building Plane Tncluided• Ciwnereenpant Statement nr Licence # 3 Sets of Plane /Plot Plan THE FFOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION: I 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 Conserva • Commission , for Dat NOTE:issuenoe of a zoning permit does not relieve en applioent's burden to oomply with all zoning requirements and obtain ell required permits from the Board of Health, Conservation Commission, Department of Public) Works end other applioabie permit granting authorities. File No. ZONING PERMIT APPLICATION (§10 . 2) PLEASE TYPE OR PRINT ALL INFORMATION 1. Name of Applicant: 1) ec.1 T Q v i ikt Q vi Address: S S LI / S j, Telephone: ,v‘- 6 1'0 / 2. Owner of Property: T,na N). Q v vt I a Address: SS y /" S t Telephone: S,a' - 4id / 3. Status of Applicant: ✓ Owner Contract Purchaser Lessee Other(explain): 4. Job Location: tSS l! I J/' I S f. ,/li'ac/4a'y T an -4fa Parcel Id: Zoning Map# o?.36 Parcel# /‘ District(s):(TO BE FILLED IN BY THE BUILDING DEPARTMENT) 5. Existing Use of Structure/Property (Res;d e 1.ce 6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary): • e rod F 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 PermitNariance/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 1/ 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) 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 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) pf Parking Spaces #` rof Loading Docks Fill: -(vol-tune-& location) 13 . Certification: I hereby certify that the information contained herein G is true and accurate to the best of my knowledge. DATE: - 3 0- 7 APPLICANT's SIGNATURE , ,•'6 I f NOTE: Issuanoe of a zoning permit does not relieve an applioant's burden to comply wIth all zoning requirements and obtain ell required permits from the Board of Health, Conservation Commission, Department of Publio Works and other applioable permit granting authorities. FILE # 9 ,'8• (Ltxi of 'or formpthn _*- Y w 4 �0_ e• gssaschaartta " T= ��V ��S *� DEPARTMENT OF BUILDING INSPECTIONS + - /( INSPECTOR 212 Main Street ' Municipal Building al f 1 Northampton, Mass. 01060 ito HOMEOWNER LICENSE EXEMPTION DATE: 5- 3 d - q '� (Please Print) JOB LOCATION: (Map) (Parcel ) (Subdivision) HOMEOWNER: 1 1 h cl An, Ai',fr,I q vt .S S 4' f/i,-, 5 i• j/ (Name & Address) Are,Mo4ipiati,.r/l4 n1060 SA'40 / ni-30g1 (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 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 y,,L,.�A �L, 1 ' BUILDING PERMIT # •ti'O4� M~TOy s t,1 f�� Gip laf Xxirtlrttntpthn 1 _*_0 W='r $p��i/ `_ �jr! �lasaacElasctta =:" �eL y+ DEPARTMENT OF BUILDING INSPECTIONS 4 ';_t`_ 212 Main Street • Municipal Building Northampton, Mass. 01060 '" Wit+' WORKER'S COMPENSATION INSURANCE AFFIDAVIT I, Df rc Wu ((tin (licenscdpermittee) with a principal place of business/residence at: SS 1/ (/, 5/. /6-#mg2I/nr,4f4; 0/ 4o (phone#) S16• 4'0/ (s ti txt/ci ty/staf chi p) do hereby certify, under the pains and penalties of perj-ury, 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 'omen• a' (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 additional sheet ifneeessary to include information pertaining to ail contractors) ( ) I am a sole proprietor and have no one working for me. (v) I am a home owner performing all the work myself. NOTE:please be aware that while homeowncra who employ person to do m*rut nanM,construction or repair work on a dwelling of not more than three units in which the homeowner resides or on the grounds appurtenant thereto are not generally considered to be employers under the worker's cocapcmaticn Act(GL152..ss 1(5)),application by a homeowner for a license or permit may evidence the legal status of an employer under the Worker's Compensation Act I understand that a copy of this statement may be forwarded to the Department of Industrial Accidents'Offloo of Insurance for the coverage verification and that failure to secure coverage under section 25A of MOL 152 can lead to the imposition of criminal penalties oomistiag of a fine of up to S1,500.00 and/or imprisonment of up to one year and civil penalties in the form of a Stop Work Order and a fine of S100.00 a day against me. • Signed this - '0�h day of 4l a y , 199 7 Ford use only J Z2ae) �� / Permit Number Y l Map# Lot ti Signature of Licensee/Permittee a v I. J ni o r/ et T. XJ f=7 1 (7Z > = 3 cn O x Z "' v -3 m 177 C 7c a Zoning Miscellaneous Additions,Repairs,Alterations,etc. Tel.No...3 non- G lie)/ Alterations iiki:r NORTHAMPTON, MASS. _l /97 _19 Additions '_}= .`A' APPLICATION FOR PERMIT TO ALTER Repair '' Garage 1. Location SS F/M s (. /Vor-iiaw-p$cln r/t(a. Oi 060 Lot No. 2. Owners name T( k Cq /vl 0 c.,; (0(1 Address -G s 4 C I in S t• Atoi i kc[Mp'4 ciPt, %(a OIOGC 3. Builder's name '.-- 1C(AD 1- (Qu',1.(at' Address -SS y eh., sf• At i'iA450110h /14,0/060 Mass.Construction Supervisor's License No. __ _ Expiration Date 4. Addition 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 ()Type of roof Fi r r9/m33 --5 ;1.13/c5 /Dv..6/e COL"r/ti9C rv(f rO./.,K9 (iccd Dorrr)13. Siding house 'Estimated cost:- A‘ eD 0 '0 The undersigned certifies that the above statements are true to the best of his, her knowledge and belief. > -ii:/ r 'Z..Qu-e:-- -c /1),eeed X 4-/-2Z-1-fr`lia,'N., Signature of responsible appi,cant (*marks /T jL5 a/` of l -Si' moles Q'r q' /•o// f oo/ Kan 1 re plot e Li/ aSyr / i;0-_, (/a3) —S/? • "1,1e3" 4nd o?''.k.,6%C Cay rt.ca e re,I( Y o iirt_5 e,tea p d'r a--• f er-