23D-110 (4) 193 FEDERAL ST BP-2000-0341
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map:Bloc • 'k CITY OF NORTHAMPTON
Lot: -001
Permit: Building
Category:roofing BUILDING PERMIT
Permit# BP-2000-0341
Project# JS-2000-0560
Est.Cost:$1500.00
Fee:$25.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group:
Lot Size(sq. ft.): 23696.64 Owner: MERRITT MICHAEL
Zoning:URB Applicant:_
AT: 193 FEDERAL ST
Applicant Address: Phone: Insurance:
ISSUED ON:09/28/1999 0:00:00
TO PERFORM THE FOLLOWING WORK:STRIP & SHINGLE ROOF
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 09/28/1999 0:00:00 $25.00
212 Main Street,Phone(413)587-1240,Fax: (413) 587-1272
Building Commissioner-Anthony Patillo
FD)
MI SEP271999 b
File No ZP00.3 Se/ DEPT
NONS
RTHAMPTON MA 0106LDING 0
ZONING PERMIT APPLICATION (§10 . 2)
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant: (' c,&c ck
Address: i°13 0°,-414."^��r mar`'(tCoTelephone: ( 3) 7 05-6—
2. Owner of Property:
Address: Telephone:
3. Status of Applicant: Owner Contract Purchaser Lessee
Other(explain): I
4. Job Location: 1 S 3 Jai Iv�.� � �K NA- .0)(.0
Parcel Id: Zoning Map# ] Parcel# \l c> District(s): v R
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/Property w•
6. Description of o Proposed� 1 e/Work/P,loject/Occupation: (Use additional sheets i necessary):
o ; �-- . 75:1\5 An nc,--' coot
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 DONT 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)
t t
10. Do any signs exist on the property? YES NO X
IF YES,describe size,type and location:
Are there any proposed changes to or additions of signs intended for the property?YES NO)c
IF YES,describe size,type and location:
11. ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE DENIED DUE TO
LACK OF INFORMATION.
This cols to be filled in
by the Building Department
Required
Existing Proposed By Zoning
Lot size
Frontage
Setbacks - frnnt I
- side L: R: L: R:
- rear
Building height
Bldg Square footage
%Open Space:
(Lot area minus bldg
&paved parking)
# of -Parking Spaces
I 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: _a 1 APPLICANT's SIGNATURE 746.`.,' )( /4-4"4°i
NOTE: Issuanoe of a zoning permit does not relieve an applioants burden to oompty witty 4111
zoning requirements and obtain all required permits from the Board of Health, Conservtstion
Commission, Department of Publio Works and other appiioable permit granting authorities.
FILE I
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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. rr __ Tel.No. Alterations
%� NORTHAMPTON, MASS. Kv,� a--719�1 Additions
Repair
" APPLICATION FOR PERMIT TO ALTER
70' Garage
1. Location l i Sa, N"r +.y , /i1 Pr o l o w Lot No. 1 f 0
2. Owner's name M\c l V <r * Address f'3 k \I,. �13®^I �-ploy t Cto(o0
3. Builder's name Address
Mass.Construction Supervisor's License No. Expiration Date
4. Addition
5. Alteration
6. New Porch ,�
7. Is existing building to be demolished? /"a
8. Repair after the fire
9. Garage No.of cars Size
10. Method of heating
11. Distance to lot lines
12. Type of roof n// 51) \A.- .5V,(8t.2.5
13. Siding house
14. Estimated cost:-
J 5j 0 a ,o a The undersigned certifies that the above statements are true to the best of his.
knowledge and belief. .
Signature of responsible applicant
Remarks
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...`' DEPARTMENT OF ➢UILDING INSPECTIONS 4VM-1:21111—=--
INSPECTOR 212 Main Street ' Municipal Building !L
Northampton, Mass. 01060 UP
HOMEOWNER LICENSE EXEMPTION
q ( Please Print )
DATE: I O — l 7 l
JOB LOCATION: C2 3� l t 0 ui'
(Map) ( Parcel) ( Subdivision )
HOMEOWNER: s tivI Lf"
( Name & Address______44FM )
11.3 R432.z-P&1Sk. Pt-r l-P.1 INA ot(Brno Olt S8-? - GS7S—
( 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.
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HOMEOWNER SIGNATURE -��^Zi...� 12%Itiw�/Gl�
BUILDING PE1:2MIT J :AU
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... ', - P" DEPARTMENT OP BUILDDZG INSPECTIONS e! 1T/— -
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212 Main Street Municipal Building `
Northampton, Mass. 01060 �`'„s `
WORKER'S COMPENSATION INSURANCE AFIIDAVIT
j, •1 Gk c,,eA (V1 e..-r '1 *—
censcrdperi tree)
with a principal place of busine mresiden at:
I q'3 Ce-d2-`krr-A , iior` a—ri`,,n ( M c- toL c, (phone#)(`/`)SI 7-c'S 2r
(a tl ce t/ci ty/stairla 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 r homeowner - cle one) and have hired
the contractors listed below who have the following wor er's compensation policies:
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Due)
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(iiith additional shod ifn--e..ray to merle& forcuaoo pertaining' to all coca-ae-on)
( ) I am a sole proprietor and have no one working for me.
jz<LI am a home owner performing all the work myself-
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NOTE:please be aware that vebilo homcownm a bo ccaploy perzom to do m,te-r-mne conructiocror repair work on a dwelling of
not mete than three units in which the bocc owner rcaca or oa tbo grounds appurtenant thereto ere Dot&ea:atty ooasidcred to be
employers under tbo waltzes eompasatieo Act(GL152,ia 1(5)),application by a homeowner for a lioccoc or permit may...ia,..•the
legal statue of an employer under tbo Workela Cocepam.ikon Act_
I understand that a copy of this statemmi may be forvoucts d to the De .rtmmt of]ndautrial Aeodeatf OfEoe of lnxx•oos forth.
coverage vrsification and that failure to seatrc caverns under soctioa 25A of MOL 152 nn lad to tbd imposition of criminal penalties :..
c oosistitta of a fun»(up to S1,303.00 and/or iniiiriso®cat of up to one yesr and eivt7 pa:attics is the form of a Stop Want Order and a
fine of S100.00 a day against me.
• For accoateatall too only .
Permit,Number
:=L. ' a7 71 1 - _: iat.if •
tesigturojc Pcitc •. .