32A-255 (36) � o
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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel. No. '`dal Alterations . X
NORTHAMPTON, MASS. 1900 Additions
APPLICATION FOR PERMIT TO ALTER Repair
Garage
1. Location a� -\�� ——51JL Lot No.
2. Owner's name1 Address Sw
3. Builder's name � Address 1u l�lorbG.t�
Mass.Construction Supervisor's License No. C?' FS t Expiration Date I (1)2-
4. Addition
5. Alteration 1> l� ,( c, a ✓ry.., �;� G�,. l�,i•. ,-� t�va w�
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:- WD
The undersigned certifies that the above statemcnts are we to the best of h:
knowledge lief.
p Signaiure ojresp nsible app scam
Remarks_ 2-0-�-1
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37�1
FE$ 2 ZCJ��O
m - DEPARTMENT OF BUILDING INSPECTIONS
212 Main Street ' Municipal Building
s Northampton, Mass. 01060
WORKER'S COMPENSATION INSURANCE AFFIDAVIT
I, PIONEER CONTRACTORS PI CON, INC.
`(licenscrJpermittee)
with a principal place of business/residence at'.
P.O. BOX 1145 Nnrt.hamntnn, MA_ 81(61 (Phone#) 413_SR6_5491
(street/ci ty/statrJzz p)
do hereby certify, under the pains and penalties of perJury, than.
(X) I am an employer providing the following worker's compensation coverage for my
employees woAing on this job:
I iherty Mlittial TnczlirnnrA Cn. wT_31S_&ggR?9_n49q �/3Q/nom
ra _
(Insunce Company) (Policy Number) (Expiration Date)
O 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) (lns-urancc Company/Policy Number) (Expiration Date)
(N)me of Contractor) (Insurance Couicari} Policy Nuuibcr) 6on Daze)
(Name of Contractor) (Insurance C:ompany/Policy Number) �vxpuauon.Uaze)
(stlach additional sheet ifaocc=ury to mchuic information permining w ail ccatradors)
( ) I am a sole proprietor and have no one working for me.
( ) I am a home owner performing all the work myself.
NOTE:please be aware that while homeowners who employ pctzam to do tmiIItenancc rousuucUOa ur repair work on a dwelling of
not more than throo units is wbach the homeowncr resides or oa t'ae gear appurtcnani thereto arc Dot gcncr2lty masiticrcd to be
employers under the worker's compcaso4on Act(GL152,ss l(5)),application by a homeowner fora license cc permit may evidence thc
legal slams of an employer under the Wort s Compeosatioa Act
I understand that a copy of this erasemeai may be forward« to tto Dcpartmcos of Industrial A=deab Oflioo of Isswranco for the
oovaage verification sad that failure to secure oovcraga unda scaioa 25A of MGL 152 can lead to tan imposition of criminal penaltics
coausung of a fine of up to S1,500.00 uxVcc®pruonmcrA of up to om year and civil pcnaaut3 in the form of a Stop Work Order and a
film of S 100.00 t day sgatinst mc.
EPo.rmit eaw use only
umber
____—Lot#
udffe-
A
Sigaahue of Licenscc1Permittee —
f °
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 V
IF YES, describe size,type and location:
11 . ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE DENIED DUE TO
_ LACK OF INFORMATION.
Tbia Col.— to ba fillad im
by tb- Building Dspartmant
Required
Existing Proposed By Zoning
Lot size
Frontage
Setbacks
- side L: R: L: R:
- rear
Building height
Bldg Square footage
%Open Space:
(Lot area minus bldg
&paved parking)
# pf Parking Spaces
# fof 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 knowle ge .
DATE: APPLICANT's SIGNATURE—{ice
(MOTE: lasuanoa of a zoning permit does not relieve an 8ppiioan `sb_u_r14eA to domply with *all
zoning r"ulrementg and obtain all required permits from the Board of Health. Conservotion
Commission. Department of Publio Work-s and other applicable permit granting authorities.
FILE #
1 1 ....
S
FEB 2 2000 File No. t
oc ZONING PERMIT APPLICATION (510 . 2
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant: PI Dyl�,� L
Address: C 'U ' I NL r Telephone: 5 S6
2. Owner of Property:
Address: 36 ST Telephone:
3. Status of Applicant: Owner / Contract Purchaser Lessee
-L Other (explain):
4. Job Location:
Parcel Id: Zoning Map# Parcel# 5 S District(s):
(f0 BE LLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/Property �4�
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 PermiWahance/Finding ever been issued for/on the site?
NO DON'T KNOW V 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)
File#BP-2000-0687
APPLICANT/CONTACT PERSON Pioneer Contractors
ADDRESS/PHONE PO Box 1145 (413)586-5491
PROPERTY LOCATION 36 KING ST
MAP 32A PARCEL 255 ZONE CB
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Buildin Permit Filled out
Fee Paid '1.,/C -6 S1/_'>''
Typeof Construction: REPLACE EXISTING BATH TUBS&WALL SURROUNDS-RMS 201,202,205,211,213
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included•
Owner/Statement or License 017890
3 sets of Plans/Plot Plan
THE F OWING ACTION HAS BEEN TAKEN ON THIS APPLICATION:
pproved 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 C ion
2 �
Signature A315irlding 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.
36 KING ST BP-2000-0687
GIs#: COMMONWEALTH OF MASSACHUSETTS
VIap:Block: 32A-255 CITY OF NORTHAMPTON
Lot: -001
Permit: Buildin
Category:Non structural interior renovations BUILDING PERMIT
Permit# BP-2000-0687
Project# JS-2000-1144
Est. Cost:
Fee: $50.00 PERMISSION IS HEREBY GRANTED TO
Const. Class: Contractor., License:
Use Group: Pioneer Contractors 017890
Lot Size(sq. ft.): 72614.52 Owner. STARNORTHAMPTON INC
Zoning: CB Applicant. Pioneer Contractors
AT. 36 KING ST
Applicant Address: Phone: Insurance:
PO Box 1145 (413) 586-5491 Workers
Compensation
NORTHAMPTONMA01061 ISSUED ON:212100 0:00:00
TO PERFORM THE FOLLOWING WORK.REPLACE EXISTING BATH TUBS & WALL
SURROUNDS - RMS 201 ,202,205,21 1 ,213
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 2/2/00 0:00:00 5616 $50.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Building Commissioner-Anthony Patillo