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29-098 (2) 1 v C � o' rri w 3 0 oN 1 p Z rT1 `1 Z yr o cn CIO > cn O .► Z ••: r _ m Zoning Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations NORTHAMPTON, MASS. AuGUS /F 192—L Additions APPLICa ATION FOR PERMIT TO ALTER Repair Garage 1. Location -3 /-/a gf,C-k 1 / Lot No. 2. Owner's name / 1..P X.— Celt Address s5' �'1 /1 `r'. c y 1 3. Builder's name mat t2: Address ./2 V :P Mass.Construction Supervisor's License No. ©s��- ' Expiration Date e476) 4. Addition 5. Alteration t� SE E Tg c,/ iS-7> ,wag J-1 ' 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, knowledge and belief. Q ignoture ojretponsable epp,icant Remarks 04�t pT0 pg Cr�� iaf ��z#l�ttnt��nn _ - 6 AUG I 8 i�C) j3iasaRCfinsctfa m DEPARTMENT OF BUILDING INSPECTIONS 212 Main Street ' Municipal Building 'a Northampton, Mass. 01060 WORKER'S COMPENSATION INSURANCE AFFIDAVIT I, :�i' LII:' rl C'7riir ?'"'� ���3✓l9 %Si/. a '7" `l t �ax� � 1C., (liPermjtt�e) with a principal place of business/residence at: 'Fd )-j�/d38 (phone#) (Street city/state/ap) 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 working on this job: (Insurance Company) (Policy Number) (Expiration Date) (v�I am a 4jjro rietor 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) (E)piration Date) (Name of Contractor) (Insurance Company/Policy Number) (Expiration Date) (Name of Contractor) (Insurance Compauy/Policy Number) (Expiration Date) (Name of Contractor) (Insurance Company/Policy Number) (Expiration Date) (attach additiomt shed ifneocn=y to include kdbr cation pertaining to all coatrutors) 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 wbilo homcown-en who employ persom to do maimmince o=stuctioa er repair work on a dwcUing of not more than tbroo units is which the homeowner resides or on the grounds appurtenwi lh=w arc not gcouaily oc,=6crcd to be e mployen under the workeez oompcusation Act(GL152,ss 1(5)),application by a homcowna for a license a P-D3:d may cvidcaco the legal dabso of an employer under the Workeles Compeoution Act I underdaad that a copy of this rut emeat testy be forwarded to the Departmc A of In�sstria!Ancideas�4ffi00 of Irnurwoa forth. coverage verification and that failure to aoatre coverages undo soctioa 25A of MOL 152 can lead to tba'impasi -of simmer peaaltiu ooaust=g of a fate of up to S 1,500.00 and/or*r6oamcat of up to one yew and civil pew ltia in the form of a Slop Work Order and a fm of 5100.00 a day against tna For dcpattmwwtun only Permit Number Mao Lot# Signature ic�see/Pertnititx t AUG 1 81999 w o i ix. I_h �V ,' 4 J � � f y � 4 oueluo'g6naoga8l9d"Pll'eMo!w!3'M'A Aq Alolos epeueo u!palnq!als!p 80LO1'XN'ap!nxuw9'rout'sp!y ao!llo laane-1—OL6l'6961 lg6uAdoo O 9-yo wjoj :a�aa :IaafgnS :woad :ol /- �E�o v r�G �=, .�� �''�"'i✓s� S err�G�.z" S s r..g ,1L r.� G. y G Div O� S • o✓/ ?C�o 0 1c .. 7?5 +''j �/- 7—Y AUG 1 81990, ilk Y7(r- n , r + 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 - side L: R: L: R: - rear Building height Bldg Square footage %Open Space: (Lot area minus bldg &paved parkingi # of Parking spaces t of Loading Docks Fill: {vol-ume--& location) 13 . Certification: I hereby certify that the information contained herein is true and accurate to the best of my knowledge. DME: 5/- APPLICANT's SIGNATUREG NOTE: lasuanoa of a zoning permit does not relieve an applioanve 6ifrden to oompty wittp,.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. FILE # � d r } ` AU 1 8 IN9 0 File No. M' -=XIG PERMIT APPLICATION (§10 . 2) r PLEASE TYPE OR PRINT ALL INFORMATION 1. Name of Applicant: Address: fog �L/ '/9 �1 �i�ys�-7. Telephone: -5 2 2. Owner of Property: _ & Address:-2",', 9 Telephone: S-ri� 3. Status of Applicant: Owner 4 Contract Purchaser Lessee Other(explain): 4. Job Location: 3 `/ 8n-,—P:n Dodo Parcel Id: Zoning Map# Parcel# District(s): Q� (TO B FILLED IN BY THE BUILDING DEPARTMEN 5. Existing Use of Structure/Property 6. Descripti n of Prop ed Us /Wor roject/Occu ation: (Use dditional sheets'f necessary) 17 r � 4 see 9 T c/A"s-P rir, 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 KNOIti/ 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-2000-0180 APPLICANT/CONTACT PERSON David Ouimette , ADDRESS/PHONE P O Box 1038 (413)527-5469 PROPERTY LOCATION 39 BRIERWOOD DR MAP 29 PARCEL 098 ZONE URA THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out - Fee Paid Typeof Construction: STRIP&SHINGLE ROOF REPLACEMENT WINDOWS,SIDING&REPLACE CONCRETE 4 X 9 DECK W/PT New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included• Owner/Statement or License 059132 3 sets of Plans/Plot Plan T OLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION: 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 Board of Health Well Water Potability Board of Health Permit from Conservation C fission Signature of Building 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. f , r 39 BRIER'WOOD DR BP-2000-0180 GIs#: COMMONWEALTH OF MASSACHUSETTS *TMa' K rz CITY OF NORTHAMPTON Lot:-001 Permit: Building Category:Non structural interior renovations BUILDING PERMIT Permit# BP-2000-0180 Project# JS-2000-0287 Est.Cost:$17800,00 Fee:$89.00 PERMISSION IS HEREBY GRANTED TO. Const.Class: Contractor: License: Use Group: David Ouimette 059132 Lot Size(sg.#1.):_13982.76 .-Owner: WILLIS DAVID T&.DFBQRAH L Zonjng_URA Applicant: David Ouimette AT 39 BRIERWOOD DR Applicant Address: Phone: Insurance: P O Box 1038 (413)527-5469 EASTHAMPTON_ 01027 ISSUED ON:812o/1999 o:oo:o0 TO PERFORM THE FOLLOWING WORK.-STRIP & SHINGLE ROOF,REPLACEMENT WINDOWS,SIDING &'REPLACE CONCRETE 4 X 9 DECK W/PT 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: LI l( �&w THIS PERMIT MAY BE REVOKED BY THE CJXY OF NORTHAMPTON UPON VIOLATIO OF ANY OF ITS RULES AND REGULATIO S. __ Certificate of Occupancy Signature: Fee Type: Receipt No: Date Paid: Check No: Amount: Building 8/20/1999 0:00:00 $89.00 + 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Building Commissioner-Anthony Patillo