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35-290 (2) DEPART NT OF•PUBIfC SAFETY COOSTRUftW"SUPERVISOR LICENSE ffnl „M fires:, Birthdate: � f � � `18f99/1999 18/19/1951 jr k OwoMIC�AFi {+IQfAu 34 CHERRY ST EASTHANPTON,, NA 11121 2>i>,>.;a«xY xrw±:isi.4u�t�t�iiiht2ri3tit+tui;tiu�2ri;ti:i2?bcK`i+i?iSiS2s;�t4itiiiiittiiYru +��.+tici.�t�tst+i�i�ti:x �x+2�:4w:�2{2325 {ttst!'?rcclix:.SckitK? ..`ti<kr,K>u.�.xMi+i'6:+2 r.t:+tSic2:i�Yf2kK+i<iii.i'ri+lr.iitfi4tYift32�iti31 >:, b c w t- 70 -� a w 3 c' ZZ m o LL-t 70 c -s Ln Z tl > L O rri Zoning i Miscellaneous Additions,Repairs,Alterations,etc. / Tel.No. Z 7 S S�S Alterations NORTHAMPTON, MASS. 2/ /[j���j 19 Additions APPLICATION FOR PERMIT TO ALTER Repair Garage 1. Location Lot No. 2. Owners name Address v 3. Builder's name Address Mass.Construction Supervisor's License No._ 2 1 �i Expiration Date 4. Addition �/J��rrl 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- /,&. 000, The undersigned certifies that the above statements are we to the best of his, knowledge and belief. Sig azure of responsible appicani Remarks �gttAlf p� a���0 aFEB i 019 =saar}1nsclls cv DEPARTMENT OP BUILDING INSPECTIONS 212 Main Street ' Municipal Building ' Northampton, Mass. 01060 ' WORKER'S COMPENSATION INSURANCE AFIMAVIT (licensee/perrnittee} with a principal place of business/residence at: e (phone#) :52 7 ySS� (stzevt/ ty/sta&2 ip) do hereby certify, under the pains and penalties of peg u-y, that: ( ) I am an employer providing the following worker's compensation coverage for my employees working on this job: ce Cq any) (Policy Number) (Expiration Date) x><Kt,r 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: (Nam f Contractor) (Insu=cc Company/Policy Nurnkr) (Expiration Date) (Name of Contractor) (Insurance Company/Policy Nwnber) (Expiration Date) (Name of Contractor) (Insurance Company/PoLiicy Number) (Expiration Date) (Name of Contractor) (Insurance Company/Policy Number) (Expiration Date) (attach additional slxa Tnoarzuy to ioclude infotma pata;n;ng to au oo�ractors} (� I am a sole proprietor and have no one working for me. ( ) I am a dome owner performing all the work myself. NOTE:please be awam that while hoaxouncts who cutploy pazom to do m&adcamc,,construction or repair work on a dwelling of not mote than throe units is which the bomeowna resides or on the grounds appurtenant tbaeto ate trot generally oo=dercd to be employers under the worker`s ompeasation Act(GL 152,ss 1(5))�,application by a homcoww for a license or permit may evid=c the legal rtat w of an employer under the,Workpea Compensation Act. I understand that a copy of thin rhtemeni may be forwarded to the Dtputtocat of IM atria Acclden&Office of In%xa000 for the coverage verification and that failure to secure covcrnge under unction 25A of MOIL 152 can lead to the imposition of criminal penal6cs consisting of a&ne of up to S1,300.00 and/or imprisomnerd of up to one year and eiva pctnttics is the fotm of a Stop Work Order and a fino of S100.00 a day against M For dgnet n-W sue onty A Permit Number Nfap# Lot# Si ofLi ermittc �t FFB 1 01999 AL v Ale C�a i j � I F 4 9 4I ✓ � � 3 �� I W d I O 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 v� IF YES,describe size,type and location: 11 . ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE DENIED DUE TO LACK OF INFORMATION. This colnma 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) # of Parking Spaces # of Loading Docks Fill: Avolume--& location) 13 . Certification: I hereby certify that the information contained herein _a is true and accurate to the best of my kn wledge. DATE: Z - APPLICANT's Si-GNATUPE NOTE: Issuan a of a zoning permit does not relieve an a IioanYs 16ur den o oompty witl�~�tl zoning requirements and obtain all required permits from the Board of Health. Conservation 4111 Commission, Department of Publio Works and other applioable permit granting authorities. FILE , FEB 1 019 File No. �:7 �: ZONING PERMIT APPLICATION (§10 . 2) PLEASE TYPE OR PRINT ALL INFORMATION 1. Name of Applicant:_ Address: /Z?� U'b=d - Telephone: S Z 7 2. Owner of Property: -,_ �-'1LC�t�I, Address: 126 //� �r�.{� Telephone: 3. Status of Applicant: Owner Contract Purchaser Lessee Other(explain): 4. Job Location: L-2Q___����r', �—A' _ Parcel Id: Zoning Map#_ Parcel#_(G � District(s): , -) - (TO BE FILLED IN BY THE BUILDING DEPARTMENT) 5. Existing Use of Structure/Property — 6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary): av- 'A 7. Attached Plans: Sketch Plan U 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 /i 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 6--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) File#BP-1999-0691 APPLICANT/CONTACT PERSON MICHAEL NADEAU ADDRESS/PHONE 34 CHERRY ST (413)527-4995 PROPERTY LOCATION 120 WOODLAND DR MAP 35 PARCEL 290 ZONE SR THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out Fee Paid /-5'L,-) Typeof Construction: FINISH 750 SO FT BASEMENT AREA INTO FAMILY ROOM New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/Statement or License 010197 3 sets of Plans/Plot Plan TH 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 Co i ion _ l ! 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. ' r i 120 WOODLAND DR BP-1999-0691 Gls#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 35 -290 CITY OF NORTHAMPTON Lot: -001 Permit: Buildb Categorv:Non structural interior renovations BUILDING PERMIT Permit# BP-1999-0691 Project# JS-1999-1285 Est. Cost: $10000.00 Fee: $40.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: MICHAEL NADEAU 010197 Lot Size(sq. ft.): 31973.04 Owner: ROHLECH TOM Zoning: SR Applicant: MICHAEL NADEAU_ AT. 120 WOODLAND DR Applicant Address: Phone: Insurance: 34 CHERRY ST (413) 527-4995 EASTHAMPTON 01027 ISSUED ON:2111199 0:00:00 TO PERFORM THE FOLLOWING WORK.FINISH 750 SQ FT BASEMENT AREA INTO FAMILY ROOM 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 2/11/99 0:00:00 $40.00 212 Main Street,Phone(413) 587-1240, Far,: (413) 587-1272 Building Commissioner-Anthony Patillo 120 WOODLAND DR BP-1999-0691 GIs COMMONWEALTH OF MASSACHUSETTS USETTS .MV-jBlock:35-2" CITY OF!NORTHAWT'ON Lot:-oat Perms Bu dinta BUIL Categary Noti ►at,�rAi i ru r renov ons GTERM, BP='f Q99-4891 l st:Cosh S 1 t10 },tb ft:W.00 PE"ISSIO)N IS HEREBY GRANTED TO. const.C1asA: Contractor: Licenser UA§Grouo: MICHAEL NADEAU 010197 I.,ot sja(sq.ft.): 31973.44 mnex- R©HLE TQM MI El. NADEAU A� �nt�lddress: Phone; lnsu set- ,14, , it R'Y ST (413)527.4995 EASTHAMPTON 01027 W.Uf&QN:211111q U:Q�:tom TO-PERFORM-THE FOLLOWING WORK.-FINISH 750 SQ FT BASEMENT AREA INTO FAMILY ROOM P ST THI&CM S FRf) HE S ET I sp etor of 1E > r .° T pe+ or f" ",M I3.r.W - ; Inspector of Buildings Umfe round: ery e: Meter: Footing Rough. Rough; * � House# Foundation: Final: Final: � �1 Rough Frame, Gas F1ire ftoayI eat Fireplace/Chimney: Final: Final: THIS PERMIT MAY E REVOKE011 E C OF NORTHAMPTON UPON VIOLATION OF AI OF ITS IULI NI) RE GGUILATIGINS: 'ate n signatu Building 21111199 0:00;00 $40.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Building Commissioner-Anthony Patillo