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38B-009 (17)
Department: Reference No: BP-.. ....1.99.9-.0393. ....... ....... ... . ...... Building, Electrical & Mechanical Permits ......................................................................................... Fee Type: Receipt No: Non structural interior renovations ............................................................................. RIS C-1999-()01007 Paid By: Pa.id..i.n.F.u.I.I..0.n:.......... Oliver Iselin ............................................................................. Thu Oct 15,1998 .. . ...... ...... Received By: 7 .Check. . .No:................... Linda LaPointe 1243 ...................................... DEPARTMENT'S COPY Amount: $40.00 ........... .............. DEPARTMENTFILE COPY 136 WEST ST CITY OF NORTHAMPTON BUILDING PERMIT Owner's pulling their own permits or dealing with junregistered contractors for applicable work do not have access to Guaranty Fund(MGL 142A) Issued: Permit No: Inspector: Tracking No.: Fee: BP-1999-0393 $40.00 GIS #: Map Block: Lot: Address: Zoning: Use Group: Lot Size: 10338 38B 009 001 136 WEST ST Sl 56540.88 Contractor: License Ty Insurance: Oliver Iselin CSL Address: License No.: Insurance No.: 36 Service Center 039073 City: State: Zip Code: Phone: NORTHAMPTON MA 01060 (413) 584-1224 Proiect No: Category of Work: Const. Class: Cost Estimate: JS-1999-0188 Non structur4l interior renovati $4,000.00 Description of Work: CONSTRUCT INTERIOR WALLS & DOORS GeoTMS@ 1997 Des Lauriers&Associates,Inc. Signature: i File#BP-1999-0393 APPLICANT/CONTACT PERSON Oliver Iselin ADDRESS/PHONE 36 Service Center 584-1224 PROPERTY LOCATION 136 WEST ST MAP 38B PARCEL 009 ZONE SI THIS SECTION FOR OF1rICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out ✓ Fee Paid f Type of Construction: Ne Non Structural interior renovaticA ono xis m Accessory Structure Building Plans Included: Owner/Occupant Statement or License# 3 sets of Plans/Plot Plan THVOLLOWING 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 i 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 f Permit from Conservation Co n1i ion 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. i OCT 1 51 Fi e �.� 1 N t ZONING PERMIT APPLICATION (§10 . 2) PLEASE TYPE OR PRINT ALL INFORMATION 1. Name of Applicant: NOk 7 NArMf PT oN I leopfa-u E S pox 931 a1041 Address: 4 7 JAty-saN t;t 6,40 kel"'I�, Telephone: 2. Owner of Property: t;W E AS A1301f& Address: Telephone: 3. Status of Applicant: Owner Contract Purchaser Lessee Other(explain): 4. Job Location: 13 0 WEST G—( NOk'1714AMP TON) MA Parcel Id: Zoning Map# 3 Parcel# 0Oa District(s): S (TO BE FILLED IN BY THE BUILDING DEPARTMENT) 5. Existing Use of Structure/Property 42 PEGti4t- tri P V s YAY - FOK1Nf-,P-t,i l RF NAT401VA L t=E t T T3 V 1 t.D Int& 6. Description of Proposed Use/Work/Pro}ect/OccupaGon: (Use addlkbnal sheets if necessary): OWNS-e 5t)it.q - 0V i OF FVTVIeE TEn AAr SPACES VSE To 13E �,t>SIn1ESS S_lLVtGL � 55 U P t U'r 5 E-it V1 CE ETAALIS14MENIS 7. Attached Plans: 'V4' 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 PermiUVariance/Finding Byer been issued for/on the site? NO DON'T KNOW YES IF YES,date issued: Gt?- 98 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 ?'L 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: N� GNANC�E S ['R-O P 0SE0 Are there any proposed changes to or additions of signs intended for the property?YES NO IF YES,descdhe size,typ©,a%d location:' I' 11. ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE DENIED DQE TO LACK OF INFORMATION. This coli to be filled in by the Building Department Required Existing Proposed By Zoning Lot size Zq ya [ st Ft Frontage , Setbacks - frnnt N*K - side L: R: O L: Nt R: No - rear 13'uFl M 60',height 3!0 ' NC' Bldg Square footage N c. %Open Space: (Lot area minus bldg e/ NC µ,• &paved parking) # pf Parking Spaces e sof Loading Docks 2 4 Fill: volume•-& location) O o 13 . Certification: I hereby certify that the information contained herein G, is true and accurate to the best of my knowledge. 'r ap, r d DATE: - �0' �`� ' tC/ APPLICANT's SIGNATURE T4,0W ckS C9 >O Vit lt ckS Arm) NOTE: Issuance of a zoning permit does not relieve an applicant's burden t16 oomply wit 11 zoning requirements and obtain all required permits from the Board of Health. Conservation Commission, Department of Public Works and other applicable permit granting authorities::. FILE # �A OCT 1 5 i998 �r Crib 01 'Naz#llumptoll s f � _ �asaachuactta EPARTMENT OF BUILDrNG INSPECTIONS 212 Main Street ' Municipal I3uilding ' Northampton, Mass. 01060 WORKER'S COMTENSAT10N INSURANCE AFFIDAVIT I, ©t l ✓rte SfCL /fJ (licensWpernuttee) with a principal place of business/residence l at: -7 t—,+ (phone#) Y/3- JYY ' i Z Z y t (street/arty/stawzip) 0,-1 b o 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) (t�I am a sole proprietor, neral contractor homeowner(circle one) and have hired the contractors listed below who have the following worker's compensation policies: �A (Name of Contractor) (Insurance Company/Policy Numbcr) (Expiration ate) JrI '. Vc4—(aT Antp-o-14z-- !r✓ Gt& a"AP/OoF261 tZ �trl /�1 /tZ (Name of Contractor) (Insurance C4mpauy/Poficy Number) (Expiration Date) (Name of Contractor) (Insurance Company/Policy Number) (Expiration Date) (Name of Contractor) (Insurance Company/Policy Number) (Expiration Date) (attach additional sheet ifneoessary to include infornudon pertaiOing to all couftaotors) ( ) I am a sole proprietor and have no one working for me. ( ) T am a home owner performing alt the work myself-. NOTE:please be aware that while homeo%imz who employ pcuom to do maidenance,oxntrvction or repair work on a dwelling of not more than throe units m which the homeowner r=dea or on t`ue grounds appurtenant thereto are not generally ocwidered to be employers under the worker's comperos ca Act(GL152,ss 1(5)�application by a homeowner for a license or permit may evidence the legal status of as employer under the Worker's Compensation Ade. I understand that a copy of this statement may be forwnrded to tho Detwrtmcua of IrAL tridl Ao6dea&Ofiioe of Imuraaoe for the coverage verification and that failure to secure coverage under s4ction 25A of MOIL 152 can lead to the imposition of criminal penalties oonsisting of a fine of up to S 1,500.00 andlor imprisonmrn of up' to one year and civil penalties is the form of a Stop Work Order and a firm of 5100.00 a day against tne. Signed this /A day of Uc ;: 199-6 For deputw&ital use only Permit Number — Map# Lot# Signahtre of LicenseelPermittee i Z z .7 Pt'1 G LC-) _ ... r' .� Z n Z cz, d > n O Z .� X m Zoning Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. `�/ 1'L`, Alterations 4 NORTHAMPTON, MASS. �' 19_L° Additions APPLICATION FOR PER IT TO ALTER Repair Garage 1. Location 26 G.�1QS i S% Lot No. 2. Owner's name NO'Z"N VA'"r"'u t''''�/'�C %)L 1 Address � 1—,4- Z-10(0 3. Builder's name OLI VLe-ef— Address 3� �NL�` a'1'tr6— Mass.Construction Supervisor's License No. ���'-3i Expiration Date t r�51 4. Addition 5. Alteration 1 rJ rg-,'t, V -- /I-XA-c I OJ 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 f 11. Distance to lot lines 12. Type of roof 13. Siding house 14. Estimated cost`- . j�, i The undersigned certifies that the above statements are true to the best of his, her knowled `ef. Signature of responsible app,icant Remarks i