32A-155 (9) s R ��
City of Northampton
4,„
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�� Department
Building
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ph,oNto Office of the Building Inspector
Permit No: BP-1999-0481 Date issued 9-Nov-1998 Fee $40.00
Map 32A Block 155 Lot 001 Zone CB Section 116 ❑ Yes ❑ No
BUILDING PERMIT
This certifies that Shawn LeBlanc CSL071480
has permission to REMOVE PARTITIONS,BATH WALLS,NEW STAIRS,SHEETROCK Inspection on site-Foundations
Over❑
at 4 MAIN ST
provided that the person accepting this permit shall in every respect Inspection of Plumbing- Rough — Over❑
conform to the terms of the application on file in this office, and to the
provisions of the Statues and the Ordinances relating to the construction Inspection of Plumbing-Finish Over❑
Maintenance and Inspection of Buildings in the City of Northampton.
Any violation of any of the terms above noted is an immediate revocation Gas Inspection Over❑
of this permit, Expires six months from date of issuance, if not started.
Inspection of Wiring Service Over❑
dd �i1/5/fed'
Inspection of Wiring-Rough C�c-.7 L i ~Ix-u-fC� "11/—Over❑
Note: A certificate of occupancy will be issued by this office upon return
of this card by the Plumbing, Wiring and Building Inspectors. Inspection of Wiring-2Finish 4 j-, /�15 /9er— Over❑
Building Inspection-Rough It 1":) -1 vh Over❑
*Plumbing and Electrical Inspections required before
Building Inspections Insulation Inspection Over ❑
Building Inspection - Finish `q � Over ❑
Smoke Detectors (Fire Department)
This card must be sted on site visible from s ub1_wa
AdioeAlW
Certificate of Occupancy 41
Department: Reference No: BP-1999-0481
Building, Electrical & Mechanical Permits
Fee Type: Receipt No:
Non structural interior renovations REC-1999-001291
Paid By: Paid in Full On:
Shawn LeBlanc Fri Nov 06,1998
Received By: Check No:
Linda Lapointe 330
DEPARTMENT'S COPY Amount: $40.01
DEPARTMENT FILE COPY 4 MAIN ST
CITY OF NORTHAMPTON
BUILDING PERMIT
Owner's pulling their own permits or dealing with unregistered contractors for applicable we rk do
not have access to Guaranty Fund(MGL 142A)
Issued: Permit No: Inspector: Tracking No.: F.•:
09 Nov, 1998 BP-1999-0481 $41.00
GIS #: Map Block: Lot: Address: Zoning: Use Group: L i t Size:
9983 32A 155 001 4 MAIN ST CB 914.76
Contractor: License Type: Insurance:
Shawn LeBlanc CSL
Address: License No.: Insurance No.:
44 Park St 071480
City: State: Zip Code: Phone:
CHICOPEE MA 01013 (413) 594-9042
Project No: Category of Work: Const. Class: C i st Estimate:
JS-1999-0914 $510.00
Description of Work:
REMOVE PARTITIONS,BATH WALLS,NEW STAIRS,SHEETROCK
GeoTMS®1997 Des Lauriers&Associates, Inc. Signature:
File#BP-1999-0481
APPLICANT/CONTACT PERSON Shawn LeBlanc
ADDRESS/PHONE 44 Park St(413)594-9042
PROPERTY LOCATION 4 MAIN ST
MAP 32A PARCEL 155 ZONE CB
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out
Fee Paid 330 ^ —
Type of Construction:
New Construction
Non Structural interior renovations _
Addition to Existing :�� �T� �i� _L� 451/1L: l f
Accessory Structure
Building Plans Included:
Owner/Occupant Statement or License#
3 sets of Plans/Plot Plan
THE LOWING 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 Conservatio ommission
Signature of Buildin fficial 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.
''?
LI NOV 6 (998 1 File No.E Q�! / 4 /,!��f/
DEFT
N°R1Ham;'TGN MAc`l'l,'-.ZONING PERMIT APPLICATION (§10 . 2)
PLEASE TYPE OR PRINT ALL INFORMATION J
1. Name of Applic t: Q�(,t.�61 Le `✓` n /`!"F
Address: " a rK ��. a ice Pe Telephone: S^q'T q()
2. Owner of Property: try-1-1 I 46,eAer 2
Address: Telephone:
3. Status of Applicant: Owner Contract Purchaser Lessee
Other(explain): C e.)- 'YMC ,.,:'Vha _1
4. Job Location: q Actlq, Srt. k , 0,1`()
Parcel Id: Zoning Map# 1) Parcel# ( 6S District(s): C (3
(TO BE FILLED IN BY THLBUILDING DEPARTMENT)
5. Existing Use of Structure/Property Q
i,6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary):
►^('()1 ' Farrlfi6d0S ) e NO1,vn U14( R4' b h 4 C Ut-Fvn )nk co( 46 r�
Stu(5 S ee -foQX -rfA.
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 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)
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 - frnnt
- side L: R: L: R:
- rear
Building height
Bldg Square footage
%Open Space:
(Lot area minus bldg
&paved parking)
# of 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 knowledge. ,
)(DATE: I1 ci.E APPLICANT's SIGNATURE t IV -
NOTE: Issuan a of a zoning permit does not relieve an applicant's burden to oomply with all
zoning requirements and obtain ell required permits from the Board of Health, Conservation
Commission, Department of Publio Works end other applioable permit granting authorities.
FILE #
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12"y pNOV V - EPARTMENT OF BUILDING INSPECTIONS
,MSPECTi0P1s 12 Main Street • Municipal Building Ntt'i:41-FILL.-•-= i
PT Northampton, Mass. 01060 r'
PvORTHAMFTON MR 01060
WORKER'S COMPENSATION INST RA_N Ch &FM)A.VT'T
i,• ShcuJA kt1Nc L
(liceIlse&permi ttec)
with a principal place of business/residence at:
I_1 -I i clYK Srt , C il �\co�C e. )11(A. o)01 (phoney ) 1 ) 0 .-,.
U (str=t/city/stai.hJap)
• 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 or homeowner (circle one) and have hired
the contractors listed below who have the following worker's compensation policies:
(Name of Contractor) (Ins-u ancc Comoaoy/PoLIcr Nambcr) (Expiration Date)
(Name of Contractor) (Insurancz CompanviPolicr Nt mb r) (Expiration Date)
(Name of Contractor) (Insu ance Company/Policy Number) (Expiration Date)
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)'
(attach:5ditionat nccct if nccr-tc.ry to incluc infccmiico pert2ining to all cc rae.o:s)
(,Q I am a sole proprietor and have no one working for me.
( ) I am a home owner performing all the work myself.
NOTE:pleasc bc aware that while hooxoµacm o.bo<mpl oy p•csom to do mint.--„car r oonsruction'or rcpaa work.on i dwelling of
not moo:than throo units is which the bomoowocr rcaicka or co the ecoundi appurtca,ct tbcao are cot gay oomidcred to bc
employe-3 under the worker's orrrtpc-o,tim Act(GL152.i1(5)),application by a bomcowacr for a liocate or permit may cvidcacc the
legal rtatua of an employer under the Workelt Compoos&tion Act_ •
I understand that a copy of.thia etat®ent may be forwarded to the Depart ocat of Industrial Aoadmcl Of5oo of Ioxuznoo for th.
coverage vaificstion and that failure to secatrc covet-ago tinder section 25A of MQL 152 can lead to the irtr tion of criminal pensltia ,.
oomisiing of a•fine of up to S 1,500,00 and/or of tip to one yar nod civil pccultics is the form of e.Stop Work Order and a
funo of 5100.00 a day apninet a>G •
For dcputincdar tsio only. •
• f Permit Number
( .. . 6 . Maiili Loh i , 1
Si of Liccascc/Pcruuttcc • •
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�j Zoning
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Miscellaneous Additions,Repairs,Alterations,etc. Tel.No.', , Alterations
't%r NORTHAMPTON, MASS. I t 19 I V Additions
i,:p`' LI
APPLICAT ON FOR PERMIT TO ALTER Repair
Ncitnri-ork Garage
1. Location W ��oo i St , Lot No.
2. Owner's name T 1Y\ 1+1 Gat t'll S I Address /I -{-
3. Builder's name �) a uJ (l � 11 C Address `► 1rk 3 ` . IC 0 'e, 0 00 ��
Mass.Construction Supervisor's License No. 0 7 I Expiration Date 3/l r2
pai
4. Addition
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 a..ve statements are true to the best of his, her
knowledge and lief.
velii
Signature of responsible app,icant
L IS
Remarks -R�Y`1UY�► y G(irti0 ' -e___ (J�,f1 \ kn� C L t�_ al CUt 11 61-L (0(
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