32A-201 (27) r ,
Department: Refe ence No: BP-1999-0522
Building,Electrical& Mechanical Permits
Fee Type: eceipt No:
Roofing EC-1999-001419
Paid By: aid in Full On:
MRS Home Improvement ri Nov 20,1998
Received By: heck No:
Linda Lapointe 25
DEPARTMENT'S COPY Amount: $40.00
DEPART NT FILE COPY 51 PHILLIPS PL
CI Y OF NORTHAMPTON
BUILDING PERMIT
Owner's pulling their own permits or dealing with unregistered c t ntractors for applicable work do
not have access to Guaranty Fund(MGL 142A)
Issued: Permit No: Inspector: Tracking No.: Fee:
20 Nov, 1998 BP-1999-0522 $40.00
GIS #: Ma Block: Lot: Address: Aonin.: Use Group: Lot Size:
6501 51 PHILLIPS PL RC 11891.88
Contractor: License Type: Insurance:
MRS Home Improvement HIC
Address: License No.: Insurance No.:
80 Damon Rd 122756
C� State: Zip Code: Phone:
NORTHAMPTON MA 01060 (413) 586-0614
Project No: Category of Work: Const. Class: Cost Estimate:
JS-1999-0992 roofing $2,500.00
Description of Work:
STRIP,PLY,& SHINGLE ROOF
GeoTMS®1997 Des Lauriers&Associates, Inc. Signature:
1-1TO
_7n
!�. NOV 1B
1 ' l
998
File No. g P9959
c).... ,
REF
F
ZONING PERMIT APPLICATION (f10 . 2)
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant: ✓`') i2 5 -`owk P --1'+^ r Cn r$e no,P,n/1
Address: G ° cam,/ tZ. C) Telephone: S-- E-L - 06 /y
2. Owner of Property: 7r TU C c Gc\-(_
Address: Sr7 pl"n 'IDS P I Telephone: S F r/- r//02
3. Status of Applicant: Owner Contract Purchaser Lessee
Other(explain): CO If•1 c f r d
(
4. Job Location: S PW`P vJ /0 ga AP4
Parcel Id: Zoning Map# 3 J Parcel# 00 I District(s): OAA-----'v
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/Property t7 r S ,a7-M'A
6. Description of Proposed UseNVork/Project/Occupation: (Use additional sheets if necessary): •
sett if 120
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 PermitNa ' in ' 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(NOT 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
# (of Loading Docks
Fill:
(volume -& location)
•
13 . Certification: I hereby certify that the information contained herein
is true and accurate to the best of my knowledgee.
DATE: prZler APPLICANT's SIGNATURE
NOTE: Issuo f a zoning permit does not relieve an appiioant's burden to oomply with all
zoning requirements and obtain all required permits from the Board of Health, Conservation
Commission, Department of Publio Works and other applicable permit granting authorities.
FILE #
I •
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lc(llAalp •
0.141-g•ril •Niarillainpfaii
'♦ Ott Y� ><�s+�cilnrcttr
t 4
y,' A/01 I p���Q EPARTMENT OP BUILDING INSPECTIONS t
v O 212 Main Street Municipal Building
Northampton, Mass.' 01060 tttlD`.
WO RICER'S COMTENSATION INSURANCE AFFED AVTT
I,. h,t t2 s Flo.,,,, r t .NA
(lit nsecJpermiant)
vrith a principal place of business/residence at:
gG 'DP Al\G✓\/ eD (phoneys) SV6Oic/ V
. (s'u-at/city/statrJzT p)
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:
(Tnsulanc Company) (Policy Ntirnlvrr) (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:
•
:a .'.lane of Contractor) (nsu rncc Company/Policy NuIIiccr) (Expiration Date)
(Name of Contractor) (lnsii_lncc Company/Pollee Nu ab':r) (Expiration Date)
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(attach:dditiec l thect if nc�-,-”ry to inch.kk info matien pertining to di coo:m tor")
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 WED°homeowners who employ persons to do tnaintr-”,:et,construct oo nr repair work.on a dwelling of
not mocc then throe,units in which the bomoowocr rai a ,or oo the crotuad,sppurtee•at th;cto art cot ecocrally considered to be
anployen under Ma worker's cm p- ion Act(GL152 51(5)),application by a booseowocc for a lirm.'a permit may....:bens Ibo
legal mates of an°employer under din Worlcola Compensation Act.
•
• I undcstaad the a copy of.thfa cwt.:owl may be,foc-ward.d to the Pcpertra,.vt of lachutrial Aoodmc'OfSoo of Ins uranoa forth.
covcnge rrcrifieaiion And that failure to Locum oovcrngo under soctiou 23A of MOL 152 can lad to lb.'in +caion of c imiasl pcailtia
ooasisthtg of a•fnc of up to S 1,500.00 andicx inzprisoczocat ottip.to one yt..r and avii p®ltia in the foam of a Stop Work Order and a
fine o(5100.00 a hay against me.
•
. For dcpeiYsse�l uao only
• PcimitNumber
. : '.'.. 1,;30 1. 'Lot#. t
S1Eaataut`ofL tc see pozmstvoc •••
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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations
wNORTHAMPTON, MASS. 19 Additions
ram- :.:
APPLICATION FOR PERMIT TO ALTER Repair
Garage
1. Location r ( c71`k\IPS P13C-c- Lot No.
2. Owner's name 7<- 'f a ce6 T T e Address
3. Builder's name w, CZ S o,^'N-P —L`^'?c'7'''e`^^e.-A Address 8 0 D p'"^c^1
Mass.Construction Supervisor's License No. 1: }-7 S'� Expiration Date I el I LS—/o?e o 0
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 S l-,, 6 1-
1
3. Siding house
14. Estimated cost:- 2-s"6 e,
The undersigned certifies that the above statements are true to the best of his,
knowledge and belief. 411111ra lb
illIV
'!Signature of response a appicant
Remarks _