18C-104 = '0
..-
.... _.
< m
m to
....
0 "10 ' -e
..,.... . ., _. rrl t
=
..
ax Z ..) ,
o >
0 cn
7i 0 r
-I
No z rn
= 0
I ' leg
XI
C.) - •
c; -i (7) z
a cn 0
.....,_ . c
› m
I--• ,
0- ,--
1..)- ■
Zoning
Miscellaneous Additions, Repairs, Alterations, etc. Tel. No. Alterations
k
i 4 41 ) NORTHAMPTON, MASS.
Cr"
.2 .epp
if
19 97 Additions
APPLICATION FOR PERMIT TO ALTER
Repair
Garage
m /1-
1. Location q 6" Le 44, -72 ,i( 4 p 1. 0 Lot No.
2. Owner's name ' j 4 ;i:. Address /9 C/224500 ,c....P: Al'''
3. Builder's name P 5 id b■-k St-t- -II' e Address 7) e
Mass. Construction Supervisors License No. 0(3,6 g9' Expiration Date 0) t .6
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 — VAN / .5. O.) & ------''
0
14. Estimated cost:- 5)0(.) ---
The undersigned certifies that the above statements are true to the best of his
knowledge and belief.
2 74.4.,-- c r.
Signature of res onsible appicant
Remarks
•
•
a., � T �1 E i (!%zt of Nz rillantp oil i =*
� ' }laASCtts
GNP. . SEP = =
assac r�—
SEP 2 DEPARTMENT OF BUILDITjG INSPECTIONS
212 Main Street • Municipal Building
FPT OF BUIL 1G INSPECTIONS P
(11i,60 Northam tan Mass.. 01060 tta�'''`
Gare
WORKER'S COMPENSATION INSURANCE AFiwAVIT
T39 i2 5x2)14 A.) c�
(li censer/permi ttee)
with a principal place of business/residence at:
,g) r; ; (�a / ,U6 2 A rn "
To m' (phone #) 3g b 2 / , 1
(street/ci sta ip)
do hereby certify, under the pains and penalties of perjury, that: •
(am an employer providing the following worker's compensation coverage for my
employees working on this job:
493 - 7 - tde, C svAt - 1060,0 ( 970 ps -- - c2OO O
(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) (Insurance Company/Policy Number) (Expiration Date)
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(attach additional rhoct ifnoocanary to include information pataiuin to all oon racton)
( ) I am a sole proprietor and have no one working for me.
( ) lam a home owner performing all the work myself.
NOTE: please be aware that while homeowners who employ persons to do m+;+ -•• , caasnution'or repair work on a dwelling of
not more than throe units is which the homeowner resides or oa the grounds appurtenant thereto are not generally considered to be
employers tinder the worker's oon pectutim Ad (GL152,a 1(5)), application by a homeowner for a license or permit may evidence the
legal status of to employe under the Workers Compeusaiioa Act
•
• I understand that a Dopy of this rtatanom may be forwarded to the Depertese t of Industrial Accident! Office o(1 e:ima os for tb.
coverage verification and that failure to cave coverage under section 25A of MOL !St an lead to the imposition of criminal penalties A.
consisting of a fine Ief up to 51,300.00 and/or imprisonment of tip to one yar and civil penalties is the form ore Stop Work Order and a
fine ot'S100.00 a day against Inc. .
•
For depatin deluxe *My
• Permit Number .
411 • ._� ..� S S,ITLVZ Map# ■ ■` Lot .
Signature tat Li' censec/p
10. Do any signs exist on the property? YES NO
IF YES, describe size, type and location: ..r ' .
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 colt 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:
{vol-tune -& location)
13. Certification: I hereby certify that the information contained herein
is true and accurate to the best of my knowledge.
DATE: j j APPLICANT 's SIGNATURE ,.t..�
NOTE: Issue a o f a zoning permit does not relieve an applioanrs burden to ply with all
zoning requl ements and obtain all required permits from the Board of Health, Conservation
Commission, Department of Public) Works and other applioable permit granting authorities.
FILE #
II) EC EIUE 4
11 SEP ,
2 S F i1eNo. Je2 ,
APT of B11 ' 4 , G PERMIT APPLICATION ( §10.2)
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant: 3° . fir) c , ?.
1 1.c ,J ), L b e r
e
Address: 77J ' i ✓ici .i. 0 Telephone: 6 �" `Y/ 4:7
2. Owner of Property: E/A) Mu & eli Z
Address: *qQ /0195 E.., '27, ?, 4° Telephone: X8 ,...6 ',,
3. Status of Applicant: Owner Contract Purchaser Lessee
Other (explain):
4. Job Location:
Parcel Id: Zoning Map# ere— Parcel# fi7 �
District(s): �J4,,1�
(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):
=Vi N1/ Si19) /00 —
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)
49 GLEASON RD BP- 2000 -0231
GIS #: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 18C - 104 CITY OF NORTHAMPTON
Lot: -001
Permit: Building
Category: vinyl siding BUILDING PERMIT '
Permit # BP- 2000 -0231
Project # JS- 2000 -0370
Est. Cost: $5100.00
Fee: $25.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: B & R Siding 100465
Lot Size(sq. ft.): 7143.84 Owner: MOODIE EBEN C & JANE P
Zoning: URB Applicant:, B & R Siding
AT: 49 GLEASON RD
Applicant Address: Phone: Insurance:
781 Bridge Rd. (413) 586 -4167 Workers Compensation
NORTHAMPTON 01062 ISSUED ON:9/2/1999 0:00:00
TO PERFORM THE FOLLOWING WORK: INSTALL VINYL SIDING
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 9/2/1999 0:00:00 $25.00
212 Main Street, Phone (413) 587 - 1240, Fax: (413) 587 -1272
Building Commissioner - Anthony Patillo
■