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DEPARTMENT OF PUBLIC SAFETY
CONSTRUCTION SUPERVISOR LICENSE
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Expires: Birthdate:
CS 021847 12/23/1999 12/23/1940
(,) . 7 Restricted To: 00
'• I AUL A WING
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116 VALLEY RD
SOUTHAMPTON, NA 01073
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��� , DEPAKI1MENT OP BUILDING INSPECTIONS
z 2 11 stn Street Municipal Building
-- _ _ Northampton, Mass. 01060 �rt+� `
WORKER'S COIYENSATION INSURANCE AWWAVIT.4--.7.:, 66,,,,t1 ,9,(tc._
r (hceasedpertmitt
with a principal place of business/residence at: .
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// .4 �� I sue. �• i� (phone#) .1 r� 7 � Ill
/O f (strt t/city/ . zip)
do hereby certify, under the pains and penalties of penury, that: •
(A5 I am an employer providing the following worker's compensation coverage for my
employees working on this job:
(Insurance Company) (Policy Number) (Expiration Dale)
( ) 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 Cornparry/Policy Number) (Expiration Date)
(Name of Contractor) (Insurance Company/Potiev Number) (Expiration Date)
(Name of Contractor) (Insurance Compary/Policy Number) (Expiration Date)
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(attadt additico,1 rho t if noccaary to ioclu&C is focmaaoa pa-calming to..1.1 Dona on)
( ) 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 wtlo bomsawncrs wbo ccaplay Dazoaz to do mairrkaaocc,cos iuctioa'or repair work on a dwelling of
not loco than throe units is which the bomoowocr residca or oa tho grounds rp eurtcnard tbccto arc not gmrratty oomiducd to be
cmployera under the worker's oomlxatdim Ad(GL152 s 1(S)).application by•becncown r fora liccnrre cc permit may evidence the
legal status of as employer undue the Worker's Coc pom&tion Act. .
I understand that a Dopy of this ter®mt may be focvve rtt d to cll."Depee:mom of loduatri.l ALCideCite O 00 of Iso"r`oos for tb.
coverage vcrificatioa sod that failure to secure cover-ago under section 2SA of MOL 152 can lend to bbd imposition of criminal paaaltiel :
cocoas.dog of a.Sae btu?to S1,500.00 aaddor of tip to one year and avII penalties ie the form of a Stop Work Ardor and a .
fire o(5100.00 achy against toe.
- - Fordepratioto atW0 only .
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Q - {' Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. � O 6 331 v Alterations
'r. NORTHAMPTON, MASS. '712/ 19 Additions
MkrRepair
. . ' APPLICATION FOR PERMIT TO ALTER
4.04-011' Garage
/
I. Location I _rte/di lir t_ . Lot No.
.
2. Owner's name ,, !l�r._ '. i� r %/ . - /.#_� Address O ASV/. IG
3. Builder's name ./ ,,4...-. _ „�__. —, .:„'A f,- Address r. /4.4. ..,3, i. 4 /,d pi.i. !4r_ti
Mass.Construction Su./ isor's License No. D cl I e i4 7 Expirati Date / /� �O -S/9rj
4. Addition /
5. Alteration X
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:-
/' The undersigned certifies that the above statements are true to the best of his.
knowledge and belief.
Signatur responsible app.lcont
7
Remarks tee �,i._� L"i/f Nib �L..� _ .4.4. . , ��∎gr:.." ��
. � ��ell
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10. Do any signs exist on the property? YES X NO
s �e�IF YES,describe size,type and location: -3 X3 an/ a _.
4114054,- A4A/L041
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 CM 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
•
I of Loading Docks
Fill:
{volume -& location) •
•
13 . Certification: I hereby certify that the information contained herein
� �' is true and accurate the best of my knowledge.
ffi E: , a8 7 APPLICANT'S SIGNATURE �' � � /
NOTE: Ws an of a zoning permit does not relieve a "'applicant's burden - oomply With all
zoning requirements and obtain all required permits from the Board of H,'1th, Conservation
Commission, Department of Publio Works and other applioable permit granting authorities.
FILE f
I L. SEP 2 8 1999
File N O 3 01-Pr
GF. U'1
ZONING PERMIT APPLICATION (§10 . 2)
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant: /GL1. 7 � Gt
Address: / _ j 1:% elephone: , a? 7 - S 111
2. Owner of Property. _/ I .I i .-t• ,,, e/!_-SL
,
Address: So !` � Telephone:
52 , — Z'16
3. Status of Applicant: Owner Contract Purchaser Lessee
Other(explain):
4. Job Location: 5.0 �� --tier.ge..."
Parcel Id: Zoning Map# 3.1 C. Parcel# 16 District(s): N 3
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/Property ¢�r_o '/ �
L/
6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary):
/
i
7. A ached 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 1 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)
File#BP-2000-0348
APPLICANT/CONTACT PERSON WING CONSTRUCTION INC
ADDRESS/PHONE 116 VALLEY ROAD (413)527-2549
PROPERTY LOCATION 50 CONZ ST
MAP 32C PARCEL 104 ZONE NB
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out
Fee Paid /1,57? .0 k%U
Typeof Construction: INTERIOR REMODELING,NEW WALL CEILING&FLOOR FINISH
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/Statement or License 021847
3 sets of Plans/Plot Plan
T LLOWING 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 fro onservat' Co /on
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.
50 CONZ ST BP-2000-0348
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map:Block:32C- 104 CITY OF NORTHAMPTON
Lot:-001
Permit: Building
Category:Non structural interior renovations BUILDING PERMIT
Permit# BP-2000-0348
Project# JS-2000-0567
Est. Cost: $20000.00
Fee: $100.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: WING CONSTRUCTION INC 021847
Lot Size(sq. ft.): 25047.00 Owner: WORLD WAR II VETERANS ASSOCIAT
Zoning:NB Applicant: WING CONSTRUCTION INC
AT: 50 CONZ ST
Applicant Address: Phone: Insurance:
116 VALLEY ROAD (413) 527-2549 Workers Compensation
SOUTHAMPTON 01073 ISSUED ON::10/12/1999 0:00:00
TO PERFORM THE FOLLOWING WORK:INTERIOR REMODELING, NEW WALL CEILING & FLOOR
FINISH
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 10/12/1999 0:00:00 $100.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Building Commissioner-Anthony Patillo