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Zoning
Miscellaneous Additions.Repairs,Alterations,etc. Tel.No, � {G I Alterations
NORTHAMPTON, MASS. h 193L Additions
a I APPLICATION FOR PERMIT TO ALTER Repair
Garage
l
1. Location �2-� otu,,; �f1 �� �Y vW�/J 1�^ Lot No.
2. Owners name / Address
3. Builder's name P1 e;er 1 °xS Address Qr 0, EnZ t I\,t\— Nbs Ayk MA ,
Mass.Construction Supervisor's License No. `g,-1 5RG 0 Expiration Date t
4. Addition �-Vv�S�Cv1�1fi.��l+n� '
5. Alteration ���'` 4t
6. New Porch
7. Is existing building to be demolished?
S. 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:-
i�Ulb The undersigned cenifies that the above statements are true to the best of hi
know le ge and bell f.
Signa ur•e of r•e ponsrb(e app.icant
Remarks Sod-
s'
-- - �" &� n Inc. JOB d/b/a MO CONTRACTORS _
Q�� �' P. BOX 1145 SHEET NO __-_ OF
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NORI'1-IA PION, MASS. 01061 CALCULATED BY DATE __-
(413) 586-5491
Pr PT,. CHECKED BY DATE
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.m D Pr'1RTMENT OF BUILDING INSPECTIONS
PFpT 0t <
J12 Main Street ' Municipal Building
Northampton, Mass. 01060
WORKER'S COMPENSATION INSURANCE AFMA AVIT
I, PIONEER CONTRACTORS PT CON,- TPJC.___________
`(Ucenste/permittee)
with a principal place of business/residence at'.
P.O. BOX 1145 Narthamptanr MA_ n1nf,1 (phone'0 413_58 491
(sU=Ucity/staid2ip)
do hereby certify, under the pains and penalties of penury, that:
(X) I am an employer providing the following worker's compensation coverage for my
employees working on this job:
I iherty M total Tnsimanra_Cn, Wf T_315-499R22_f1499 - 4 L-Kn/nn
Qnsurance Company) (Policy Number) (Expiration Date)
O I am a sole proprietor, general contractor or homeowner (circle one) and have hued
the contractors listed below who have the following worker's compensation policies:
(Name of Contractor) (Insurance Corn-any/Policy Number) (Expiration Date)
(Name of Contractor) (Insurance Coinpaiv/`Policy Nuinbcr) (Expi-mt on Date)
(Name of Contractor) (Insurance Company/Policy Number) �Lxplrauon Date)
(attach additional sboct if neoeauy to iae}ude information pertaining wall cwtmcton)
( ) 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 awam that whilo homeoymm who employ pasom t4 do amLa mane,,R cYtoo or repair work on a dwelling of
not mora than throo unit'is which the hom&owncr raids cc oa t5e q out's apptuteoarrt thwcto arc not CCnerzlly oomickrtd to be
employees under the wvricees onmperos tion Act(GL 152,ss l(5)�application by a homeow=for a!keen-c or permit may cvidcaoc tho
legs!status of an amployor under the Worlcors Compamation Act,
I undastaad thzt a oc py of this cutemeut may ba forwwxiad to tho Dcpnrtmcn2 of IndsutmJ A=d-a&Offioa of Inauanca for the
coverage vaificatioo and that failure to&==covmNn c undo suction 25A of MGL 152 can lend to the imposition of criminal penaWc
ooausfiag of a fmc of up to S1.5oo.00=&or imprisonment of up to ooc year and civil pcaaltia in the form of n Stop Work Order and a
futo o(S100.00 a day againA ma
For dca WxX l w 0,11Y mt NuPermi er
Niap#-- - Lot#
Sigloahue of LiccvscclPermi e
y -
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
- side L• R: L: R:
- rear
Building height
Bldg Square footage
%Open Space:
(Lot area minus bldg
&paved parking)
# of Parking spaces
f of Loading Docks
Fill:
Avolume -& location)
13 . Certification: I hereby certify that the information contained herein
G is true and accurate to the best of my knowledge.
DATE: - ' -� 7� APPLICANT's SIGNATURE
NOTE: lesunnoa of a zoning permit does not relieve an a p oan burden o oompty with oil
zoning requirements and obtain all required permits from the Board of Health. Conservtation
Commission. Department of Pubiio Works and other applicable permit granting authorities.
FILE #
File No.
FP?� -ZOYXB PERMIT APPLICATION (§10 . 2)
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant:
Address: Bk4 1 �il�t lra.1-G - Telephone: ,— S'(AI
2. Owner of Property:
Address: l Z-!5' 9)r, Telephone:
3. Status of Applicant: Owner Contract Purchaser Lessee
(Other(explain): 66A e r
4. Job Location: 1(s-A t-tj% r-
Parcel Id: Zoning Map# �o�� Parcel# District(s):
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/Property LA
6. Description of Proposed U /Work/Project/ cupation: ( se additi nal sheets if necessary):
7. Attached Plans: �_Sketch Plan Site Plan L/ 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 Permit/Variance/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)
File#BP-2000-0629
APPLICANT/CONTACT PERSON Pioneer Contractors
ADDRESS/PHONE PO Box 1145 (413)586-5491
PROPERTY LOCATION 125A PLEASANT ST
MAP 32C PARCEL 165 ZONE CB
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Buildiniz Permit Filled out
Fee Paid
Typeof Construction: ERECT 4 X 4 ATTENDANT'S BOOTH
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included•
Owner/Statement or License 017890
3 sets of Plans/Plot Plan
T 4OLLOWING 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 Conservaf mmission
� 3
Signature of Building Officifif 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.
125A PLEASANT ST BP-2000-0629
GIS#: COMMONWEALTH OF MASSACHUSETTS
r%�4 .Block: 32C 165 CITY OF NORTHAMPTON
Lot: -001
Permit: Building
Category shed BUILDING PERMIT
Permit# BP-2000-0629
Project# JS-2000-1125
Est.Cost:$1200.00
Fee: $50.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: Pioneer Contractors 017890
Lot Size(sg.ft.): 105415.20 Owner: PITONIAK MATTHEW M&
Zoning:CB Applicant Pioneer Contractors
AT: 125A PLEASANT ST
,4pplicantAddress: Phone: Insurance:
PO Box 1145 (413) 586-5491 Workers Compensation
NORTHAMPTON 01060 ISSUED ON.12130199 0:00:00
TO PERFORM THE FOLLOWING WORK:ERECT 4 X 4 ATTENDANT'S BOOTH
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 12/30/99 0:00:00 5537 $50.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Building Commissioner-Anthony Patillo