32C-171 (12) f r gj
DEC ! 61999
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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations
NORTHAMPTON, MASS. 1 g Additions
APPLICATION FOR PERMIT TO ALTER Repair
s Garage
1. Location a5u P/ea,s,&Avf- .5f 7W"PrvIJ mbe r Lot No.
2. Owners name Address
3. Builder's name C- a v/p-S d Po!4VeAE- Address U6
Mass.Construction Supervisor's License No. DD X90 D Expiration Date ► '2.T4 /1"1
4. Addition
5. Alteration r` 'JZ> -IxTC4!Lg !� r-( c k c.J A-L c-- �� =�PGt� '(4, Gr
6. New Porch
7. Is existing building to be demolished? .N1
8. Repair after the fire
9. Garage No.of cars Size
10. Method of heating_l/�4
11. Distance to lot lines
12. Type of roof
13. Siding house
14. Estimated cosL- Q,00, a o
The undersigned certifies that the above statements are we to the best of his
knowledge and belief.
CZ-
S nature of responsible appicant
Remarks
m
; j yna3f7[C�IIftI15
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DE ENT OF BUILDDZG INSPECTIONS
DEPT OF 8111 Ei;a�tFdSPEI T1,.,2 �� Street ' Municipal Building -IWO Ce
� )Northampton, Mass. 01060
WORKER'S COMPENSATION INSURANCE AFFIDAVTr
L /-J"Abet" ef,
(li ��)
with a principal place of business/residence at:
(phone#) S S��
(street/City1SWd2ip) oiv&a
do hereby certify, under the pains and penalties of perjury, that:
(Y; I am an employer providing the following worker's compensation coverage for my
employees working on this job:
,s (y) '4 00
(Insurance Company) (Policy Number) Pwtibn 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 sheet ifnecenuy to iaclu k infncmatiaa peruiaing to an ooalrncton)
( ) 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 vrhilo homeowners who employ p==to do m iatenancc contnwionor repair wait on a dwelling of
ant aroca than thooe units is whichtbe homeoaraer resides ex on the grounds apputtenaatthexeto arz not gmetalty oomidasd to be
employers under the worka's cowpe osstion Act(GL152,s1(5)J application by a homeowner for a license or permit may evidence the
legal slams*fan employer undar the Wockeet C,ompemation Act
I understand that a copy of this statemcut may be foswa:dod to the Deparmroot of Iaehatrial Aoeddw&Offioe of hrwraow for the
oove mge verification sad that failure to seatre cov=V under section 25A of MGL 152 can lead to the'iarpoaitiea of ariminai penalties
coasLemg of a Sae oftep to$1,500.00 and/or imprbonmemt of up to one year and civil pemltie s in the form of a stop Work Order sad a
fine of 5100.00 a day against mc.
For dq l use only'
I /G Permit Number
Aa AC Map# Lot#
%nature of LicenseelPermi
-
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.
Thin co2ama to be filled in
by the Bai2d=g Department
Required I
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 parkingi
# of -Parking Spaces
#- of Loading Docks
Fill:
(voi-ume--& location)
13 . Certification: I hereby certify that the information contained herein
is true and accurate to the best of my knowledge.
DATE: APPLICANT's SIGNATURE
NOTE: Issuanoe of a zoning permit does not relieve an appiloont's burden to oomply wlt"'all
zoning requirements and obtain all required permits from the Board of Health. Conservation
Commission. Department of Publio Works and other appilooble permit granting authorities.
FILE #
DEC I 1999
File No.
DEPT OF BUILDING INSPECTIONS
NORTHAMPTON MA 01G60 �
ZONING PERMIT APPLICATION (§10 . 2)
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant: /V0/?7 i r 44 M Xa iU Z--d M d 4i7a ZC N C--
Address:c2 —lo P) T S;-J— N',5-,r Telephone: 4JI.3 �szld-6
o�CrpO
2. Owner of Property: &Aid- rvi
Address:`f $r w)s, 11. If I?A— Telephone: `iLZ&_So77 '7 7
3. Status of Applicant: Owner Contract Purchaser l/ Lessee
Other(explain):
4. Job Location: Pjay-S jl.� r— 6-j-
Parcel Id: Zoning Map# Parcel# / 7/ District(s):
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/Property RC-7-Ale— S.426ES — A J., 1-2-7 - 5e/,,p&
6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary):
lV,oA-i 2 CAP eA) ,33//C& R!�,¢/P 40,444 5x/ 77
7. Attached Plans: Sketch Plan Site Plan Engineered/Surveyed Plans
Answers to the following 2 questions may be obtained by checking with the BuRding Dept or Planning Department Files.
8. Has a Special PermiWadance/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? NOS_ 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-2000-0598
APPLICANT/CONTACT PERSON NORTHAMPTON LUMBER CO INC
ADDRESS/PHONE 256 PLEASANT ST (413)584-5480
PROPERTY LOCATION 256 PLEASANT ST
MAP 32C PARCEL 171 ZONE GB
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Buildiniz Permit Filled out
Fee Paid O
Typeof Construction: REPAIR CAP ON EXISTING BRICK WALL
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/Statement or License 007900
3 sets of Plans/Plot Plan
THE 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 from Conservation Commissiop,,;7
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.
256 PLEASANT ST BP-2000-0598
GIs#: COMMONWEALTH OF MASSACHUSETTS
0 amBlock: 32C- 171 CITY OF NORTHAMPTON
Lot: -001
Permit: Building
Category:Non structural interior renovations BUILDING PERMIT
Permit# BP-2000-0598
Project# JS-2000-1070 -
Est.Cost:$3000.00
Fee: $50.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: NORTHAMPTON LUMBER CO INC 007900
Lot Size(sg.ft.): 171 19.08 Owner: WHITE GAIL M
Zoning:GB Applicant: NORTHAMPTON LUMBER CO INC
AT: 256 PLEASANT ST
Applicant Address: Phone: Insurance:
256 PLEASANT ST (413) 584-5480 Workers Compensation
NORTHAMPTON 01060 ISSUED ON:12128199 0:00:00
TO PERFORM THE FOLLOWING WORK.-REPAIR CAP ON EXISTING BRICK WALL
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 Sienature:
Fee Type: Receipt No: Date Paid: Check No: _Amount:
Building 12/28/99 0:00:00 20729 $50.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Building Commissioner-Anthony Patillo