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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. 'tea Alterations X
NORTHAMPTON, MASS. Gt7 Additions
APPLICATION FOR PERMIT TO ALTER Repair
Garage
1. Location Lot No.
2. Owner's name U Yalti.li 61 � c Address So
3. Builder's name QN ay.��;�r !/.t_r.r,�"(►,L:�� Address P+ 0 11,,ts— Nod"�^(A),n
M
Mass.Construction Supervisor's License No. C71"1 T5 0 Expiration Date III U�-
4. Addition
S. Alteration �.s�t>r1], ��\zw + TA-.,
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 cos
The undersigned certifies that the above statemcnts are we to the best of h:
knowledM
a
Signature of rasp nsible app+cant
Remarks
4�t1AMp�O
9 ! MAR 1 0 2000 }aiaSaRthtiartta
_ DEPARTMENT OF BUILDITNG INSPECTIONS
212 Main Street ' Municipal Building '
Northampton, Mass. 01060
wORI ER'S COMPENSATION INSURANCE AI+MAVIT
I, PIONEER CONTrRA TORS PT CON.- INC, _
`(licensepJpermittee)
with a principal place of business/residence at:
P.O. BOX 1145 Nn tr _hamptnn, MA-_ 01061 (phone#) 413_48 491
(st=ucity/staldzip)
do hereby certify, under the pains and penalties of perjury, that
(X) I am an employer providing the following worker's compensation coverage for my
employees working on this job:
I iharty Mutual Tnsttranra rn, WCT_31S_499822_0499 /QQ
(lnstuance Company) (Policy Number) (Expiration Date)
( ) I am a sole proprietor, general contractor or homeowner (circle orle) and have hired
the contractors listed below who have the following worker's compensation policies:
(Name of Contractor) (Insurance CompanyfPolicy Number) (Expiration Date)
(Name of Contractor) (insurance Colupauy"PoLcy Nu nt,:r) (ExpirWon Date)
(Name of-do ntractor) (Insurance Compauy/Policy Number) �nxptrdnon Dam)
(arum additional sheet if naemuy to include information Wining to all 000dreztors)
( ) I am a sole proprietor and have no one workdng for me.
( } I am a home owner performing all the work myself.
NOTE:please be awam that while homeowocn wbo cmplcy pawns w do m&kacn• c,-cAOStntwoa or repair work on a dwelling of
not morn than tbree units is which the bomeown r residn or oa t5e uvjr is aw=tcnam ibeccto sic oot gmcrady oomide cd to be
employers under the worker's oompeau4on Act(GL152 m 1(5)),appticatioo by a bomeowncr for a b0cux a permit may evidence the
legal status of as employer under the Workces C•ompomation Art
I understand that a copy of this statemeat may be fbrwwdo to the Dcparmseoa of iO,&ut rial A:oeadcnty Office of Inzrsranoe for the
coverage vet dCMUon and that W=to*caste coverage raider soction 25 A of MOL 152 can lead to the imposition of Mminal penalties
000sistiag of a fine of up to S 1,500.00 andfor mat of up to am y=and civil pcaaltia in the form of a Stop Work Order and a
find of S 100.00 a day against me.
For dM=t- W—ady
/ Permit Number
3 l Map# Lot#
Sioaahu ofT.i �rIPernl ttC6
e —
10. Do any signs exist on the property? YES _ NO
IF YES,describe size,type and locaten:���,_
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 MAST BE COMPLETED, or PERMIT CAN BE DENIED DOB TO
LACK OF INFORMATION.
Thies colas to be filled is
by th• Finildiaq Da}�araaeat
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
&peved parking)
# Pf Parking Spaces
trof Loading Docks
Fill:
-(volume--& location)
13 . Certification: I hereby certify that the information contained herein
G is true and accurate to the best of my knowle ge .
DATE: `s ! (�� APPLICANT s Sl"GNATURE ~
NOTE: Issuanoo of a zoning permit does not relieve an pplioan s burde to dom i with to
zoning P Y 11
g equlramants and obtain all required permits from the Board of Health, Consarvption
Commission, Department of Publio Works and other appiioabie permit granting authoritiou.
FILE #
File No. �a t
ZONING PERMI T .APPLICATION (§10 . 2)
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant:
Address: P U ' �(I� i4, �tD r G.�,(��v. Telephone: 5 �'b --S"}� 1
2. Owner of Property:
Address: Telephone:
3. Status of Applicant: Owner / Contract Purchaser Lessee
VOther (explain):_ l.uv, �n-ti�,rd
4. Job Location: S6_ �j �� ,�
Parcel Id: Zoning Map# Parcel# District(s):
(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):
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 Permit/Variance/Finding ever been Issued for/on the site?rb
NO DON'T KNOW v 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)
36 KING ST BP-2000-0777
GIs#: COMMONWEALTH OF MASSACHUSETTS
MU::Block: 32A-255 CITY OF NORTHAMPTON
Lot: -001
Permit: Building
Category:Non structural interior renovations BUILDING PERMIT
Permit# BP-2000-0777
Proiect9 JS-2000-1144
Est.Cost: $8000.00
Fee: $50.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: Pioneer Contractors 017890
Lot Size(sg. ft.): 72614.52 Owner: STARNORTHAMPTON INC
Zoning: CB Applicant: Pioneer Contractors
AT. 36 KING ST
Applicant Address: Phone: Insurance:
PO Box 1145 (413) 586-5491 Workers
Compensation
NORTHAMPTONMA01061 ISSUED ON:3113100 0:00:00
TO PERFORM THE FOLLOWING WORK:REPLACE EXISTING BATH TUBS & WALL
SURROUNDS - RMS 31 1 ,313,510,512
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 3/13/00 0:00:00 5695 $50.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Building Commissioner-Anthony Patillo