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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. t Alterations X
NORTHAMPTON, MASS. 19 Additions
APPLICATION FOR PERMIT TO ALTER Rcpair
Garage
1. Location vN G ! t-1D �C Lot No.
2. Owners name stw N D Y-VA f�--. , 7-^c Address St,..w^-Z1
P C' P� o i 1 u,— No��c� ul ab�
3. Builder's name �cs�•�e;�r .�„-�(�.��� Address wy-�,, MA .
Mass.Construction Supervisor's License No. C7\-7 SGt 0 Expiration Date 111 102—
4. Addition / D
5. Alteration Enszl `-k e w G(, 1 lrS -4 42 A s
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- tj
The undersigned certifies that the above statemcnts are true to the best of h:
knowledge lief.
Signature ofresp nsible app,icant
Remarks
OQ'TtiAMp�O
s a , Crz vz#l�ttmnn
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m y.- °'D"ARTMENT OF BUILDFNC; INSPECTIONS
212 Main Street ' Municipal Building
Northampton, Mass. 01060
WORKER'S COMPENSATION INSURANCE AFFIDAVIT
PIONEER CONTRA TORS.PI CON,. INC.
`(licenser�permittee}
with a principal place of business/residence at.
P.O. BOX 1145 Nnrthnm tnn, MA' f11f161 (phoney#)_ 413_586_5491
(street city/s a1r/2:ip)
do hereby certify, under the pains and penalties of perjury, than
(X) I am an employer providing the following workers compensation coverage for my
employees woriang on this job:
Liberty Mutant TngitrAnr P f n, Wf'1-31r,–d99R?2 n499 4,/-Anr/nn
(insuianee Company) (Policy Number) (Expiration D- =)
O 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 CompanyiPoLicy Number) (Expiration Date)
(Name of Contractor) (lnsurancc Comn-,uiyiPoky NumF,:r; (Cxpirltion Date)
(Name of Contractor) (Insurance Compauy/Policy Number) irxpuzuoa Date)
(awch additional thect if necavey to mchxle mfotmanoa pert:uaing Wall x0 L con)
( ) I am a sole proprietor and have no one working for me.
( ) I am a home owner performing all the work myself.
NOTE-.pica be aurae that wtiilo homcowocrs who employ pciam W do maimanaacr,cotzstrvcuoa or repair work oa a dwclliag of
not moeo than throe units is which the homeowner reside%or oct t_.ac p-,>u;w5 aplxutcaaai thado arc not grncr�y 000sidcrcd to be
employers under the worker's compeasatioa Act(GL152,=1(5)�a fpliration by a homeowner for a liccase cc pen-rut may cvidcncc tho
legal status of an employs under tho Worker'&Compoosation Aci-
I understand that a copy of this atatemeat may be forwarded to the pcparta o of lndusRi ai A=&C&Off oo of Inxusnoa for tha
coverage verificniioo sad that Wore to aoatre covcrago under saxioa 2 5 A of MOL 152 can lead to tba imposition of criminal penalties
oomisiing of a fine of up to$1,500.00 and/or inxprisoaax:ni of up to one year and civil penalties in the form of a Stop Work Order and a
fum of 5100.00 a day against me
For dopanmedal—only
Permit Number
Map# Lot#
S&aturt of Licensce/Permittee e
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 V
IF YES,describe size,type and location:
11 . ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE DENIED DUE TO
LACK OF INFORMATION.
Thi= cclu= to be filled in
by Ghe 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
&paned parking)
# pf '.Parking Spaces
htrof 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: I�I� (n� APPLICANT's SIGNATURE— �
NOTE: Issuanoe of a zoning permit does not relieve an 8ppiioan s burden to mply with all
zoning reo-quirem @nts and obtain all required permits from the Board of Health, Conservation
Commisslon, Department of Publio works and other applicable permit granting authorities.
FILE #
i'
File No, 616 t
��la�tiF°alp
f BONING PERMIT APPLICATION (§10 . 2}
PLEASE TYPE OR PRINT ALL INFORMATION
r�
1. Name of Applicant:_
Address: P 'U ' �V?� 114���16 rj/�li�+,(���• _Telephone:
2. Owner of Property:
Address: 36 5T I r_ Telephone:
3. Status of Applicant: Owner Contract Purchaser Lessee
'1/Other(explain): _
4. Job Location:
Parcel Id: Zoning Map# Parcel# District(s):
(TO BE FILLED
\ IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/Property X
6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary):
&\'S� L�L LA A&2xx) ]� A,1�2 W�—<�"AJQJ/)
7. Attached Plans: Sketch Plan —Site Plan Engineered/Surveyed Plans
Answers to the following 2 questions may be obtained by checking vrith the Building Dept or Planning Department Files.
8. Has a Special Permit/Variance/Finding ever been is:;ued for/on the site?rb
NO DON'T KNOW V YES IF YES,date issued:
IF YES: Was the permit recorded at the Registry o`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 Obtainer , date issued:
(FORM CONTINUES ON OTHER SIDE)
File#BP-2000-0666
APPLICANT/CONTACT PERSON Pioneer Contractors
ADDRESS/PHONE PO Box 1145 (413)586-5491
PROPERTY LOCATION 36 KING ST
MAP 32A PARCEL 255 ZONE CB
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out
Fee PaidS�o S�
Typeof Construction: REPLACE EXISTING BATH TUBS&WALL SURROUNDS-RMS 513, 515, 516, 517
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
THE FOLLOWING 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
ayal Board of Health Well Water Potability Board of Health
Permit from C.,00nsse`rvatio ommission
Signature of Buildin - fficial 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.
Building 1/19/00 0:00:00 5590 $50.00
Ow
212 Main Street,Phone(413)587-1240, Fax: (413)587-1272
Building Commissioner-Anthony Patillo
36 KING ST BP-2000-0666
GIs#: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 32A-255 CITY OF NORTHAMPTON
Lot: -001
Permit: Building
Category:Non structural interior renovations BUILDING PERMIT
Permit# BP-2000-0666
Project# 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(sq.ft.): 72614.52 Owner: STAR NORTHAMPTON 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.1 119100 0:00:00
TO PERFORM THE FOLLOWING WORK.REPLACE EXISTING BATH TUBS & WALL
SURROUNDS - RMS 513, 515, 516, 517
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:
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Building Commissioner-Anthony Patillo