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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. -CCj Alterations
a NORTHAMPTON, MASS. 19-1 Additions
APPLICATION FOR PERMIT TO ALTER Repair Garage
1. Location /t&/ Lot No.
2. Owners name Address Q
3. Builder's name Address , n
Mass.Construction Supervisor's License No. c Expiration Date
4. Addition
5. Alteration_
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, her
knowledge and belief:
' Signature of responsible applicant
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DATE PAMAXYM
xkewev�{•:xan v}.x..::,h}s:}:e>}>,xn:a•• a:::o.:. 1, ... ...: .. ?:�•
THIS CERTIFICATE IS ISSPED AS A MATTER-OF IIHORMATION
ONLY AND CONFERS NO-RIGHTS'UPON THE CER 04CATE
Martin J. Clayton ins Agcy Ina HOLDER. THIS CERTIFICATElbONS NOT AMEND, EXTI�ND'OR ,
1449 Northampton street A E COVERAGE AFFORDED
R O. Box 999 COMPANIES AFFORDING"COVERAGE
"yoke MA 01041.0989
COMPANY
A Crum i Forster Ins. Co.
INSURED
COMPANY
Salenski Roollny and 8 Granite State Ins. Co.
Shang Co. Inc.
103 South street COMPANY
Holyoke NA 01040 C
COMPANY
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THIS 13 TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CEPT14CATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TE WA
ONS AND CONDITIONS F SUCH POLICIES. UM17S SHOWN MAY HAVE 3EEN REDUrtED BY PAID CLAIMS.
CO POLICY EFFECTIVE POLICY EXPIRATION ;
LTR TYPE OF INSURANCE POLICY NUMBER DATE OAWD/M DATE (M oDD/YV) LIlfTS�r�'i v,, t b,,
{ L 030K LViBU Y RENEWAL OF: 12/01/98 12/01/99 OENeIAL'AdDaECiATE s "Z'
_ NMMBTCW OETIHiAL LI18t RY 5031595242 rnoouciai+q A
a: CLAW MADE Q OCCUR PT3RBONAL
OWNEI S&CONTRACTOR'S PROT D EALl1 Y r
AuwMDetELIABLITY 1336457205 01/01/99 01/0.1%00• I
let
,
M A
AUTOS
i
AUTOS ;
ONIPM LIABILITY AUTO CN Y EAR `
x =,✓
ANY AUTO OTHER THAN`AM OWN'
'EACH ACCaoe�r'
_k R
ElICESS LIABILITY EACH OOC&IWIENCE s" k
RUMBRELLA FORM A60F631ATE
OTHER THAN UMBRELLA FORM 3
YICls®13 COMPENSATION AND YYC STAID OTIi
EMFLOYERS'LIABILITY
B WC5827089 12/31198 12/31/99 EL EACH ACCIDEN` 3 1100000
THE PROPRETOR/ INCL EL DISEASE-POLICY LMR ,i __ 500 000
PARTNERSEECUTNE
OFFICERS ARE: EXCL EL DISEASE-EA EMPLOYEE Is 100#0001"'
DIHER
DESCRIPTION OF OPERATIONMOCATIONSNEHICLESISPECIAL ITEMS
'�+i'$n:•:•{tin.'
3f s:R.1. r. •}fi
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES SE'CANCE IM MCI THE,
EXPIRATION DATE THEREOF,THE LSWM COMPANY WILL ENDEAVOR:TO MAL
18 DAYS WRITTEN NOT=TO THE CERTIFICATE Hmw NAMED To THE Lin
BUT FAILURE TO MAL SUCH NOTICE SNAIL'IMPOSE NO 08410ATgN 0R 1JABL1iY
OF ANY KIND UPON THE COMPANY '! e
AUTHORIZED REPRLINIPRATN! j
Herold F. Clayton, Jr.
DOWN
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°4 APR 711
(Mf� of wart 11allip foil
"'.1N(zPFCgI`+ti` dS4ACyns�lt>:
r9 DEPARTMENT OF BUILDrNG INSPECTIONS
i
212 Main Street ' Municipal Building 'o
Northampton, Mass. 01060 y '
WOR-KER'S COMTENSA` ION INSURANCE All t AVIT
(Iia;nserJpennitiee) --- U
with a principal place of business./residence at:
do hereby cclti?y under the pains and penalties of perjury, ulat
xI and an employer providing the following compensation cove;1111e for my
eulployees working on t11is job:
(Insurance Company) (P0HCy Nurnlxr) (Expiration 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 Compaiiy/Pokc,Number) (Expiration Date)
(Name of Contractor) (Insurance Company/Poky Number) (Expiration Date)
(Name of Contractor) (Insuran(-- Compauy/Policy Num_bu) (Fay imdon Date)
(Name of Contractor) UDszlran�Company/Policy Number) (Expiration Date)
(anaeh additica�l sheet ifncccaisry to inch,.&iafQnnjLEoa Pertaining to all ooakadon)
( ) 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 Strut that v f)i10 homeowocr3 wbo employ pasom to do mam*m+a�>,coastructioo or rtpair work on a dwelling of
not morn than thtoo units in wtnch the homoowncr resides a oo tho grounds appurtmant tbeccw,uc not gcrxrally cow dcmd to be
employcrs under tbo veorKces 0=Pc=z1ica Act(GL152-m 1(5)�application by a homeowner for a ficenst oe permit may evidenoe the
legal dshss of en omployec under tho Workce&Compecaation Ad
I uadctzt+nd dud a copy of this ctzt-f may ba forwnnind to tho Dcp ri of lndutr d A.=,4-x&Off o0 of IIISLta000 for d-
covcrx verific alion and that failure to scmm covcmgo unda section 25A of MaL 152 can lead to the imposition of crimmsl pensl6cs
consisting of a fmc of up to S 1,500.00 andloc of up to ooc y=and civil pmaltia in the form of a Stop Work Otdcr and a
fino of s 100.00 I day agaiMA me
Signed this _day of 1999 For dcgtttmaeA use ooty
Permit Number
A Map; Lot 4
gnature of Li crmiticc
10. Do any signs exist on the property? YES NO '7``4
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 cclw= 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)
:pf -Parking spaces
# 'of Loading Docks
Fill:
'4vol-time--& location)
13 . Certification: I hereby certify that the information contained herein
G is true and accurate to the best of my knowledge.
y,
APPLICANT's SIGNATURE �r
lasOjntiae of a zoning permit does not relieve a90&pplloanru purdan to comply wltfr,,aU-
zoning requirements and obtain all required parmitsofrom the Board of Health, Conservation
Commission, Department of Pubtlo Works and other applioabla permit granting authorities.-
FILE #
File No.
ZONING PERMIT APPLICATION (§10 . 2
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant:
Address: Telephone:
2. Owner of Property:
Address: Telephone:
3. Status of Applicant: Owner Contract Purchaser Lessee
Other(explain):_
4. Job Location:
Parcel Id: Zoning Map# Parcel# � z_ 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 PermitA/adance/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)
A +
60 WILLIAMS ST BP-1999-0828
GIS#: COMMONWEALTH OF MASSACHUSETTS
MQ Block: 32C-274 CITY OF NORTHAMPTON
Lot: -001
Permit: Buildina
Category:roofing BUILDING PERMIT
Permit# BP-1999-0828
Project# JS-1999-1464
Est. Cost:$3580.00
Fee:$20.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: S E Sulenski 101718
Lot Size(sq.ft.): 10280.16 Owner: PIECH HELEN
Zoning:URC Applicant: S E Sulenski
AT.• 60 WILLAMS ST
Applicant Address: Phone. Insurance:
103 South Street (413) 532-3630 Workers Compensation
HOLYOKE 01040 ISSUED ON.•41711999 0.00.00
TO PERFORM THE FOLLOWING WORK.-SHINGLE ROOF ON ADDITION & FRONT ENTRY PORCH
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 Deuartment 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 4/7/1999 0:00:00 $20.00
212 Main Street,Phone(413)587-1240,Fax:(413)587-1272
Building Commissioner-Anthony Patillo