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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. 573�?--A6gU Alterations
C5 Additions
a NORTHAMPTON MASS. 19� Repair
APPLICATION FOR PERMIT TO ALTER Garage
1. Location 96 611 1,0-a X12ale F Lot No.
2. Owner's name 2VZ
/`f.&W12Z d4l't1t Address j
3. Builder's name J Address +z
Mass.Construction Supervisor's License No. y Expiration Date c/" j bevo
4. Addition l�f ,l���l ///YJ�Z�O' L ✓j2 �li
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:- � CJ v ti/� 0-0
The undersigned certifies that the above statements are true to the best of his, her
knowledge and belief.
,n
Si azure of responsible applicant
Remarks
/m G /C .
OT
PH\ItN'T+SHOP
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g HfR of Nerd 1juillptoll -
m ;tF1'T Of =, DEPARTMENT OF BUILDING INSPECTIONS
212 Main Street ' Municipal Building
Northampton, Mass. 01060 y `
WORKER'S CON PENSATION INSURANCE Avrr
`' (�iC✓nsee/peruiittec) &—
with a principal place of business/residence at:
�iYS/s(air/zip)
do Hereby cet-ify, usider idle pains and penalties of perjlrry, that:
(VI am an employer providing the following v:orr_er�s compensation coveiI'ge for my
employees wor-�ng on this job:
(Insurance Company) (Policy tY on Daze}
( ) I am a sole proprietor, general contractor or homeowner (circle on(-,) and have hired
the contractors listed below who have the following worker's compensation policies:
(Name of Contractor) (Lasi=cn Company/Policy Number) (Expiration Date)
(Name of Contractor) (Lasuran� Company/Poticy Number) (Expiration Date)
(Name of Conn-actor) (In=C-- Compa.ny/Poucy Numb-s) (Expiration Date)
(Name of Contractor) Gnsu=c-- Company/Policy Number) (Expiration Date)
(—ah zdditioml shoe(tfnt c to mchi6c iafwwitioc pert&, g to all oodrnctocs)
( ) I am a sole proprietor and have no one working for me.
( ) I am a home owner performing all the work myself.
NOTE:plense be aware that v hilo bomeoxven wbo cmplay pasons to do mabii�c=sbiicGoa or repair work ott a dwelling of
not more th-an tbr� units in which the homaowmr r=dcs or oc the gourds appurtenant thacty arc no(gully ooandaed to be
employes under tbo worittr's o=pc=s4cn Act(GL152$s 1(5)�appluation try a homeowner for a Gone cc permd may evidcnoc the
legal rtat"of an employer undortha Workcet Compomition Ad
-
I understand that a copy of thix vuicmcot mxy ba forwardod to tho Dcpurtmn of 1ndu4ri d Ax 6d=&OISoo of Iascuwco for tho
covczage vaificatioo and that failure to secure cov ry=dcr scc6ce 25A of MGL 152 can lead to the imposition of criminsl penalties `
oomisting of a fine of up to 51,500.00 and/or impri:s n of up to occ year and civil p�hics in the fotm of a Stop Wotic Order and a
fine of 5100.00 a day against me_
Signed this day of ' /C 199? For dPutnx:aw—colr
Permit Number
Z, �� Maf Lot#f
lure of Li crmit tm
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 BaildIny Department:
Required
Existing Proposed By Zoning
Lot size
Frontage
Setbacks - front
- 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-ume--& location)
13 . Certification: I hereby certify that the information contained herein
G is true and accurate to the best of my knowledge.
DATE: APPLICANT's SIGNATURE ZP G fL�j'
1" NOTE: Issuanoe of a zoning permit does not relieve an +yjpfplioanYs bard to comply witht,,.rpll
zoning requirements and obtain all required permits from the Board of Health, Conservation
Commission, Department of Publio Works and other appiiomble permit granting authorities.
FILE if
5'
File Noff—bo 1
r cF ZONING PERMIT APPLICATION (§10 . 2)
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant: .
Address: C.�� Teleph
2. Owner of Pro rtY�e f
P
Address: !� Telephoner
3. Status of Applicant: Owner / _Contract Purchaser Lessee
Other(explain):
4. Job Location:
Parcel Id: Zoning Map# _ Parcel# District(s):
(TO BE FILLED IN BY THE BOOING DEPARTMEN
5. Existing Use of Structure/Property
6. Description of Proposed UseNVork/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?
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)
4
30 OVERLOOK DR BP-2000-0112
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map.-Block:29- 196 CITY OF NORTHAMPTON
Lot:-001
Permit: Building
Categorroofin BUILDING PERMIT
Permit# BP-2000-0112
Project# JS-2000-0176
Est.Cost: $3380.00
Fee:$50.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: S E Sulenski 101718
Lot Sizes . ft. : 19035.72 Owner: LESTER HOWARD M&JILL B
Zonini:URA Applicant. S E Sulenski
AT: 30 OVERLOOK DR
Applicant Address: Phone: Insurance:
103 South Street (413) 532-3630 Workers Compensation
HOLYOKE 01040 ISSUED ON:7129/1999 o:oo:oo
TO PERFORM THE FOLLOWING WORK.-STRIP & SHINGLE ROOF
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 7/29/1999 0:00:00 $50.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Building Commissioner-Anthony Patillo