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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations
NORTHAMPTON, MASS. 19 Additions
APPLICATION FOR PERMIT TO ALTER Repair
r - Garage
Location vs- 1 /0, Flo/'eV1 C r— Lot No.
!. Owner's named r r— ��2 �f C Address
S. Builder's name (.t� S -7-r'1117 /1/mss 5-, .'�75 Ke �:r ,Address
Mass.Construction Supervisor's License No. % Expiration Date
�. Addition
i. Alteration
i. New Porch
�. Is existing building to be demolished?
3. Repair after the fire
>. Garage No.of cars Size
). Method of heating
Distance to lot lines
?. Type of roof
S. Siding house d, 4
t. Estimated co C31 C�
The undersigned certifies that the above statements ewe to the best of his, her
knowledge lief.
Signature of responsible app,icant
°marks
. a.�°rya Cr�i-�"Iorf•�az��tt»t�rfnit
11�W,- r
� d �a�sarl,osrtt� .
DEPARTMENT OP BUILDING INSPECTIONS
212 Main Street ' Municipal Building
Northampton, Mass.' 01060
W 0R110ER'S C.01 & NSA TON"INSURA.NC:E ,, AVIT
(li�nserlpermi uec)
with a principal place of business/residence at:
. (phoney/)
(sit/city/stalrl�p)
do hereby certify, under the pains azd penalties of pCoury, that:
( ) I am an employer providing the follo`vwi g vorker's compensation coverage for my
employees worlring on this job.
Gust nQ; Company) (Policy Numb--r) (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:
-t (�1= Oi COntractor) (Lris an_cc COrnoa�y/Pot1Ci N�?lC<r) (E\71t8t?Oa DIIC)
(N..me or Contractor) -- - 0=u-:ancc COIIIDuaY/POhCr\uric-_-r) (Expiration Date)
(Name of Contractor) (tnsurancz- Company[Pol,cy Numbex) (Ex'ptlation Daic)
(Name of Contractor) (Iasurancz- Comoaffy/Policy Number) (Expiration Date)
(�tuctl dditi r!Icct irncoc to include irro ,ica pat" to all oodraton)
( I am a sole proprietor and have no one working for me.
( ) I am a home owner performing all the work myself.
NOTE:plc3-rc be atrarc that who tx a ,AVm Hao cmplay per%aw to do mi f^•^n coasvuctioo-or repair work m a d..clliag of
aot morn th:n tbroo units is t\Jaich the 6:,= -ocr ro.ido oc oo the vounda appttr�tbccx°uc not Ccncatty oomiduod W be
amployan under tha wock cc s oea slim Act(G L152.=1(5)),appliabon lry►botncoA-D r for a Gccax oc permit n3ay cv:d—tho
legal rt3Au oran a=piop<undertbo Workoes c cv o3--t Act-
• I o.ade,tnad dada oopy ortL:u mt.®mt may bo rosd.d to the Dop.sameot of Industrial OfS of h,x` roc tb.
covazgc vaificotion aad that U=to s,==covmv under soctiov 23 A of MOL 159.cap ltxd to tbd imp?sitioa of aimind pmtlrin
oomiatiag of a.ffmc bf up to S 1�OQJ00 anNoe ni of ti+p w one yor and avt�pcailtia is tae form oC a Slop W ock Ocdcr and■
f nc 0(5100.00 a day.ignia l tax
For dgwwti3dow tiao ocay,
Pch`aiit•-Numbcr
Sip=hazic Of L, cilni ;cc
' ':tik•'.:'�:i'-w w`71�::.4:.�.�r�v'T���.X��x...;�:: .. I:a�'+"`a!'3.{lir:• ..
s
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 MAST BE COMPLETED, or PERMIT CAN BE DENIED DUE TO
LACK OF INFORMATION.
This cola= to be filled in
by the Building Aepartment
(Required I
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)
# of -Parking spaces
# of Loading Docks
Fill:
--(volume -& location)
13 . Certification: I hereby certify that the information contained herein
_a
is true and ccurate to the best of my kno dge.
�
r
DATE: APPLICANT's SIGNATURE
NOTE: Iss anoe of a zoning permit does not relieve aji applioant's burd n to oomply With all
zoning requirements and obtain all required permits from the Board of Health, Conservt+tion
Commission, Department of Publio Works and other applionble permit granting authorities.
FILE #
File No.
ZONING PERMIT APPLICATION (§10 . 2)
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant: f
Address: �z;���/ ��*1420 Telephone: �^ � � S� � � '7
2. Owner of Property: f_ &"t-V- y 11-11:�
Address: y T c �✓� r Alcrr,?c-e Telephone: V -L5Z? 7'9'
3. Status of Applicant: Owner Contract Purchaser Lessee
Other(explain):
4. Job Location: /^70 rr) C `f' //zc,
Parcel Id: Zoning Map# Parcel# ` District(s):
(TO BE FILLED IN BY THE BUILDING DEPARTMEN
5. Existing Use of Structure/Property e-
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 PermiVVariance/Finding ever been issued for/on the site?
NO DON'T KNOIAI 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)
Department: Reference No: BP-1999-0523
.............................
Building, Electrical & Mechanical Permits
....•...•. .............................................................................
Fee Type.- Receipt No.-
I
Vinyl siding REC-1999-001420
... ..........•........ ........ ........................................................
..... ................................
Paid By: Paid in Full On:
Western Mass Siding & Roofing Fri Nov 20,1998
..•..•.•... ... .........................................................................
... ................... ..............
Received By: Check No-
Linda Lapointe 2380
.........................................................................................
......................................
DEPARTMENT'S COPY Amount- $20.00
----------- --------------
DE1111ARTMENTFILE COPY 48 HICKORY DR
CITY OF NORTHAMPTON
BUILDING PERMIT
Owner's pulling their own permits or dealing with unregistered contractors for applicable work do
not have access to Guaranty Fund(MGL 142A)
Issued: Permit No: Inspector: Tracking No.: Fee:
20 Nov, 1998 BP-1999-0523 $20.00
GIS 4: Map Block: Lot: ,,.,.,Address: Zoning: Use Group: Lot Size:
lug
4887 48 HICKORY DR URA 17859.6
Contractor: License Type: Insurance:
Western Mass Siding & Roofing HIC
Address: License No.: Insurance No.:
63 East Street 105630
City: State: Zip Code: Phone:
EASTHAMPTON MA 01027 (413) 586-5227
Proiect No: Category of Work: Const. Class: Cost Estimate:
JS-1999-0993 vinyl siding $6,500.00
Description of Work:
INSTALL VINYL SIDING
GeoTMS@ 1997 Des Lauriers&Associates,Inc. Signature:
..mow __�.;_ � um�-:-�--
CITY OP NORTHAPTON M
BUILDING PERMIT
ROOFING WINDOWS & DOORS -
SIDING
48 HICKORY DR , Map 29 - Parcel 163
Fee $20.00, Applicant Western Mass Siding &
Roofing
BP-1999-0523 JS-1999-0993
Date issued 20-Nov-1998
---------------------------------------------------------
--Building Inspection -
Rough
Building Inspection
Finish
Approved b .
pp Y
wilding Commissioner
This certifies that Western Mass Siding&Roofing has permission to(INSTALL VINYL SIDING)
situated at 48HICKORY DR,provided that the person accepting this permit shall in every respect conform
to the terms of the application on file in the office of the Building Department,and to the provisions of the
Statutes and the Ordinances relating to the construction,Maintenance and Inspection of Buildings in the
City of Northampton.Any violation of any of the terms above noted is an immediate revocation of this
permit.Expires six months from date of issuance if not started.All installations of windows,siding,
roofing materials and doors shall be to manufacturer's specifications.
The contractor is responsible to hire a licensed electrician if the removal or relocation of any
electrical lines or fixtures is required for installation of siding products.
• +f