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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations
NORTHAMPTON, MASS. �� � 19L/ Additions
- A ICATION FOR PERMIT TO ALTER Repair
f Garage
1. Location
-no��1 �' l /U L J Lot No.
2. Owner's name Address
3. Builder's name 2 52 ex r-.,7u` o(& ,ro Address �y�� h1,)
Mass.Construction Supervisor's License No. C-5 195119j5— Expiration Date ° D
4. Addition /
5. Alteration e i J f�A� +c4� Cleo-0 �'' ' - -
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 statcmcnts are we to the best of his.
knowledge and belief.
/ Signature odes nstble apgicam
Remarks
_7777
0
9 � �asasc4asctts
PT OF BUILDING INSPECTIONS LPARrmENT OF BUILDING INSPECTIONS
NORTHAMPTON MA 01060
212 Main Street ' Municipal Building '
Northampton, Mass. 01060 '
WORKER'S COMPENSATION INSURANCE AFFIDAVIT
(licenscdpennitzce>
with a principal place of busulesslrasidence at:
7`
(strret/ci ty/stalrJa p)
do hereby certify, under the pains and penalties of perjury, that-.
( ) T am an employer providing the following worker's compensation coverage for my
employees working on this job:
(Insurance Company) (Polity Number) (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:
bl' awe � xS lt.relJ X'Ree04 e'x, i n' Ix c/"i
(Name of Contractor) (Insurance Company/Policy N ) (Expiration Date)
alzr ._ yotope-k S ,
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(Name of Contractor) (Insurance Compauy/Policy Number) (Expimdon Daze)
(Name of Contractor) (Insurance Compauy/Policy Number) (Expiration Date)
(aia—h addition]sheet ifnoo=Lry to iach>dc information pertniain8 to all 00�try n)
( am a sole proprietor and have no one working for me.
( ) I am a home owner performing all the work myself.
NOTE_pleaw be aware thsi whilo homcowncra wbo employ persons to&mm i,•f•,,•,,,e Luc ioa or n pa's work on a dwelling of
not morn than throe units in which the homeowner rtmdcs or oo tho grounds appurtcaant thereto arc cot gcomily oocudacd to be
cmploycra under the worker":oompcusation Act application by s homeowner for a lane cc pcfro�may evidence tbo
legal rtahra of an amployae under the Worker's Compemation Ad
I uadastsnd that x Dopy of this slatemaol may be faa-wuded to tho Dtpartaxat of Industrial Aocidmaf Otfioo of Iawrsaoo for the
cover g verificnlion and that failure to taure covr rago under suction 25A of MOL 152 can]cad to tho impositioa of aiminal peaaltrea
00austmz of a inx of up to$1,500.00 and/or of up to one year and civil pcmllia in the form of a Stop Work Order and:
find 0(3100.00 a day against me.
For del use 0
Permit Number
Maps Lot�
Signature of Liccnsee/Pcrnuttce Date -
a.,,..A aY� ; -.ice' •�
10. Do any signs exist on the property? YES NO Ott
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 cols to be filled in
by the Building nt
(Required I
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
&paged parking)
# of -Parking Spaces
# of Loading Docks
Fill:
-{volume -& location)
13 . Certification: I hereby certify that the information contained herein
is true and accurate to the best of my knowledge.
DATE: I-K_=� /17 � APPLICANT's SIGNATURE
NOTE: Issuanoe of a zoning perrnit does not relieve an a lio Ys bu en to oompty witty an
zoning requirements and obtain ail required permits f m the Boa of Health, Conservation
Commission, Department of Publio Works and other applicable permit granting authorities.
FILE #
UL-1111a
D
File No. (/
�E NQRTHA4A DING Mho,06015
ZONING PERMIT APPLICATION (§10 . 2)
PLEASE TYPE OR PRINT ALL INFORMATION
Address: �� �'o c�`r� T lephone.
2.
Address: Telephone:
3. Status of Applicant: Owner __Contract Purchaser Lessee
Other(explain): /
4. Job Location: A)
Parcel Id: Zoning Map# 4:�gg Parcel# District(s):(9�
(TO BE FILLED NN BY THE BUILDING DEPARTMENT)
5, Existing Use of Structure/Property
6. Description of Proposed Use/Work/ProjectlOccupation: (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)
File#BP-1999-1075
APPLICANT/CONTACT PERSON Z.J. KOSIOR
ADDRESS/PHONE 44 BRYAN AVE (413)527-2547
PROPERTY LOCATION 51 BATES ST
MAP 25A PARCEL 046 ZONE GI
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled ut
Fee Paid
Typeof Construction:_CONSTRUCT HANDICAP RAMP
New Construction
Non Structural interior renovations
Addition to Existing_
Accessory Structure
Building Plans Included:
Owner/Statement or License 054835
3 sets 9f Plans/Plot Plan
THE LOWING 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
Septic Approval Board of Health Well Water Potability Board of Health
Permit from Conservation ission
Signature of Building Of cial 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.
51 BATES ST BP-1999-1075
GIS#: COMMONWEALTH OF MASSACHUSETTS
CITY OF NORTHAMPTON
Lot:-001
Permit: Building
Category: alteration-addition BUILDING PERMIT
Permit# BP-1999-1075
Project# JS-1999-1800 y
Est.Cost: $7000.00
Fee: $40.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: Z. J. KOSIOR_ 054835
Lot Size(sq ft.): 46173.60 Owner: NORTHAMPTON MONTESSORI SOCIETY
Zoning:GI A licant. ,_. J. KOSIOR
AT: 51 BATE:,ST
Applicant Address: Phone: Insurance:
44 BRYAN AVE (413) 527-2547
EASTHAMPTON 01027 ISSUED ON.*611711999 0:00:00
TO PERFORM THE FOLLOWING WORK:CONSTRUCT HANDICAP RAMP
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 6/17/1999 0:00:00 $40.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Building Commissioner-Anthony Patillo