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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations
NORTHAMPTON, MASS. � ��'/� Z� 1qf Additions
APPLICATION FOR PERMIT TO ALTER a Repair
Garage
1. Location �� L�"���/Y�✓�w �//� Lot No.
2. Owner's name d /'� �,�/1//� Address2a
3. Builder's name/%ici-A,e-e- �/�i�.���'�— Address 41a Qwinle-->
Mass.Construction Supervisor's License No. O 0 �� `�� 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 /"V//'
13. Siding house
14. Estimated cost:-/�,y, 'o o
i
The undersigned certifies that the above statements are we to the best of his, her
knowledge and beli
ign urt of r—es-pgnsible app.icanl
Remarks STS i�� /STi�-G �%'ti.9cT .�/D lr/ooD i�v'6L<=j-
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t ` 41999 „� +tsartrflnsrtta
DEPARTMENT OF BUILDING INSPECTIONS
pF Sp. 41vSpECSt. -.
)F.R. !�1AU.". u 2 Main Street ' Municipal Building 'o
Northampton, Mass. 01060 '
WOR-KER'S COMPENSATION INSURANCE A t t A.VIT
Gicenset/permitiee)
with a principal place of businessIresidenc-e at-.
(strt/city/stafdap) P/3C,%
do hereby certify, under the pains and penalties of pefJury, that:
/am an employer providing the following worker's compensation coverage for my
employees working on this job:
(Ins=ce Company) (Policy Number) (Expim oa Daze)
( ) 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 Company/Policy Number) (Expire6on Date)
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(Name of Con=dor) (Insurance Compauy/Policy Number) (Expiration Date)
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(ntlarh additioond sh ifnoc,=ixry to include infocmiIIon pertaining to all coatradon)
( ) 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 awate that whiJo hemeoµacm who caxplay persona to do mxk •�„cr,moo or repair work on a dwelling of
not moco than throo tuxiu in.winch the honxown resides ac oa the grounds xppurtcaani ibrs(o arc not wally oo=dacd to be
employes tlndCr the vAxiccs"s compensation Act application by a homeowner for a li—cc permit may cvidcooc the
legal ont" of ao employee uodortho Workees compmsaiioa Act
I undasUnd d3id x copy of thu rwcmmt may be forwarded to tbo DcpartmcA of l as uid Aaidw&OffiOe of 1aA"vnoe for tb.
ooverage va ificsiioo and that CaU=to ecaun covango tusdcr soction 25A of MOL 152 tan lead to t1ri ilo*ss on of criminal Ixnaltica
oocna wg oC a fix of up to S 1,51]0.00 andlee imprison of tip to one ycar and civil pcmttin is the form of a Stop Work Order and: '
fine of 5100.00 a day against mc.
=Number G
sigaaturo c&. i crmit2cc
f .
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 Building Department
Required
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
&paced parking)
# of Parking Spaces
# of 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 knowledge.
DATE: APPLICANT'S SIGNATURE
NOTE: 1 a oe of at zoning permit does not relievq-An applioant' bYlyden to oomply With
all
zoning requirements and obtain all required permits Trom the Board of Health, Conservation
ion
commisaion, Department of Publio Works and other applioable permit granting authorities,
FILE #
n r� IC
-� File No
G.-OU
ZONING PERMIT APPLICATION (§10 . 2)
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant:
Address: 0C44<,rir—ea.ST Telephone:
2. Owner of Property: 4�/"-"
�C,ri�yGYL !fir /G/� /fr/yl�;�elephone: y/3 5 'l 53��
Address: � S
3. Status of Applicant: Owner _Contract Purchaser Lessee
G' Other(explain):
4. Job Location: �2
Parcel Id: Zoning Map# 3 Parcel#_ 7 District(s):
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5, Existing Use of Structure/Property
6. Description of Proposed UseNllorkRroject/Occupation: (Use additional sheets if necessary):
i
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 KNO:^:__Z,--' _ 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_�ZDON'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
20 GLENWOOD AVE BP-1999-0845
GIs#: COMMONWEALTH OF MASSACHUSETTS
Map:Block:25A- 137 CITY OF NORTHAMPTON
Lot: -001
Permit: Building
Category:roofing BUILDING PERMIT
Permit# BP-1999-0845
Project# JS-1999-1493
Est.Cost:$4500.00
Fee: $40.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor., License:
Use Group: Michael Shannon 007547
Lot Size(sa. ft.): 9844.56 Owner: ERVIN ERIN
Zoning:URB Applicant: Michael Shannon
AT 20 GLENWOOD AVE
Applicant Address: Phone: Insurance:
40 Garfield St (413) 772-0764 Workers Compensation
GREENFIELD 01301 ISSUED ON.'4/l4/I999 o:0 m
TO PERFORM THE FOLLOWING WORK:STRIP,PLY & 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 4/14/1999 0:00:00 $40.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Building Commissioner-Anthony Patillo