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Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. 7_'64P o� Alterations
NORTHAMPTON, MASS. I Additions
APPLICATION FOR PERMIT TO ALTER Repair
a
qp p Garage
1. Location 1 l �''1� 1Q-`� Q� Lot No.
2. Owner's name r"S :]J�a?Q-k �66 Address 1���S'W4L b P-I 01E
3. Builder's name-em O �[(11�C.'�,lR.� Address
Mass.Construction Supervisor's License No. 5� Expiration Date
4. Addition ,cG
5. Alteration�k WPV- Dr�l 3►{Q�A't�0*
6. New Porch
7. Is existing building to be demolished? M�
8. Repair after the fire
9. Garage No.of cars Size
10. Method of heating RA
-
11. Distance to lot lines
12. Type of roof
13. Siding house
14. Estimated cost- 0f OCO
e undersigned certifies that the above statements are we to the best of his.
kn w dge be I'
Signature of responsible app icant
Remarks 0� Al.�'C�'R-�YCtO 'fn k16 r 'ox, 16.
!17, Z r
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� 1 DEPARTMENT OF PUBLIC SAFETY
j CONSTRUCTION SUPERVISOR LICENSE }
j Number: ° Expires: Birthdate; I'
CS 8551 11j22j2880 e1�22{1951
Restri9ted To:= Oe
l .a►74 C*u.10 AVID S, POMERANTZ
664 MAIN ST
AMBERIT, MA 01002
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t FEB 2 51999
PARTMENT OF BUILDING INSPECTIONS
"FPT OF R11H 5'7 F�f, 12 Main Street ' Municipal Building
E � �' Northampton, Mass. 01060
WORKER'S COMPENSATION 1NSURANCE + ' AVIT
(1 i censer/permi flee}
with a principal place of business/residence at:
ckq � (phone#) �i o �J ALl � pi
(street/ci /statr/ap)
do hereby certify, under the pains and penalties of perlwy, that:
( ) I am an employer providing the following worker's compensation coverage for my
employees working on this job:
(Insurance Company) (Policy Number) (Expiration Date)
(VK am a sole proprietor, eneral contract or homeowner (circle one) and have hired
the contractors listed below who have the following worker's compensation policies:
'e�r�a rr��u�rrA
(Name of Contractor)) (Insurance Company/Policy Number) Z�adoa Date)
Nmm (ff0(_ NAVV D A( CM% (A)G_ 43—V —IRI
(Name of Contractor) (Insurance Comp van /Policy Number) (Ea rustier Date)
(Name of Contractor) (Insurance Compauy/Policy Number) (Expiration Date)
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(attach additional shed ifneocntry to inchrde kdbrmirion pertaining to all ooat nctors)
O 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 aware that wbilo homeoKVcrs who employ pctsom to do�%mm,rice con3buction or rcpas work on a dwelling of
not more than throe units m which the homeowner raids or on the grounds apptutcmnt thereto are nor gwcrally ooasidered to be
compensation under the veorket's compation Act(GL152-s 1(5)),application by a homeowner for a license or permit may evidence the
legal stahra of an employer under the Wocicor's Compensation Act
1 understand that a copy of this rzatemmt maybe forwarded to the Dcpertmcut of Industrial Accidea&Offioe of Insurance for the
coverage vaifiauioa and that failure to secure oovcrago tinder section 25A of MOIL 152 can kid to the'impe ri ion of criminal ptnawcs
comuting of a fine up to S1,500-00 and/or im{ttuocracrit of tip to one yew and civil penalties in the form of a Stop Work Order and a
of S 100.00 a day against roc.
For deputa�sl use only
permit Number
qut#Late
i ofL,i ermit2ce i
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 col== to be filled in
by the Building Department
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
&paved parksng�
i
# of Tarking Spaces
# rof Loading Docks
Fill:
-(volume--& location)
13 . Certification: I hereby certify that the nformat ' co ained herein
�f i41.. no+ ai nd accurate to the best of my kn edge.
DATE: APPLICANT's SIGNATURE
NOTE: a zoning permit does not relieve an ap li ant's rd to Damply With 4211
zoning requirements and obtain all required permits f m th Boa of alth. conservation
iCommiselon. Department of Publio Works and other ap tonbi perm F'oInting authorities.
FILE #
r
I
x FEB 2 51999
.rPTnFi~'lW n� � i File No.
ZONING PERMIT APPLICATION (§10 . 2)
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant: L71 ZM�' , DPr- ��Mgg 144MKS14
Address: 'I�td �1 � 5'r �C Telephone: �o
2. Owner of Property: ` ��Z.I��tE _.
Address: L, 'pQ-iQlr::� Telephone: 5?k 3�ioo
3. Status of pA plicant: Owner Contract Purchaser✓ Lessee
Other(explain):
4. Job Location: T1
Parcel Id: Zoning Map#� Parcel# District(s):
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5, Existing Use of Structure/Property COMWOULIAL, —
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.
S. 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 D ument#
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-1999-0728
APPLICANT/CONTACT PERSON ELEMENTS OF STRUCTURE
ADDRESS/PHONE 664 MAIN ST (412)256-8053
PROPERTY LOCATION 99 INDUSTRIAL DR
MAP 25A PARCEL 188 ZONE GI
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT L�
Fee Paid
Buildina Permit Filled out
Fee Paid 41 2X
Typeof Construction: INTERIOR OFFICE RENOVATIONS-HAMPSHIRE RETIREMENT
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/Statement or License 054510
3 sets of Plans/Plot Plan
THE F PnOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION:
pproved as presentedibased 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 Co on
Signature of Building Official 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.
99 INDUSTRIAL DR BP-1999-0728
GIS#: COMMONWEALTH OF MASSACHUSETTS
MaL:Block: 25A- 188 CITY OF NORTHAMPTON
Lot:-001
Permit: Building
Category'Non structural interior renovations BUILDING PERMIT
Permit# BP-1999-0728
Project# JS-1999-0556
Est.Cost:$30000.00
Fee: $120.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: ELEMENTS OF STRUCTURE 054510
Lot Size(sq.ft.):: 172497.60 Owner: FINN WILLIAM L&STEPHEN C
Zoning:GI Applicant: ELEMENTS OF STRUCTURE
AT: 99 INDUSTRIAL DR
Applicant Address: Phone: Insurance:
664 MAIN ST (412) 256-8053
AMHERST 01002 ISSUED ON:212611999 0:00:00
TO PERFORM THE FOLLOWING WORK.-INTERIOR OFFICE RENOVATIONS - HAMPSHIRE
RETIREMENT
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 Shmature•
Fee Type: Receipt No: Date Paid: Check No: Amount:
Building 2/26/1999 0:00:00 $120.00
212 Main Street,Phone(413)587-1240,Fax:(413)587-1272
Building Commissioner-Anthony Patillo