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25A-187 (4)
ry AJ rn -7 - Q� W W W I. z r - o t � O Q 3 N bd c O A n X- w ° to t n C co ° N ti Q � F N cF Q i[] I O cl- r O s � ° 0 o CF 3 o C+ �o p ro co �o O ri W D 4s. O `= r0 GN R° GI CJl C O 1 N N P g c-F O v O Q Ln Q X1 N Q �+ I C11 3 z l .. < D m L Z Z 3. QO 1 Zoning Miscellaneous Additions,Repairs,Alterations,etc. Tel.No Alterations NORTHAMPTON, MASS. dWIL ZO Op Additions % Repair APPLICATION FOR PERMIT TO ALTER Garage 1. Location AS.So N a ENT S yS rte ik s-. llyc $2 VW(VC Lot No. 2. Owner's name Address Builder's name BAKeof-( 4 Address Z4( KIND S1" Mass.Construction Supervisor's License No.—Q-3 0 73 L Expiration Date <, 4. Addition 5. Alteration X 6. New Porch ,t 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':11-2�-p Q The undersigned certifies that the above statcmcnt_s are we to the best of h: knowledge and belief. Signature of responsible app icant rtemarks �ieLGG/��/( /y/✓t.V U/'.LCL� (,�ffLL_S �N�/.�i� l ; BOARD OF BUILDING REGULATIONS 'f+lF License: CONSTRUCTION SUPERVISOR Number: CS 030739 t, Birthdate:D.Al20I1941 Expires:0,!/20/2001 Tr.no: 5640 Restricted To: 00 CECIL R JACOBS 241 KING ST '~�' :� NORTHAMPTON, MA 0'1060 Administrator l'(4ei Board of Buildinq Regulations One Ashburton Mace, Rm 1301 Boston, Ma 02108-1618 License: CONSTRUCTION SUPERVISOR LICENSE Birthdate: 09/20/1941 Number: CS 030739 Expires:09120/2001 Restricted To: 00 CECIL R JACOBS 241 KING ST NORTHAMPTON, MA 01060 Tr.no: 5640 Keep top for receipt and change of address notification. '' ,, t/PLC✓ tr'CJ1>+vTltf�lLC/t�'Cll�� Cl�t/%,Q'�;11X-G'#lfl:if�t{�J F� f.."I I'll•r,n Ifi/ I/ &""P",,ri rrLha1�7F41R7t3 { rr',"Mptw Ht, t.i�iw 04�ttAMP�o $ B �arrRC�nrrttr DEPARTMENT OF BVILDr NG INSPECTIONS C=oe-l 212 Main 'Street a Municipal Building r' Northampton, Mass. 01060 x= ? WOPLEMR'S COMPENSATION INSURANCE AFFIDAVIT / (liarasaJpermittee) 4' with a principal place of business/residence at: `74t I-IlAt6j (strt Vdty/sta&2/ p) do hereby certify, under the pains and penalties of petury, that: (✓� I am an employer providing the following workers compensation coverage for my employees working on this job: C'0 6,Z60` 1Y4 12 6(t, 1y(t N/}roc-.i _ ,/W X lv dc)-3(, Z .3 a=urance Company) (Polity Number) (Expiration Date) ( I am a sole proprietor, general contra or or homeowner (circle one) and have hired the contractors listed below who have the following worker's compensation policies: N6011440 LLC-1F1 C , / 5 /(--Q gSZd -�-q 9., -0U (Name of Contractor) (Insurance Comparry/Policy Number) (Expiration Date) (Name of Contractor) Q.nsurance Conipany/Policy Number) (Expiration Date) (Name of Contractor) (Insurance Compauy/Poticy Number) (Expiration Dale) (Name of Contractor) (Insurance Company/Policy Number) (Expiration Date) (attach additional shed ifnwe uy to ineltsda iafauutioa pa4ciaiag to all ooatrndors) O I am a sole proprietor and have no one working for me. O I am a home owner performing all the work myself. NOTE:please be aware tied while hoc=wo=who eaiplcy pc==w do Cana,caatructioaor rtPair work om a dwelling of mot metre than thtue uaitt is which the bomwwma resides or om the pmi6 sppuewma thatch an oot geaemay=Tidered to bo employers uada the worker's,00mpms 4an Act(GL 152,a 1(5)�application by a homeowner for a Game or permit tmy es ideaoe the legal status of an ea:ploysc under the Wockees Co�oa Acs. I understaad that a copy of this etatew nt easy ba forwarded to the Doput=d of Induslri a!Aocidea&Office of Imursnoe for the coverage veriftcxiioe and that failure to seatre cover p ut:eler section 25A of MOL 151 can lead to the ia*s Oa of trimmtl penalties comistiag of a&ne'of up to S1,300-00='Nor ka*5onmeai of up to one year Lod civil pem]ties is the form of a Stop Waric Older�a�a Em of S 100.00 a day tpiaA tae For&Putw�uao only Permit Number e=J �iy { Lot# Signature of Li ermittee BARRON & JACOBS 413 585 8T1S R�r;, .2S QO 10: 24a P. 01 �.a P•2 10. E)o any sioris aidst on the p(aper P YES x NO if YGS,desodbe size,type and location: aM F .) IJ PW 31(4 y- A-z:o A,re there any pmposad changes to or add-Mons of signs intended for the property?YES_ NO-X- tF YES,describe size,type arld locaton'. —, x ALL 1N.FORIiiA° X01f MVST BE COM.PUTEDor or PERMIT CAN' BE' DENIRD DUE TO LACK 0-F TRYORW10M- This e02mm to b* fit:-d in try the ftil&m Required Existing Proposed By Zoning Lot size Frontag© Sotbacks --- __� side l,'- R: L._R. rear Building height 131dg Square footage 0/60pen Space: (Lotarea m1nus bldg i 6gsvad parkjzg) # Mof vasa=king Spaces # of Loadihq Docks FiIL. {vO_Z-Ume'-& location) 13. Gertlfl cation: I hereby certify that the Information contained htireija is true and accurate to the best of my know.t�eddgo. DATE! a0l APP.LXCANT`S STGNRTU" felt NUTS: laauenoas of o zoning pormli dove not ralleve an sppileantw burctan to ooeslWr 0000 wil "Wnq requiramenim and obtain etit reimulred permits from the laearrd of moan. ConuwiwtaV*n Gommtwelon, Department of Publio Worker and othor applioeble permitt granting aulhortt iww. BARRON & JACOBS 413 38n 8715 P. 02 20 EPT or glj+ .57 ZOVIIVG PER= APPLICATION (910 . 2) PLEASE TYPE OR PRMTT ALL JWPORMATION 1. Name of Applicant: 466,kowl-- �--- Address:, )UST'A' A1, - 6 2. Owner of property, o& lek "dPAZ41J Address-, Telephone: 3. Status of Applicant: Owner —Contract Purchaser�Lessea 0her(explain) 4. job LoCaLi011-' Parcel Id: Zoning Map# Parcel# Distdct(s): (TO BE FILLED IN BY THE BUILDING DEPARTNIENI� 5. Existing Use ofStructure/Property M AW rAzTu,Q1�Y a- 6 Descon of Proposed Use or roject]Occlipation: (Use additional sheets if nece%sary), 6'5�9t'i'- M6 If P 4- P- 4��io -C -.d Lk A 7. Attached Plans; sketch Plan Site Plan __ErV1neered1Sutvey.ed Plates Answers to the following 2 quesfions may be obtained by chocking with the BuildIng Dept or Planning DepaM*ot Plies, S. HSS 2 Special PerrylitiVariance/Finding ever been iSgLad for/on the cite? NO E)ON*T KNOW y YES IF YES,date _-- IF YES,. Was the permit recorded at the Registry of Ceeft? No._.,_- boN'T KNOW L_X_ YEG_ IF YES: enter Book Page_ and/or Document#, 9, Does the site contain a brook,boy of water or wetlands? NO_ DON'T KNOW—.,Y YES-- IF YES,has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained Obtained date issued;_ File#BP-2000-0926 APPLICANT/CONTACT PERSON Barron&Jacobs ADDRESS/PHONE 241 King St (413)586-8998 PROPERTY LOCATION 82 INDUSTRIAL DR-ABSORBENT SYSTEMS MAP 25A PARCEL 187 ZONE GI THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out Fee Paid 54W 1 S® Tyueof Construction: ERECT NEW OFFICE WALLS INSIDE EXISTING SPACE New Construction Non Structural interior renovations Addition to Existing- Accessory Structure Building Plans Included: Owner/Statement or License 030739 3 sets of Plans/Plot Plan THE OLLOWING 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 Conservat commission __Permit from CB Architec e c Committee Signature of Building Official Da e 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. i 82 INDUSTRIAL DR-ABSORBENT SYSTEMS BP-2000-0926 CIS#: COMMONWEALTH OF MASSACHUSETTS + `Map:Block:25A- 187 CITY OF NORTHAMPTON Lot: -001 Permit: Buildinq Catep_ory:Non structural interior renovations BUILDING PERMIT Permit# BP-2000-0926 Project# JS-2000-1702 Est.Cost: $2500.00 Fee:$50.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use GroML Barron & Jacobs_ 030739 Lot Size(sq. ft.): 21 5622.00 Owner: FOOTE ROBERT T JR zoniniz: GI Applicant. Barron 8t Jacobs AT. 82 INDUSTRIAL DR - ABSORBENT SYSTEMS Applicant Address: Phone: Insurance: 241 King St (413) 586-8998 Workers Compensation NORTHAMPTONMA01060 ISSUED 0N:4125100 0:00:00 TO PERFORM THE FOLLOWING WORK.-ERECT NEW OFFICE WALLS INSIDE EXISTING SPACE 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 4/25/00 0:00:00 5441 $50.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Building Commissioner-Anthony Patillo