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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. L.:: p 7 -,i 2�f Alterations
NORTHAMPTON, MASS. 12 19 Additions
APPLICa ATION FOR PERMIT TO ALTER Repair
Garage
1. Location `T `'O2 10{ 's': 1_ /L,1 l 1 z��J Lot No.
2. Owner's name an.T?ri Address '251ci j3Rt t sr— `rzi-/
3. Builder's name 1-x/1. ,r3y., Address -25,4(c r 2,+s
Mass.Construction Supervisor's License No. 'r QL-3 722- Expiration Date 1,1,01,?40L,
4. Addition
5. Alteration 4ete r-4..Az Jec 4 ZC41d
6. New Porch
7. Is existing building to be demolished? A)0
8. Repair after the fire /U 0
9. Garage A/0 No.of cars Size
10. Method of heating 1V01v-f-
1 l. Distance to lot lines
12. Type of roof AL-,Off-IM 777
13. Siding house
14. Estimated cost:- /��dry,
The undersi n certifies that t above to ents are we to the best of his, her
knowledge lief. /
✓�.,' � Signature of responsibie app,icant
Remarks Acv-rl�
a4 30 1&
1
X04
�tssarfjtrsrcia
`t; Z J -
m D ARTMENT OF BUILDING INSPECTIONS
2 2 Main Street e Municipal Building '•o
, `'-eta i t•iH,i4�_.l � �� .?
a.r . . Northampton, Mass. 01000
WORKER'S COiYLPENSA`)ION INSURANCE A + t AVTT
(li cell ser/permi tree}
with a principal place of businessJresidence at:
(c ry—; S'r. LP5��?-1 n?��! (�tg C�iOZ � (phone#)
(str�city/slalrJzip)
do hereby certify, under the pains and penalties of perjury, that:
O I am an employer providing the following workers compensation coverage for my
employees working on this job. .
(Insurance Company) (Policy Number) (Expiration Date)
am a sole proprietor, general contractor or homeowner (circle one) and have hired
the contractors listed below who have the following workers compensation policies:
1e(Name of of Contractor) (Insu an Cornoaa7/Poticf Nutnbcr) (Expiration Date)
(Name of Contractor) (insurance CompanyiPoilcc,�Numt-2r) (Expiration Date)
(Name of Contractor) (Insurance CompanyiPolicy Numbs) (Expjmtion Date)
(Name of Contractor) (Insurance Comparry/Policy Number) (Expiration Date)
(aft—h additional shoct ifnocc=u y to indudc ia� a pcztnining to au o z�
O I am a sole proprietor and have no one working for me.
( ) I am a home owner performing all the work myself.
NOTE:plcasc be aware that whilo homcoKVcr3 wbo coaplay per-.ow to do m.m ica-.a coasrru on or-Vair work oo a d%Sx1 iag of
not mcco than throo units in Winch the hoax owner rc udca or on the gmuaris appurtc=A thwcto arc not ecocraliy ooasidacd to he
employes under the vemicces compcasatien Act(GL152,a1(5)),,application try n homcovmcr for a 6ccase oc p-mit may evidence the
legal dt h, o£an omployoc undertho Worlcces com{*osatica Aei
I unda'A=d djA a copy of this VW--d MAY bo foci Hied to the Dcparancat of Indu 11 Acid=&Of Go of 1nnxU-MCO for the
oovcrago verification and that failure to seatrc cavcntgo tinder soctioa 25A of MOL 152 can lead to the imposition of criminal pcmltics
comisting of a fine of up to S 1,500.00 and/or imprisoszm�of tip to onc yar and civil pcaaitics in the form of a Stop Work Ordcr and a
fum oC5100.00 a day aga.inA—
'� For icpat uio oaty
Pcimit 2lumber
Lot.#
Sigrt,-t4u�ofLi ' crmiti,cc
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 comma 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
&p?x,ed parking)
# of -Parking Spaces
f of Loading Docks
Fill:
{vol-ume--& location)
13 . Certification: I hereby certify that the information contained erein
is true and accurate to the best of my knowledge.
DBE: APPLICANT's SIGNATURE .��
NOTE: Issunnoe of a zoning permit does not relieve an (loans burden to oom wlt"-*l1
zoning requirements and obtain all required permits from the Board of Health, Conservation
Commission, Department of Publio Works and other applioable permit granting authorities.
FILE #
�I IL a
R t?C 2 o
r
Fi 1 e NO.
ZONING PERMIT APPLICATION (§10 . 2)
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant: L~"Iu rJ caggb& -co
Address: k' lephone:
2. Owner of Property: ��aw e+
Address: 1 r,��Telephone:
3. Status of Applicant: Owner Contract Purchaser Lessee
Other(explain): C_GN VzazreV
4. Job Location:
Parcel Id: Zoning Map# c;P-Y C Parcel# g3 District(s): y-- (.0
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/Property
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 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 f 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 a/� 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-1999-0414
...................................
Building, Electrical & Mechanical Permits
.......... .............................................................................
Fee Type: Receipt No:
Roofing
... ..................................................................................... REC-1999-001112
Paid By: Pa.id..i.n.F-u.I.I..0.n:...........
Brian Greenwood
......................................................................................... Wed Oct 21,1998
• . ...... ............
Received By: Check. . .No:...................
I. ind.a..Lapointe 2352
...... . .........................................
......................................
DEPARTMENT'S COPY Amount: $20.00
...........................
I)F.PARTMENT FILE COPY 319 BRIDGE ST
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: Trackini!No.: Fee:
21 Oct, 1998 BP-1999-0414 $20.00
GIS 4: Mat) Block: Lot: Address: Zoning: Use Group: Lot Size:
4468 25C 083 001 319 BRIDGE ST URA 130680
Contractor: License Type: Insurance:
Brian Greenwood CSL
Address: License No.: Insurance No.:
366 East St 053724
Li!E State: Zip Code: Phone:
EASTHAMPTON MA 01027 (413) 527-3531
Project No: Category of Work: Const. Class: Cost Estimate:
JS-1999-0820 roofing $1,500.00
Description of Work:
STRIP & SHINGLE ROOF
GeoTMS@ 1997 Des Lauriers&Associates,Inc. Signature: