38B-156 (5) .+ . Z
to :*7
c1
M
Z M
N r-. F e y
Z
w
w� {t.; .r
ce c z
o O
Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations
a NORTHAMPTON, MASS. 19 Additions
APPLICATION FOR PERMIT TO ALTER Repair
Garage
1. Location 14 Lot No.
2. Owner's nameQfiNiC2 �-PON6kgF, Ja,r,<& Address Ll MAJC sC,ti .4�ii:
3. Builder's name JT0 f2 '9L,iL-0 =j j Address,- 2G h1�Yf,{�,►v;1lL �t o��,vE}a� �ti, VA.-ci0i3
Mass.Construction Supervisor's License No. 0941G-4 Expiration Date
4. Addition
5. Alteration ti- ;t-y0orr f��3[c�rr,cvt
6. New Porch
7. Is existing building to be demolished? r-I o
8. Repair after the fire
9. Garage /UJ No.of cars Size
10. Method of heating c f--
11. Distance to lot lines t=r2c-v7 ?u r%2eorL- ie-� S i dE-S 20
12. Type of roof_ ��I 'Is -5 V.,A co,
13. Siding house \41(1,
14. Estimated cost:- '% 000-
The undersigned cent? es that the,4bove statements are we to the best of his,
knowledge and bet'
Signature of responsible app,icant
Remarks S 71acbtG-,O 0 21 0-
-�0 6zfLy of
a e s SEP 2 2 nx 4rnt}� >�rl
,�:sssc}IASCtts -
DEPARTMENT OF BUILDITjG INSPECTIONS
212 Main Street a Municipal Building '
Northampton, Mass.* 01060
WORKER'S COWENSATION INSURANCE A.FTIDAVIT
(Lcen Permlttre)
with a principal place of business/residence at:
(phone#) 0? 76 3
(st=ecity/staic/ap)
do hereby certify, under the pains and penalties of perjury, 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)
(k 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:
t1c,C-
(Name of Contractor) (Insurancc Company/Policy Numb,--,) (E)piration Date)
(Name of Contractor) (Insurance Companv/PolicY Number) (Expiration Date)
(Name of Contractor) (Insurance Company/policy NumntYS) (F -piration Date)
(Name of Contractor) (Insurance Company/Policy Numb-r) (Expiration Date)
(ankh idditioc.]xS ct ifnbo=.ry to iac-1tuic i focn Co,patnining to.11 oc2rzdon)
VNI
I am a sole proprietor and have no one working for me.
( ) I am a home owner performing all the work myself.
NOTE.plcnse be aware that Flo bomcowacn Abo cQ:Xptoy pctsons to do gird-,••e wosr oo'or rtpair work on a dV'-WMg of
not mote than throe unit is which the bomwwocr r=,3.l or oa the groins rpputcnant tbadn arc not goocratly oo=dcrcd to be
caVloym undee the wo kces compca dicn Act(GL152.xs 1(5)),application by a boa=--=for a liccwc or perma may-idcnce the
]cgal nasus of an employs under the Woricces Coo:V ox tioa Act-
I undcrataad that a copy of this chlcmml msy be for wurd.d W the Dopertrncvs of InrSuOisl A t oe of raau.,no.f«tb.
oova-i< vaMcatioa sad that failure to sow=cover o under seuioa 23A of MOL 132 caa 1.4 to the'imposition of crimin4 pmsltia
oomstina of a foe»Iup to S1,500.00 wdor mpr�oamcnt of tip to oa ycr and eivi pen-lies is the form of a Stop Work o der na
fm ors
.00 aaay si ai M,
For&yr�1»w only
Gr Permit Ntunbrr
1t..ap:l':' Lot#l'
-- si o1'L:iocasce/Pe;rmittce •_.. ,. -�,r�v��;;. .:�< �: _ _. . . ... - - .
n p SEP 2 2 IQQQ s
Date: I
l�
G
IIDRi
BUILDERS
i
`ZX iv T"'J"O, ti IN�z:v
ups" �------.---
4
JAEAgc2SPAN4, 120
James Ross Builders•236 Haydenuille Rd.•Whately,MA 01093•(413)247.7634•Email:jd @jdrbuilders.com
10. Do any signs exist on the property? YES NO it
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 Banding Department
Required
Existing Proposed By Zoning
Lot size
Frontage
Setbacks Z 2 0 ci
- side L: z o R: 2c L: 2u R: Z0 5�
- rear
Building height
Bldg Square footage
%Open Space:
(Lot area minus bldg
&paved parkingi
# of Parking spaces
f of Loading Docks
Fill:
{vol-ume--& location)
13 . Certification: I hereby certify that the information contained herein
is true and accurate to the best of my kno edge.
DA'Z'E: 91-2z �`i APPLICANT's SIGNATURE ,
NOTE: Issuanoe of a zoning permit does not relieve an 1 oanra burden to comply U!tJW alt
zoning requirements and obtain all required permits f the Board of Health, Conservation
Commission, Department of Publio Works and other ap lionble permit granting authorities.
FILE #
U so
Fi 1 e NO.
ZONING; PERMIT APPLICATION (§10 . 2
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant: wc-'as
Address:,'-13k- LL'l -TL-* AA4 Telephone:Li;t3
2. Owner of Property:Qt` N el`C pcm-w&- t;ix
Address: Lk rr\A0%%cri Ave` Telephone:%3 '-)1 2,S-
3. Status of Applicant: Owner Contract Purchaser Lessee
,X, Other(explain): `c "Cft Tc
4. Job Location: c4 mnn,%r t-k X'c
Parcel Id: Zoning Map# J 5 6 Parcel# t S 4 District(s):
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/Property `� ,-y
6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary):
erYVCU�dL of `tj'c' 'j'i x-�'c:'Ur ,t-:uw;: W ck tzC-V�kc- Z-�L-."rt.l A- S i N 6 i.t: A
7. Attached Plans: Sketch Plan k 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 KNOIAI K 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 K 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-2000-0328
APPLICANT/CONTACT PERSON JDR BUILDERS
ADDRESS/PHONE 236 HAYDENVILLE RD (413)665-7587
PROPERTY LOCATION 4 MADISON AVE
MAP 38B PARCEL 156 ZONE URB
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Buildina Permit Filled out
Fee Paid �1
jypeof Construction: REPLACE 2 WINDOWS WITH SINGLE PICTURE WINDOW
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/Statement or License 074104
3 setsof Plans/Plot Plan
THE LLOWING 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 Co ssion
2
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.
x
4 MADISON AVE BP-2000-0328
GIs#: COMMONWEALTH OF MASSACHUSETTS
MaQBlock:38B- 156 CITY OF NORTHAMPTON
Lot:-001
Permit: Building
Category Non structural interior renovations BUILDING PERMIT
Permit# BP-2000-0328
Project# JS-2000-0529
Est.Cost: $1000.00
Fee: $50.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: JDR BUILDERS 074104
Lot Size(sa. ft.): 8015.04 Owner: BURKE DANIEL&PENELOPE K SARB
Zoning_URB Applicant: JDR BUILDERS
AL. 4 MADISON AVE
Applicant Address: Phone: Insurance:
236 HAYDENVILLE RD (413) 665-7587
WHATELY 01093-0066 ISSUED ON.0912311999 0:00:00
TO PERFORM THE FOLLOWING WORK.-REPLACE 2 WINDOWS WITH SINGLE PICTURE WINDOW
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 09/23/1999 0:00:00 $50.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Building Commissioner-Anthony Patillo