17C-082 hear ,1`9 99 01 : 27p P. 1
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Miscellaneous Additions,Repairs.Alterations,etc. Tel.No.t7A 7 —Cf�o� Alterations _
NORTHAMPTON, MASS. '� cyC 90 19ji Additions
a Repair Il �y� 1V h
APPLICATION FOR PERMIT TO ALTER --�-
Garage _ _
1. Location L4� �� ► y 4 57r+-.7 Nor T4 G ri pfo h i M CL �/ Lot No. ,`
2. Owner's name l(d it K I ;h5 ---__— ddress-k 7 d!%�4 57 4/&,,71q.% elv3 ��tjq
3. Builder's name Dot/ IS (4rjerh7rA 04914S. A 40,*Address 205 S• Wp g-, S4-e 1 4yr-Yr-r,,11,44w
Mass.Construction Supervisor's License No. 6 6 d 3 S Expiration Date S/00
4. Addition
5. Alteration 51 r1P old 1'oof;,ti /-+Stio�7� 4 1-y=i /s' , . tC1 d C �►> ��Y -�-
6. New Porch (-( q ob Y C j-!y r!
7. Is existing building to be demolished? f7 d
8. Repair after the fire 06
9. Garage No.of cars
10. Method of heating
H. Distance to lot Iinees
12. Type of roof
13. Siding house
14. Estimated cost- ?5oo
The undersigned certifies that the above simcincnts are true to the hest of f
knowled e and belief.
Sivature of responsible app,icont
Remarks
Mar e4 99 08: 55a p. 4
APR 5
a�tt�MAp -
� � �iastetrfltt,:rtls —
DEPARTMENT OF BUILDFTJG INSPECrIONs
212 Main Street - Municipal Building '
Northampton, Mass. 01060 ��` V-
WORT ER'S COWENSATION INSURANCE AF t AVIT
Door, s eci h -�
(licen�perrniatc)
with a principal place of btlsWi ess/residence at:
) 0/770 1�1 � �In I!r>, t�a 1 _(Phone#) -5 0/St
� (:�S/city/siatrJziP)
do hereby certify, under the pains and penalties of perjury, that:
I am an employer providing the following worker's compensation coverage for my
employers working on this jab:
ej,-,,_f 1,4'h Ir bi a00�W 6 00 1/1//00
Unsure Compa.tzy) (Policy Number) (Expiration Date)
( ) 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) (Expimbon Date)
(Name of Contractor) (Inswance Compaay/Poticy Number) (Expiration Date)
(Name of Contractor) ! (Insurance Compaay/policy Number) (Expimtioo Dale)
(Name of Contractor) (Ins'u=ce.Compuxy/Policy Number) (Expiration Date)
(attach addidoair sh'r ifneo—..ry to il>h iafamxt oa pertniuing to aI)ootmadon)
O I am a sole proprietor and have no one working for me.
( } I am a home owner performing all the work myself.
NOTE'pleaxe be awvtc that wUo bcu=woco utio employ pasom to do ntx;..jcmu cc,eoosbisctioa,w repair work oo a dwelling of
tot more than thmo units is which tfae homoowncr rcukka or oa tbo gnxtodh xppattentn4ih7ctn arc not gtsxrvSty oonndacd to Ix
cwlcym under the vmrk=`s oomp=-4ou Aa(GLI52xt I(5)1 appti m6m by a homwwtis far a i Ccox or pa=d tnay cvidmcc the
legal cram"of an employer uudor tho Work&?"Coaopoaulioa Ad.
I uadaA=d du&x oopy c f tb,6 mt<mmi mxy bo foriwrded to tl O °fl"oo of I�for dt„
oovcsage vuiFc eioa and thet failuhr to enure oovazV under soWoa 2-SA of MOL 152 an lad to tbo impnsitioa of aimhW pwalbcs
oomLtIIUg of t lme bt up to S l 500.00•adlor un{ttiaonuxat of up W ooc yar and avt�pc"03 to the fottn of a Stop W Otk Otdsr and a
fim of$100.70 a day agtuast UY
For dapsttme.W tuo only
Pcrxnst Nttmtx;r
St afL'ia 154'' 'ermiticc
t:par It 99 01 : 27p p �
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 ealr. .., to ba filled iz3
by the Building Dwpartment
Required
Existing Proposed By Zoning
Lot size
Frontage
Setbacks -fm _ --
- side L: R: L: R:
- rear
Building height
Bldg Square footage
%Open Space:
(Lot area minus bldg
&paved pa kLnr j
_ 4
# pf Parking Spaces
of Loading Docks
Fill:
-(vol-tlme --&c .location)
I3 . Certification: I hereby certify that the information contained herein
�r is true and accurate to the best of my knowledge.
DATE: 3Z2-0191 C _ APPLICANT's SIGNATURE
NOTE: Issuanoe of as zoning permit does not relieve an ap to comply Wltlr gall
xoning requirements and obtain all required permits from the Board of Health. Corrscrvation
�Commission, nepar-tment of Publio Works and other applicable permit granting eautheritics.
FILE #
hpa r 1'9 99 '� ' I"7 _.. p . 2
APP 5 Po '
File No.
ZONING PERMIT APPLICATION (§10 . 2
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant: 0bu 4 G! h L
S / e�le:p1h�o ne:Address: � � 4� 7/376
2. Owner of Property: )( i 1 "
Address: H 7 �t; S) No f A /h_�I foh Telephone: Sc/ -I — 3 ct a 7
3. Status of Applicant: Owner _ Contract Purchaser Lessee
Other(explain): Co 't'f y re, C --fi'
Q. Job Location: 'I y?--- 5 F --
Parcel Id: Zoning Map#_ Parcel# District(s):
(f0 BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/Property
6. Descri ption of Proposed Use/Work/Project/Occupation: (Use add nal sheets if necessary):
1 ele Gjr 04 " C i'Yh h
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 I/ 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 ✓ 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)
r s
47 HIGH ST BP-1999-0827
GIs#: COMMONWEALTH OF MASSACHUSETTS
Map-Block: 17C-082 CITY OF NORTHAMPTON
Lot: -001
Permit: Building
Category:roofing BUILDING PERMIT
Permit# BP-1999-0827
Project# JS-1999-1463
Est.Cost:$8500.00
Fee: $20.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: DOUGLAS DEANE 060375
Lot Size(sa.ft.): 14592.60 Owner: NEJAME MARK A&JULIE G KLING
Zoning:URB Applicant: DOUGLAS DEANE
AT: 47 HIGH ST
Applicant Address: Phone: Insurance:
BEAR HILL FARM (413) 625-0152
SHELBURNE FALLS 01370 ISSUED ON:417/1999 o:o m
TO PERFORM THE FOLLOWING WORK.-STRIP & SHINGLE ROOF,DEMO (1) CHIMNEY & REPAIR
(1) CHIMNEY
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 4/7/1999 0:00:00 $20.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Building Commissioner-Anthony Patillo