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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Y13- 3-27- 05'22 Alterations
NORTHAMPTON, MASS. '4142145-1' 19 `j i Additions
a APPLICATION FOR PERMIT TO ALTER Repair
Garage
1. .3 3 U ak r d ye Ro RD Lo%L e,vc e Lot No.
2. Owner's name G iN^ /uc Ke R- Address 33o &,oye +V
3. Builder's name Address__ 3 E.4-5 T•.�ral- 9AP l�/esTifna»aia.✓ /pia
Mass.Construction Supervisor's License No. 10,V7'1 S Expiration Date 7-1 3 vu
4. Addition
5. Alteration
6. New Porch
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 hest+ S ;V X. - FiaIt
13. Siding house 5cxn..itr£0 f1h4'Ke1; - C�PAP- Re cAld o> . ] Std -
14. Estimated cost:- �41000,06
The undersigned certifies that the above statements are we to the best of his, her
knowledge and belief.
Signature of responsible app icant
Remarks %LAEe- �H�Ng/e S - de ��i°yc 6,A .
� QCL aD,DRox 7 5� o't' S�I>i�`�9
o4� �z �.
s� Crit� of 'Wart aillpfun
Ali 2
OF 3t DEPARTMENT OF BUILDING INSPECTIONS
r s 212 Main Street ' Municipal Building
Northampton, Mass. 01060 V
WORKER'S COMPENSATION INSURANCE AFFIDAVU
j/
I /LLl R� l"n- i At-mi4Ki5
(licensec/permittee}
with a principal place of business/residence at:
3 SAS mp7an� RoflD iNe5T,4,gl1,l /,, 4,4 oio z7 (phoney#) y/3-5-Z7-05_2Z
(st rti city/statehip)
do hereby certify, under the pains and penalties of perjury, that:
O I am an employer providing the following worker's compensation coverage for my
employees working on this job.
(Insurance Company) (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:
�,f1lctlAt+- P �ALinAKlS /'IGitcMRn�S LNSwgh.✓C�° 6°!*�uP —�' / /
(Name of Contractor) (Insurance Comparry/Potiq Number) (Expiration Date)
(Name of Contractor) (Insurancc Compare-v/Policy Number) (Expiration Date)
(Name of Contractor) (InSIi Cn Comparly/Poky Number) (Expiration Date)
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(attach addihoail sbect ifne«isiry to include information pertaining to rev cc�ractors)
(XS 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 whilo homcowvm wbo employ periom w do mamtcnancS construction or repair work on a dwelling of
not mac than throe units in which the honww ocr r=dea or oo tbo groAz63 appurtenant thereto arc not generally 000sidcred to be
employers under the work&%oompc 4ca Act(GL I52,ss1(5)),application by a homeowner for a Uccwte cc permA may evidence the
legal etatua of an employer under the Workers Compensation AeL
I understand thzt a oopy of this ctsicmmt may be forwruded to the D) partmmt of Industrial Ancidm&Of SOO of Inwewon for the
coverage vaificaiioa and that fail=to strure oovcrage under section.25A of MOL 132 can lead to the imposition of criminal pcnaW-
000sistiag of afire of up to S 1,500.00 and/or imprison of tip to one yar And civil penattia in the form of a Stop Work.order and a
find of 5100.00 a day against tun
For d trso only
Permit Number
Kii Map# Lot t#
Surat ue of Li ermittee
10. Do any signs exist on the property? YES NO X
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 colama to be filled in
by the Building Department
Required I
Existing Proposed By Zoning
Lot size
------
Frontage --
Setbacks
- side L• R: L: R:
- rear
Building height 13 +T
Bldg Square footage
%Open Space:
Lot area minus bldg
&paved parking) _-
# of "Parking Spaces
f of Loading Docks
Fill:
{vo1-ume--& location)
13 . Certification: I hereby certify that the information contained herein
is true and accurate to the best of my knowledge.
D?II"E: S-2/-9`d APPLICANT's SIGNATURE
NOTE: Issuanoo of a zoning permit does not relieve an applioant's blUrden to oomply with''all
zoning requirements and obtain all required permits from the Board of Health, Conserwotion
Commission, Department of Publio Works and other mppiiomble permit granting authorities.
FILE if
.tp (J
�.�
AUG 2 1 r
DEF 8 � �#
File No. �
ZONING PERMIT APPLICATION (§10 . 2)
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant: l,(//G4/A-�- P f`f4 -mAK/s
Address: 3 6L-1wA-mn7y.1 AAD Telephone: 1-113 5-2 7 -0-5-2 Z
2. Owner of Property: 6 INA '7uc X 2 rc
Address: 33o 15,aidge 9Ao 7`1o/Le,-c< Telephone: „5"S6 73 70
3. Status of Applicant: Owner X Contract Purchaser Lessee
Other(explain):
4. Job Location: 930 FOA T>
Parcel Id: Zoning Map# ! ' Parcel# / .> District(s):
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/Property ges. //,I M e
6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheetsif necessary):
/zeg/g c e RoO'C''-q 7 TR 1OPiA,4 BIND Z /±42Lw/'
— --k®A I lZ aND P2 /17 SQ Of -t&A A:"/efl ce VAX SARK eS
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/Vadance/Finding ever been issued for/on the site?
NO V DON'T KNCV%' 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 X 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)
Department: Reference No: BP-1999-0221
...................................
Building, Electrical & Mechanical Permits
.........................................................................................
Fee Type: Receipt No:
Roofing REC-1999-000457
.........................................................................................
......................................
Paid By: Paid in Full On:
William Kalmakis Fri Aug 21,
... 1998
............... .........................................................................
..................................
Received By: Check No:
Linda Lapointe 2048
.........................................................................................
......................................
DEPARTMENT'S COPY Amount: $20.00
...........................
REIPARTMENT FILE COPY 330 BRIDGE RD
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: Tracking No.: Fee:
21 Aug, 1998 BP-1999-0221 $20.00
GIS 9: Map Block: Lot: Address: Zoning: Use Group: Lot Size:
1433 17A 123 001 330 BRIDGE RD URA 9713.88
Contractor: License Type: Insurance:
William Kalmakis HIC
Address: License No.: Insurance No.:
3 Easthampton Rd 104245
Qy-i State: Zip Code: Phone:
WESTHAMPTON MA 01027 (413) 527-0522
Pro 6ect No: Category of Work: Const. Class: Cost Estimate:
JS-1999-0253 roofing $4,000.00
Description of Work:
STRIP & SHINGLE ROOF,? SQ SHAKES
GeoTMS@ 1997 Des Lauriers&Associates,Inc. Signature: