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Miscellaneous Additions,Repairs,Alterations,etc. I el.No. /' �� Alterations
NORTHAMPTON, MASS. q 7 19 Additions
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' APPLIa CATION FOR PERMIT TO ALTER Repair
Garage
1.1. Location ✓10 r7 /y1 l S 7 Lot No.
2. Owner's name A 1(r,, / V c y\ h e Address ��-WvrTh t2
3. Builder's name h 6oxa t 4 G�� Address f Y L 2e S; f a hcfr��rGh 2401
Mass.Construction Supervisor's License No. 0'7006 ( Expiration Date 3 G ^O
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 S ?r.p �-trd i s7Cl aS Yeti'' d. ►^^cnS lQ�►c7 ( Sh�h�fe
13. Siding house T^S7c4 I, V 'A J`vt`�_� Y S/-a// 1/r V1 dig S
14. Estimated cost:- 4 O
The undersigned certifies that the above statemcnts are we to the best of his.
knowledge and belief.
P�z .
Signature of responsible app,icant
Remarks
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DEPARTMENT OF BUILDDQC INSPECTIONS
212'Main Street ' Municipal•Building
Northampton, Mass. 01060
WORKER'S CONTENSATTON INSURANCE AFMi AVIT
h l �lQrlclS 1 7CCC-�• S
. (1;ccnscrJperm;U.cc) .
with a principal place of business/residence at:
S -7, C4 �Ljhum p1Q� �ti (phone#) Q /
(tt�v�ity/stat�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 CQmpaIIy) (Policy Number) OE.xpiratfon Dana)
( ) I am a sole roprietor eneral contractor or homeowner(circle one) and have hired
the con actors listed below who have the following worker's compensation policies:
(Name of Contractor) (Insurance Company/Policy Numbcr) (Expiration Date)
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(Name of Contractor) Qnsurance Company/policy Numbu) (Expiration Date)
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
( sdditioml,hxt if nooeaary to mc]%X&inrocmiti oo pczo,iaing to all ooatr c )
f I and a sole proprietor and have no one worldng forme.
( ) I am a home owner performing all the work myself.
f
NOTE:ple=se be aware tLd Whilo homoowom wbo employ pasooa to do�;c•oce mcziuctioa•or noa r work m a dwelling of
not moce thaw throe units in which the bomoa%,o r residn or ca the Vouaca appurteaant tha,de arc Dot Ce oc n. 000zidaed to be
conplaym under tbo wockcei Aompenratioa Act(G Li52.=1(5)).appUmsoo by a homce wnia for a Gocnx or perma may evidc ooc the
legal Axt', of as employer uodw the Worrcaea Compemalioa AzL
I uodcrstaod that a oopy of this shtemad may be focw ardad to the Departn-cat of lnd•ia d Aeeid*-&OPSoe of locum—ford-
.odvaage vrrification>Aadthat faihtreto socuut oovass k under soction 25A of UOL 132 c=k►d to the iMposidd of aimiasl penalties • -
oomuting of It 65e bCup to S I,A00.00 m&-impcno=meal of tip to one year and dQ pemWes in the fear of k Stop Wo•le Order and a
fine of Sloo.00 a air&PInA lac •.
Fordep=taamhluw ooy
t ley Permit Number
-��i--a )&PI Lot I
: a Signahac of LQpatsscelperm.ittac .
10. Do any signs Oast 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 N0_2�-
IF YES,describe size,type and location:
11. ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE DENIED DUE TO
LACK OF INFORMATION.
This colwa to be filled in
by the Rui.ldinq Department
Required
Existing Proposed By Zoning
Lot size
Frontage
Setbacks
- side L: R: L: R:
- rear
Building height
Bldg Square footage
%Open Space:
(Lotarea minus bldg
&paved parking)
i# of Parking Spaces
f of Loading Docks
Fill:
l vo1-ume--& location)
13 . Certification: I hereby certify that the information contained herein
is true and accurate to the best of my knowledge. n
DME: APPLICANT'S SIGNATURE
NOTE: Issuanoe of a zoning permit does not relieve an appiloanra burden to oompty wRlp_all
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 #
AUG 61999
IaEPT OF`SkiF FyS
File No.
atS� �.. .��,0rtT
ZONING PERMIT APPLICATION (§10 . 2)
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant: 7-60mu S '>'!:� Gins
Address: i(q L y C J z Telephone.Ly d ) S')-9 �a f
2. Owner of Property: cr ed V Z` n''t e
Address:[ 1Z- AlO r'7k1 1"upl(f Telephone: S S S Lr f-/
3. Status of Applicant: Owner _Contract Purchaser Lessee
Other(explain): ,/
4. Job Location: I �� AlUr Y6 �I ' tQn�� r 6f e''1 C e -/mil Q .
Parcel Id: Zoning Map#_ 1'214� Parcel# y2f District(s):
(TO BE BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/Property Ott
6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary):
�S1u11 Ines.- � QS SZrt)� o [d lkl 'vlL2
Tei s7a 1I UL'VXYI
V 11,i er.7 "ndpu. s
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 DON'T KNOtN' 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)
i A
122 NORTH MAPLE ST BP-2000-0150
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 17A-211 CITY OF NORTHAMPTON
Lot:-001
Permit: Buildina
Category:replacement windows/siding BUILDING PERMIT
Permit# BP-2000-0150
Project# JS-2000-0243
Est.Cost:$22190.00
Fee:$25.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: THOMAS BACIS 126116
Lot Size(sa.ft.): 19209.96 Owner: VENNE ALFRED J
Zoning:URB Applicant: THOMAS BACIS
AT: 122 NORTH MAPLE ST
Applicant Address: Phone: Insurance:
114 LINE ST (413) 529-0801
EASTHAMPTON 01027 ISSUED ON.'811111999 0:00:00
TO PERFORM THE FOLLOWING WORK.-INSTALL VINYL SIDING, REPLACEMENT WINDOWS &
STRIP & SHINGLE ROOF
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 8/11/1999 0:00:00 $25.00
212 Main Street,Phone(413)587-1240,Fax:(413)587-1272
Building Commissioner-Anthony Patillo