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17C-243 (2) 01 ie �onvntoowiec�l o�✓j�aaoacfiudef!a BOARD OF BUILDING REGULATKM ! License: CONSTRUCTION SUPERVISOR Number. CS 057009 { i - Birthdate: 11/06/1963 � Expires: 11!06/2000 Tr.no: 4272 ?'! ( Restricted To: 00 MICHAEL J MCKENNA 209 POMEROY MEADOW RD ( «. �s%�'►�7 SOUTHAMPTON, MA 01073 Administrator .,. •...,, •:..>...,,:v S Y .:..v:i� +,.t?S?..,.., �f"r.r tn:' ,ivt:•,..vtH t> ,.v>2..v*CKM2v 7i:•2'•Jih+t ,..rtr ,., > o � 'fl < �. . n M .�. sk C M O� t�- i% D m z M i O Cl Z M to O mV ::E L Zoning Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations Alterations NORTHAMPTON, MASS. Additions APPLICATION FOR PERMIT TO ALTER Repair_, Garage 1. Location 93 -V- IN-A(AlrtLL r (ore_v)f Q_ Lot No. 2. Owner's name 7�t-�{�ii�l P�A p�- �t2. Address SAM e/31, h'�hy;/e DD� 3. Builder's name Mac 6A-zl ,� W L-Ren� Address r J�� VhA4J-d U/ I-eD Mass.Construction Supervisor's License No. y�7 00 l Expiration Date Z2- 4 " Zb o e) 4. Addition 5. Alteration 6. New Porch 7. Is existing building to be demolished? � S. Repair after the fire 9. Garage No.of cars Size 0. Method of heating t� 1. Distance to lot lines 2. Type of roof 'Kylc,14e- 3. Siding house 4. Estimated cost--� / The undersigned certifies that the above statcmcnts are we to the best of his, her knowledge and belief. Signature of responsible app scant '.emarks � Ix). D ^ &QAll' �NVY, � O�CtUMp�O ., T Y! ♦ r � LL APR 7ISS8ChliStttS )Fr. of BU tPARTMENT OF BUILDING INSPECTIONS INSPECTOR Main Street • Municipal Building '>a North,,unpton,MA 01060 Applicant Information / Name �� I ��Ce49dIy —AA Location -13kz -, ---- —_-------city ------------------- E3 I am a homeowner performing all work myself f?J I am a sole proprietor and have no one working in any capacity ❑ I am an employer providing workers' compensation for my employees working on this job. Company Name— Address C i t Y------------------- Phone #---------- Insurance Co._------------_—Policy#------ --- Company Name Address City Phone# Insurance Co. Policy# Failure to secure coverage as required under Section 25 A of 1001-152 can lead to the imposition of criminal penalties of a fine up to$1500.00andlor one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of$100.00 a day againstme. I understand that a copy of this statement maybe forwarded to the Office of Investigations of the DIA for coverage verification. I do hereby certilyy under the pairs and penalties of perjury that the information provided above is true and correct. Signature —GstyfGl� "' Date Print Name 4 O t t Chgc J li7`14 2/wa Phone# Official Use Only Do notwrite in this area to be completed by city or town official City or Town Petmit/License# p BnIHMDepr ❑Liceming Boazd Check if immediate response is required ❑Selecbx='Dept. Contact Person Phone# Health Dept. 1 � 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 colas= to be Pilled in by the Building Depazt ,,t I (Required Existing Proposed By Zoning Lot size Frontage Setbacks - frnnt - side L: R: L: R: - rear Building height Bldg Square footage %Open Space: (Lot area minas .bldg &pax,ed parking\ # of Parking Spaces # f'of Loading Docks Fill: -(volume -& location) 13 . Certification: I hereby certify that the information contained herein (, is true and accurate to the best of my knowledge. DATE: y-Al� j APPLICANT's SIGNATURE NOTE: la usls mnoe of at zoning permit does not relieve an applioanYs rden to comply witFt all zoning requirements and obtain all required permits from the Board of Health, Conservation Commission, Department of Publio works and other applicable permit granting authorities. FILE # IL 3 APR 1 6 File No. ^,Fps 4F lNSPE-°' ;. KING PERMIT APPLICATION (�10 . 2� PLEASE TYPE OR PRINT ALL INFORMATION 1. Name of Applicant: Address:_ E-;�p9 �70' -q r_''��e�Telephone:__ M a' 2. Owner ofProperty: Df ,), Address: c_1 !"f- Si Y)© Telephone: 3. Status of Applicant: Owner Contract Purchaser Lessee Other(explain):_MrA_S0,A, 4. Job Location: T3 +_ ij Parcel Id: Zoning Map# / �� Parcel# District(s): ✓L�(/- (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): RUAN'L gbd PA—M-10-144-e- 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 PermiUVariance/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 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) 93 NORTH MAIN ST BP-1999-0854 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 17C-243 CITY OF NORTHAMPTON Lot: -001 Permit: Building Categ_oa: chimney rebuild BUILDING PERMIT Permit BP-1999-0854 Project# JS-1999-1502 Est.Cost: $7000.00 Fee: $20.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: MICHAEL MCKENNA 057009 Lot Size(sq. ft.): 10585.08 Owner: PARKER DAVID JR Zoning:URB Applicant: MICHAEL MCKENNA AT: 93 NORTH MAIN ST Applicant Address: Phone: Insurance: 209 POMEROY MEADOW RD (413) 527-1266 SOUTHAMPTON 01073 ISSUED ON.-411611999 0:00:00 TO PERFORM THE FOLLOWING WORK:RELINE,REBUILD,REPAIR CHIMNEY & FIREPLACE 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 4/16/1999 0:00:00 $20.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo � „,�,. 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