17C-260 (7) x.�
5 1 fir'"e
4
x
J I:I:1 tf!1�It IIlili�lllkL
I
j > o
a
z tm
4 G
r Z
- v O
et
Q t's7 O
° a tr1
I A
Zoning 1�
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No.4'/.3 L,? 6 'Y,>^y`{ Alterations
NORTHAMPTON, MASS. 19 Additions
a APPLICATION FOR PERMIT TO ALTER Repair
Garage
1. Location / Lot No.
2. Owner's name Addresm2 c'�
3. Builder's name Address
Mass.Construction Supervisor's License No. o!�Kn 9 2 9 Expire on Date 6 'ola �5
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
13. Siding house
14. Estimated co?3' p®z)s
Q The undersigned certifies that the above statements are we to the best of his, her
knowledge and belief.
A/0
Signal o sponsible apgicant
Remarks
�SEP 2 9 X998
t. �aaaxcllnsrtta
ca DEPA
DEPT OF I3UfL NG IP1S RTMENT OF BUILDrTjG INSPECTIONS
r
POHAh°�7 � �r� 21� Main Street ' Municipal Building
Northampton, Mass. 01060 '
WORKER'S COMPENSATION INSURANCE AFFMAVTT
I, 1
(li cer__see/permi tzee)
with a principal place of business/residence at:
�3 (phone#) t/f3 9� ys yy
( ty/stairJrip) 0161),
do hereby certify, under the pains and pe ties 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)
( ) 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) (Lasusancc Comparfy/Policy Number) (E>-Tiration Date)
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(Name of Contractor) Qmsurance Compauy/Policy Number) (Expiration Date)
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(&ttach addltioQll sh oct if z6o=sary to iwlu C m+(xu on pertaining to all oxit' tors)
09 I am a sole proprietor and have no one working for me.
( ) I am a home owner performing all the work myself.
NOTE:plisse be awatc that whilo l cmcowvcrs,A bo ecnplay persoos w do m R,t.-,,,,.�co¢s4lxsioa or mpair work on a dwelling of
not moan than throe units in which the homoowncr rcaidcs o<oa the grounds appurtensat thm- o arc not gwcrally oomidcrcd to be
employes under the wodlccr's oompa Salton Act(GL152_"1(5)),application by a homcow=for a liarise cc permit may evidence the
legil status of an employer under tho Worn?'Compxmaiic n Act.
I under'stxnd that a copy of thix statemcat may be forwarded to tha Dcpwtmcad of Induuuj l Acci Offioc of Imuranoo for the
oovez g verification and Hutt failure to sewn oova-?.V under section 25A of MGL 152 can lead to tho'imposition of criminal pc-16-
00nisting of a fine of up to S1,500.00 an&oc irvrisoamcuL of tip to one year and civil penalties in the form of a Stop Work Ordu and a
find of S 100.00 a day against me
For dot—oak'
Permit Number
— l7.- Map# Lot#
tgnattttx o t
Uatn
Brockway-Smith Company
Serving New England.Architects since 1891
Offices and Exhibit Areas
. jYT 146 DASCOMB ROAD 203 READ STREET 470 NO.MAIN STREET L'
W (Route 93-Exit I6) PORTLAND, ME 04103 E. LONGMEADOW, MA 01028
ANDOVER, MA 01810 (207)774-6201 (413) 525-3377 + ��
(617)475-7100
DENNIS M. PELLETIER Residence
R.F.D. #1 BOX 30
COMMERCIAL- RESIDENTIAL ARCHITECTURAL REPRESENTATIVE FRE(207) 865-433132
DATE JOB
Y .
)
SEP 2
}
DEPT OF 8UjLDi!
f
111 v°`-r
' l
{
.f
Y
F .l
I I
ra _
i .
,
yy
i
b'eY
t !
Availa11e to 4erve you WA O�udgeE �rice3, indow eLJetaiCir4� and
�pec �ritin�
COR/AN®
EMD DERMA-DOORS OU FONT
STEEL DOOR UNITS Vanity Top and Bowls
Bathtub Wall Kit - Kitchen Counter
v
10. Do any signs ebst 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 colu= to be filled in
by the BaiIA=q Department
Required I
Existing Proposed By Zoning
Lot size
Frontage
Setbacks
- side L• R: L:
- rear
Building height _ a"
Bldg Square footage
%Open Space:
(Lot area minus bldg
&paved parking
# 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 knowl dge.
D�II"E: oZ - _ APPLICANT's SIGNATU
NOTE: lmsuanoe cVt a zoning permit does not relieve an applio ti to oomply W!t" .011
zoning requirements and obtain all required permits from the Boa Health. Conservation
Commission, Department of Publio Works and other applioable permit granting authorities.
FILE #
t
l
i
�Lj_ SEP 2 9 IJ96
DEPT OF iG l Et;�, �'S File No�� ���
NORTHAMPTON, MA 01VO
ZONING PERMIT APPLICATION (§10 . 2)
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant:
Address: ; _ 7 done:
a
Y.
2. Owner of Property:&A fL7L'-
Address:of D -Wlephone: G 03-
632,?-2,
3. Status of Applicant: Owner Contract Purchaser Lessee
Other(explain):
4. Job Location:
t 1 •
Parcel Id: Zoning Map# � 7< Parcel# � . District(s):
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/Property
6. De ription of Proposed Use rk/Project/Occupati n: (Use additiona she is if nec ssa
el Ll 44 X/`
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 KNO 1 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)
File#BP-1999-0339
APPLICANT/CONTACT PERSON Tom Boyle
ADDRESS/PHONE 43 Damon Pond Road (413)296-4544
PROPERTY LOCATION 72 NORTH MAIN ST
MAP 17C PARCEL 260 ZONE URB
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out
Fee Paid 1i_ &4&
Type of Construction:
New Construction
Non Structural interior renovations
Addition to Existina
Accessory Structure -
Building Plans Included•
Owner/Occupant Statement or License#
3 sets of Plans/Plot Plan
T� ,FOLLOWING 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 Commission
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.
Reference No: BP-1999-0339
Department: ...................................
Building, Electrical & Mechanical Permits
.........................................................................................
Fee Type: Receipt No:
Building- Renovation REC-1999-000899
.........................................................................................
Paid By: *Paid ...F...u'l"I...0...n':...........
Tom Boyle Thu Oct 01 1998
...... ...... ....
. .... ......
Received By: . ......C h eck.No:...................
Linda Lapointe 4416
.........................................................................................
......................................
DEPARTMENT'S COPY Amount: $40.00
.................. ........
DEPARTMENT FILE COPY 72 NORTH MAIN ST
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:
BP-1999-0339 $40.00
GIS#: Mau Block: Lot: Address: Zoning: Use Group: Lot Size:
1858 17C 260 001 72 NORTH MAIN ST URB 12066.12
Contractor: License Type: Insurance:
Tom Boyle CSL
Address: License No.: Insurance No.:
43 Damon Pond Road 040979
Liin State: Zip Code: Phone:
Chesterfield MA 01012 (413) 296-4544
Pro iect No: Category of Work: Const. Class: Cost Estimate:
JS-1999-0709 alteration-addition $3,800.00
Description of Work:
REPLACE REAR PORCH& STAIRS
GeoTIVISS 1997 Des Lauriers&Associates,Inc. Signature:
NEW
� T
f , City of Northampton
,
�� R4
Building
Department
Office of the Building Inspector
Permit No: BP-1999-0339 Date issued 5-Oct-1998 Fee$40.00
Map 17C Block 260 Lot 001 Zone URB Section 116 [] Yes ❑ No
1[;U1J1LJD1NG
This certifies that Tom Boyle CSL040979
has permission to REPLACE REAR PORCI I& STAIRS Inspection on site-Foundations Over❑
at 72 NORTH MAIN ST
provided that the person accepting this pern>it shall in every respect Inspection of Plumbing-Rough Over❑
conform to the terms of the application on file in this office, and to the
provisions of the Statues and the Ordinance.;relating to the construction Inspection of Plumbing-Finish Over❑
Maintenance and Inspection of Buildings in the City of Northampton.
Any violation of any of the terms above noti;d is an immediate revocation Gas Inspection Over❑
of this permit, Expires six months from date of issuance,if not started.
Inspection of Wiring Service Over❑
Inspection of Wiring-Rough Over❑
Note: A certificate of occupancy will be issued by this office upon return
of this card by the Plumbing, Wiring and Building Inspectors. Inspection of Wiring-Finish Over❑
Building Inspection-Rough Over❑
*Plumbing and Electrical Inspections required before
Building Inspections Insulation Inspection Over ❑
Building Inspection - Finish OK / 4-��-q��Over ❑
K' Smoke Detectors (Fire Department)
This card^must be posjtd on site visible from public way
Certificate of Occupancy
Buildin : -ommissioner
A_