31A-118 (7) Department: Reference No: BP-1999-0384
Building, Electrical & Mechanical Permits
Fee Type: Receipt No:
Renovation REC-1999-000996
Paid By: Paid in Full On:
Western Mass Siding&Roofing Tue Oct 13,1998
Received By: Check No:
Linda Lapointe 2310
DEPARTMENTS COPY Amount: $20.00
DEPARTMENT FILE COPY 26 VERNON
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:
13 Oct, 1998 BP-1999-0384 $20.00
GIS it: Map Block: Lot: Address: Zoning: Use Group: Lot Size:
5727 31A 118 001 26 VERNON ST URB 10933.56
Contractor: License Type: Insurance:
Western Mass Siding& Roofing HIC
Address: License No.: Insurance No.:
63 East Street 105630
City: State: Zip Code: Phone:
EASTHAMPTON MA 01027 (413)586-5227
Project No: Category of Work: Const. Class: Cost Estimate:
JS-1999-0762 windows replaced $2,700.00
Description of Work:
INSTALL REPLACEMENT WINDOWS
GeoWS®1997 Des Laurlers&Associates,Inc. Signature:
I'.
\i'l': OCT 13 @%
�ON'INS� ' File Noei9 5,17
ND
t
Nor O THAMPTOlt k01 6,1
ZONING PERMIT APPLICATION (§I0 . 2)
PLEASE TYPE OR `PRINT ALL�^ /�INFORMATTION
1. Name of Applicant:,s� We>-IOr//h ///ass if
Address: C 3 C_l ,T S5T` 7 C s74,�f`ao, Telep one: R C- S.2 2
2. Owner of Property:y�/ ✓a..., v 5 t7 14 hra '-
Address: ;,C I�Pfine h 5t ,. ,.p.T,,.- Telephone: S's 9 . 7 $'/ 7-
3. Status of Applicant: OwnerContract Purchaser Lessee
Other(explain):p
C l
4. Job Location: a .4r reyynn Yr $7 /V6��
r7-4o pt t-+
Parcel Id: Zoning Maptq/JT- Parcel# eV District(s):tf'tt
(TO BE FILLED IN BY THE BU DING DEPARTMENT)
5. Existing Use of Structure/Property �6— y
6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary):
l S /lee if:"C v n..., o ,...-7" (.✓/r rillri ai
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/Variance/Finding ever been issued forton the site?
NO DON'T KNOWYES^„ it 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)
•
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:
IZ. ALL INFORMATION RUST BE COMPLETED, or PERMIT CAN BE DENIED DUE TO
LACK OF INFORMATION.
This cola to be filled in
by the Building Department
Required 1
Existing Proposed By Zoning
Lot size
Frontage
Setbacks -front
- side L: R: L: R:
- rear
Building height
Bldg Square footage
%Open Space:
(Lot area minus bldg
&payed parking)
f of Parking Spaces
# of Loading Docks
Fill:
(volume -& location)
13 . Certification: I hereby certify that the information contai ed herein
is true - d accurate to the best of my know
DATE: / / ?F APPLICANTS SIGNATURE
NOTE: last nos of a zoning permit does not relieve an a. •lioants bu an to comply with all
zoning - • uiretnents and obtain all required permits from the Board of Health. Conservation
Commission. Department of Public Works and other applicable permit granting authorities.
FILE f
P-.44,4: jit,e -"1 QL.itg of Northampton
lit
it-,40141.4a 'if.lie nr.T { 3 . a an.«<ya.<It, t —
-' x SQ£p Th(FNT OF BUILDING iNSP£CrtONS ��=
^ , Main Street ' Municipal Building
Northampton, Mass. 01060 le
WORKER'S COMPENSATIONAFFIDAVIT� INSURANCE AFFIDAVIT
1. _ 1//// nn 9 _Lccb ato .__—
(1iccastdpercutnic)
With a principal place of business/residence at: r'±
6 j(�,ps7---Sr �5rHv,. our 77 (pboneft) cca S22 7
straticity/stattinp)
do hereby certify, under the pains and penalties of pen-my, that.
O I am an employer providing the following worker's compensation coverage for my ,
employees wor'koag or: this job:
([nsivaoce Company) (Policy Number) (Expiration Dare)
( ) I am a sole proprietor, general conrractor or homeowner (circle one) and have hired
the contractors listed below who have the following workers compensation policies_
Sorra: of Con-ma-mil Bt.mance Cor ,/Poling Vu bar) (laaaanraraoa Date)
(Nam-,of Coctrac or) (Lx inn Corn , F r I - ?Euuit-zi) (i uararion Da)
(Name of Coonacto() (t[suranCompany/Policy Nnmler) (Expjrat'ion Dare)
(Name of Contractor) (I surance Company/Paficy Number) (Expiration Date)
( •earl eaEra vis l shcct;feecc.,,,y to 17%.1116Z Lriklm,:ioo pUtw':nx u.L.vcanon)
(Uj Z am a sole proprietor and have no one working for me
O I am a home owner performing all the work myself.
•
NOTE:pluwsc beware Wet c hilohcmrouncrl wt10 amloy pe todo nuninninnonninnintinini en rcav work M"anular&Qi-
oat
ron Inca ih_a t..-"Ca taut is t'1 th-hx+wrxtxr tm.:u«m tfn 9arinian awn& `�ttbccd an a(£nann'dk•=oatd w Le
cranky=tw9v do wakdr r tarniUm An(oL152nr(5)),apnhanca by a itexneouvrfc+licca=or pcnurt only VFW-A-the
legal straw of m asglay.c under inn Worinnit Compensation Aa1..
I undera..ud that atopy otill/sat®mt risky Sc fm wdtd to We Dgemw4 of]rd.sc:il,waek.M Oboe of Im.0 nm fir ib.
covangc settillation and that tail=to secure nava-Aga t¢dcr e<ctioo 25A ofMCJL 152 an tsd to tin imposition ofcawio=1 pmalua
cccsirir,of a.fine clap to StiXi2.00.ag«Agabaan A of tip w oac yea And civil aziia a the ata stop Work Oran,and.
line of 1109.00 ICILY a,iml sex. ..
S
FccdsWtnsadattw my
Permit Number
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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations
( / /3NORTHAMPTON, MASS.
:.,4,!"-
19 Q'.� Additions
APPLICATION FOR PERMIT TO ALTER Repair
Garage
1. Location ale VPrnpn 57 6 Lot No.yin2. Owner's name /a. n 9C I-/t. (7 ,rde �/ Address a c 14,2 en',n en3T 7,r/L{SrPLr v. n
tiotoo
3. Builder's name W C9 re r n ,O7nc S' j. Argo°f Address 6 ? C 5 T 5T <ccx s / a— /fe., /We
Mass.Construction Supervisor's License No. D 3 '-i CC 4 Expiration Date 1 //7/`! r
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
10. Method of heating
11. Distance to lot lines
12. Type of roof e
13. Siding house I� ac�o ac,- „-+ •e n"T` W r�r ala a, c
14. Estimated cost:- $'0. 7d 0- a, .
The undersigned certifies that the bo statements are true to the best of his, her
knowle and belief.
Pira I
Signature of responsible upp„cnnt
Remarks