23D-099 (4) 22 NUTTING AVE BP-2000-0587
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map:Block:23D-099 CITY OF NORTHAMPTON
Lot: -001
Permit: Building
Category:replacement windows/siding BUILDING PERMIT
Permit# BP-2000-0587
Project# JS-2000-1052
Est. Cost: $8000.00
Fee: $25.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: Ed Corbett Jr 1 16069
Lot Size(sq. ft.): 9191 .16 Owner: SAMSEL JOSEPH A&CECILIA A
Zoning.I TR_B ,4w,!i.kant: Ed CorbettJr
AT: 22 NUTTING AVE
Applicant Address: Phone: Insurance:
4 Reed Street (413) 586-5192
NORTHAMPTON 01060 ISSUED ON:12/14/99 0:00:00
TO PERFORM THE FOLLOWING WORK:INSTALL VINYL SIDING & REPLACEMENT
WINDOWS
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: C=': E Hill.::a:
Final: Smoke: Final: 6K /t ` t 3' e/G
THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTIIAM PTON UPON VIOLATION OF
ANY OF ITS RULES AND REGULATIONS. z '°
� '
Certificate of Occupancy signature:
Fee Type: Receipt No: Date Paid: Check No: Amount:
Building 12/14/99 0:00:00 $25.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Building Commissioner-Anthony Patillo
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Fi 1 e No./&/°U v 5 O ( DEPT OF BUILDING INSPECTIONS
NORTHAMPTON,MA 01060
ZONING PERMIT APPLICATION (§I0 . 2)
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant: ca? 4
Address:
177
,-4421 S}� Telephone: -58V-657/
2. Owner of Property: TO e✓ S s�—
Address: -2,2- 64 /sg A</— Telephone: S&&— 0386
l
3. Status of Applicant: Owner Contract Purchaser Lessee
Other(explain):
4. Job Location: $ .¢— }.
�3D Parcel# 9? /
Parcel Id: Zoning Map# District(s): 1,a,"/"'
(TO BE FILLED IN BY THE BUILDING DEPARTMEP41)
5. Existing Use of Structure/Property
6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary):
`� ✓y s1 Jy _4 /4ce/nc,r U,i'c4
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 PermitNariance/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)
.
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 col= to be filled in
by the Building Department
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 minus bldg
&paved parking)
# of Parking Spaces
# of Loading Docks
Fill:
{volume -& location)
13 . Certification: I hereby certify that the information contained herein
is truer� and accurate to the best of my knowledge.
NOTE: 1sLsu��� a zoning does'S not
permitn t relieve an applioanrs burden to comply with elf
zoning requirements and obtain ell required permits from the Board of Health, Conservation
Commission, Department of Public Works end other applioable permit granting authorities.
FILE #
..,:cttAM pi.
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/ ►woej t$ r�I of T ti amptoi
tt: i• Jiliassarbnsetfts
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DEPARTMENT OF BUILDING INSPECTIONS r‘a1 -
212 Main Street ' Municipal Building
Northampton, Mass. 01060 r'
WORKER'S COMPENSATION INSURANCE AFFIDAVIT
I, i (ibi'L'e --
clipermittee)
with a principal place of business/residence at:
`, � e� :Sf A) 7A✓ Mht. (phone/0 5-6Y" V 571
(sti ect/ci ty/staieizi p)
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 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) (Insurance Company/Policy Number) (Expiration Date)
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(attach additional sheet ifnecesary to include information pertaining to all contractors)
(VI 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 while homeownera who employ persons to do Era inrr"anre,construction or repair work on a dwelling of
not more than three units in which the homeowner resides or on the grounds appurtenant thereto are not generally ooaridcrcd to be
employers under the worlcee's r -rmarion Act(GL152.a 1(5)),application by a homeowner far a license or permit may evidence the
legal ststna of an employer under the Wodcor's Compensation Act
I understand that a copy of this statement may be forwarded to the Departmca2 of Industrial Aoddect&Office of Insurance for the
coverage verification sad that failure to segue coverage under section 25A of MOL 152 can lead to the imposition of criminal penalties
oomisting of a fine of up to S 1,500.00 and/or imprison of up to one year and civil penalties in the form of a Stop Work Order and a
fore of 5100.00 a day against toe.
For departmental use only
Permit Number
- /,14-99 Map# Lot#
Signature of Liccnseefpermittec Date
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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations
a%4 NORTHAMPTON, MASS.Z7ee 19 �� Additions
�' `%4' APPLICATION FOR PERMIT TO ALTER Repair
-z.era, Garage
1. Location 09& /UC177r✓9 /4VC Lot No.
2. Owner's name Jo cd .SAiis Se Z-- Address -.S a^ —
3. Builder's name�'C-/ C_U,C -11— Address `( �-e-e e/ S T
Mass.Construction Supervisor's License No. O(o"7`7 so Expiration Date t/-30--.?s 'C'
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 WA/ ( Si eF/ /,,/G/O:/f
14. Estimated cost-
The undersigned certifies that the above statements are true to the best of hip
knowledge and belief.
4
Signature of responsible applicant
Remarks