24A-037 (6) 44 BLACKBERRY LANE BP-2000-01 25
GIS#: COMMONWEALTH OF MASSACHUSETTS
Ma.:B . • CITY OF NORTHAMPTON
Y6,
Lot: -00
Permit: Building
Category:roofing BUILDING PERMIT
Permit# BP-2000-01 25
Project# JS-2000-0188
Est.Cost: $5100.00
Fee: $25.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: MITCHELL HAWKINS 1 13957
Lot Size(sq.ft.): 5357.88 Owner: LAFOGG JUDY
Zoning:URB Applicant: MIT HE L HAWKIN
AT: 44 BLACKBERRY LANE
Applicant Address: Phone: Insurance:
P 0 BOX 107 (413) 774-6834
GREENFIELD 01 302 ISSUED ON:8/2/1999 0:00:00
TO PERFORM THE FOLLOWING WORK: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 8/2/1999 0:00:00 $25.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Building Commissioner-Anthony Patillo
r
File No.Wbt)I a-S
ZONING PERMIT APPLICATION (§10 . 2)
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant: 111tOU1 e)/lw*C
Address: P o t&c4 107 6FI f flM Telephone: 17' ( 3\1
2. Owner of Property: u1J�y 1( ,6(5
Address: t(11/143 I1%ii e,fiki Telephone:
3. Status of Applicant: ('" Owner Contract Purchaser Lessee
Other(explain):Q� ,o /��/
4. Job Location:
C��TJ l 1/c) 1/90 k i3
Parcel Id: Zoning Map# Parcel# District(s):
(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):
oe, t lIW uxbcQsr}Ape
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 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 column 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
&p.3ved parking)
# of -Parking Spaces
" 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 k owled e
DATE: V/. �`li(( i APPLICANT's SIGNATU
NOTE: Issuance of a zoning permit does not relieve an eppiioenrs urden o comply with all
zoning requirements and obtain all required permits from the Board of Health, Conservation
Commission, Department of Publio Works and other applloable permit granting authorities.
FILE #
f'
O ci o4. .
�
;,���, .�'x a (rzr of �dl �ttnran• 1• _* _
i<1V.0y•'All Atassac4rudts . . ` =," —
., DEPARTMENT OF BOILDDiG INSPECTIONS �� _j i
• . • . 212'Main Street ' Municipal.Building rt„ • ':`
Northampton, Mass. 01060 r`',. ,`
WORICER'S COMPENSAEON INSURANCE A.FIID.A.VTT
I, 11iwtS .
(h 1 )
with a principal place of business/residence at: •
• li
1 0 f o y 07 ( 1 fr 0 td o 2 (phone#) `i/3 7 7//4j
(strt et/city/staidzip)
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:
Thr\ to(r; iSi(Poo{$ • •
(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) (Fxpirntion Date)
(Name of Contractor) (Insurance Company/Policy Number) .(Expiration Date)
(Name of Contractor) (Insurance Company/Policy Number) (E�"piration Dale)
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(attach additional:hoc(ifnooenary to include information pertaining to ell coat:anon)
( ) I 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 whilo boaxowncrs wbo employ pasona to doe•;+-<�sn/-•.- coc ciioo'or repair work on a dwelling of
not morn thin throe units in which the homoowocr roicl s cc on the rrouodi:workout theccto arc not gcoaally comidcrod to be
cmployrrn under rho waiter's oompcosatioa Act(GL152,13 l(5)),applintioa br a bomcowo r rota Gorse a permi(may cvidcnoc the
legal rtasua of an employee under the Woe-toea Compemalioe Ant •
I uode staisd that a Dopy of this ehlamant may be forwarded to the Dop.rtaoeet oflnduatrid Aoeideohl OfSoo of Imaatsooe for the •
cove agc vtriSeation cad that failure to secure coverage under section 23A o(MOL 152 csa lad to the imposition of crienTail penalties • :i
coesiatiag eta foe eft"to S 1,500.00 aad/or imprisoaroad o(tip to ore yw and duct peaaltia in the form eta Stop Work Order•and a
tine 0(5100.00 aday against tne: • •.
-
t p,, Focdopatm� coy
+ltaaaoo
• ' 111114 .":k.
Permit Number -
:� .. Map:f Lot
'—�� s- of LipcsQ Tercet ttce MCP .
-a
xi v
v
r)
tys so
v -o
o- '°
cri
m
3 c Ov,
E. r- -, z m
"6 � (7). z
> > > cn O
Z
s ..1 m
0 S.
_a M
1
Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterati ns
0 NORTHAMPTON, MASS. 1 9 Additio s
' � APPLICATION FOR PERMIT TO ALTER Repair
.� )) Garage
1. Location q�� �f/ "O1( c� L 1 .,Q Lot No.
2. Owner's name\AvQ y (ft6, 36 Address
3. Builder's name it/1-1tL1 1(4 S Edb nr14 Address 0 tm y C87 G? 1 I IL A)
Mass.Construction Supervisor's License No. thilteJ IMP ((,tiQi,�7 Expiration Date 7/60t91
4. Addition
5. Alteration)ttrA sfr Pnkc Jl31e
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 t 1la CvdC(7S 0 AP , N a ccA6tektu 4hi
13. Siding house
14. Estimated cost;, l.
-f 310 Q
The undersigned certifies that the above statements are true to the best of his.
kn ledge and belie
9 ./dibbufsi
Signature of responsible appican!
Remarks