11A-057 (4) i
8 VILLONE DR BP-2000-001 1
GIS#: COMMONWEALTH OF MASSACHUSETTS
Ma :Bl CITY OF NORTHAMPTON
Lot: -001
Permit: Building
Category:renovation BUILDING PER1VIIT
Permit# BP-2000-0011
Project# JS-1999-1661
Est. Cost: $8000.00
Fee: $25.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: David Fortier 008926
Lot Size(sq.ft): 34194.60 Owner: GOLEC DONNA
Zoning:URA Applicant: David Fortier
AT: 8 VILLONE DR
Applicant Address: Phone: Insurance:
32 Laurel St (413) 586-8965
NORTHAMPTON 01060 ISSUED ON:7/6/1999 0:00:00
TO PERFORM THE FOLLOWING WORK:CONSTRUCT SET OF STAIRS FOR EACH UNIT
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 $knature:
Fee Type: Receipt No: Date Paid: Check No: Amount:
Building 7/6/1999 0:00:00 $25.00
212 Main Street,Phone(413)587-1240,Fax:(413)587-1272
Building Commissioner-Anthony Patillo
File#BP-2000-0011
APPLICANT/CONTACT PERSON David Fortier
ADDRESS/PHONE 32 Laurel St (413)586-8965
PROPERTY LOCATION 8 VILLONE DR
MAP 11A PARCEL 057 ZONE URA
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out
Fee Paid
Typeof Construction: CONSTRUCT SET OF STAIRS FOR EACH UNIT
New Construction
Non Structural interior renovations
Addition to Existing A
Accessory Structure
Building Plans Included:
Owner/Statement or License 008026
3 sets of Plans/Plot Plan
THE 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 Co ervation Commissi
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,Departtnent
of public works and other applicable permit granting authorities.
P _NIIWNn
al �9 j Fi1 e No. �JUL 61 - QO // '
� I
DEPT Of BLIP; -
ZOrTLTG PERMIT APPLICATION (§10 . 2)
NO.RTEI,, ` ,
— ----PLEASE
...__._.. .__PLEA SE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant: U t Q 4-6/L%ail_ I_
Address: -2? t%/-}o!Z L c ( , Telephone: �V(,� �5 6 c
nn(2 J4 U�
2. Owner of Property: �/a Al /. , OG/Z�
Address: �L d 2 a'JC/4S
Telephone: .."-Yes) - 3 `) (-7 l 5
3. Status of Applicant: Owner Contract Purchaser Lessee
Other(explain):
4. Job Location: g tht L l>/V LZ
Parcel Id: Zoning Map# Parcel# District(s):
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/Property L.'t( ,C/q' 1 /L.,y
6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary):
Scr of:- ly//2s Orr / 4cf Ui/ 7
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
&paved parking)
# of Parking Spaces
# rof Loading Docks
Fill:
-(volume -& location)
13 . Certification: I hereby certify that the information contained herein
G is true and accurate to the best of my know edge.
DATE: APPLICANT'S SIGNATURE G'!
NOTE: Issuenoe of a zoning permit does not relieve en eppiioents burden to comply with all
zoning requirements and obtain all required permits from the Board of Health, Conservtation
Commission, Department of Publio Works end other applioeble permit granting authorities.
FILE #
f ,i x f f
----"------71--- j--1\\ . rs.
. • r,-- 1@ L \\ - - -i7. ..t.e,.
e•t.W.livi i. • ---_-_------..--ni am
�}`_Ani ll .� PT f 8U!l.-. ,, INS 01060 N5 At assac4asctta =f MI I-
=
t�'V`i r SIORTVAINPTON rfly =v*�=
-rei % DEPARTMENT OF BUILDING INSPECTIONS • =_i f_
212.Main Street ' Municipal•Euilding
Northampton, Mass. 01060
WORKER'S COMPENSATION INSURANCE AFFIDAVIT
I, _______aaL2± - 02'i liqf2_
Oicenscdpermlttec)
with a principal place of business/residence at:
S,-. L u 2(k c- �)t (Phone#) . 6—,F (, 6
(strut/city/statrla p)
do hereby certify, under the pains and penalties of perjury, that: I
( ) I am an employer providing the following worker's compensation coverage for m,,
employees working on this job:
•
(Insurance Company) (Policy Number) (Expiration Date
( ) I am a sole proprietor, general contractor or homeowner(circle one) and have ' ed
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 D )
(ankh addition l,h,ct if n -,,.y to include inrocmabo°pertaining to di 000tadon)
(Ism a sole proprietor and have P P no one working for me.
( ) I am a home owner performing all the work myself
•
NOTE:please be aware that whiho 6omoowners wbo employ prior to do a.•ir•t,-,.,,n cructioo'or rzpaa work on a dwc-tim'g of
not meet than throe units in which the bomoowncr resides or oa tho grounds sppurtrawt thereto arc Dot Crnavlly oocnidacd to be
employers under tbo worker's 000spensatioa Act(GL15Z4s 1(5)),applitttioo by■bomcowDcr for a liccase a Pam2 may evidc000(hc
legal status of an employer wader the Woeko*a Coc pc aijoa Act
I understand that a copy of this atatemmt may be forwarded to t e Departmaot of Industrial Aocidoatar OtSoo of rnsunooe for for
coverage-verification and that failure to scare cover under section 25A of MQL 152 can lead to tbw•imposition of criminal penalties
oomisting of a-fine of up to S 1,500.00 Dadra impz iocmen of ' to one :a
Sao of Stoo.00 a day against sae.• y and civil pmariia iD the form of a Stop Work Order sbd a •
ifFordapsrtmrntal ts,o Daly46/ Pgrmit Number
•. •:•.:,�. Signahtrc of LiocuscclPcrruitLce Maps Lot
./
. , - I
> o
-r -a
v
N C n-
Z T t.,
(_.ram vo 0 `V C -v
}L1 �otrl
m
CD OZ mm
e. 'co C% , 5
3 cn O
o Z - e —9
a;4 rn
a 7 t? :v
_- 0 0 > M
-I
C �^ Zoning
Miscellaneous Additions,Repairs,Alterations,etc. lTel.No. d 6- �'j 6 D Alterations
%r NORTHAMPTON, MASS. 7 / 19 Additions
" FA' APPLICATION FOR PERMIT TO ALTER Repair
Garage
1. Location g VAL0AJa S 1 . Lot No
n
2. Owner's name V o N AN Al CEO L it Address 2 1
3. Builder's name 0(4 v i 0 ro 2 I t 1?2 Address "Z. cti ST
Mass.Construction Supervisor's License No. Expiration Date
4. Addition
5. Alteration
6. New Porch SrA l 2 (AA-'/ 6c F i/4 C tl CJ ti/7-
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 cost-
4 F0 ,& , au
The undersigned certifies that the above statements are true to the best of his,
know dge/and pelief.V ,
Signature of responsible appnicait
Ij
Remarks