11A-066 (7) Q'
59 FRONT ST BP-2000-0241
GIS#: COMMONWEALTH OF MASSACHUSETTS
Ma :B1ummow CITY OF NORTHAMPTON
Lot:-001
Permit: Building
Category:ROOFING/SIDING BUILDING PERMIT
Permit# BP-2000-0241
Project# JS-2000-0385
Est.Cost: $19300.00
Fee: $25.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: Robert Thibodo 104465
Lot Size(sq.ft.): 17598.24 Owner: DEGNIM JAMES&AMY
Zoning:URA Applicant: Robert Thibodo
AT: 59 FRONT ST
Applicant Address: Phone: Insurance:
P O Box 201 (413) 586-0391
NORTHAMPTON 01061 ISSUED ON:9/7/1999 0:00:00
TO PERFORM THE FOLLOWING WORK:SHINGLE ROOF OVER 1 LAYER & INSTALL VINYL
SIDING
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 9/7/1999 0:00:00 $25.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Building Commissioner-Anthony Patillo
Y k lt'h
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iii.
File No. 1
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DEPTaBut ERMIT APPLICATION (§10 . 2)
NORTHWF
LEASE TYPE OR PRINT ALL INFORMATION
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1. Name of Applicant:
' !1/ 3/
Address: ' el pho t 7��775� Ls." '
/
2. Owner of Property: .yLl tf7 -fVe ñiJ) 1
Address: /I ` ' -Pe del p one: (5 7 — ?F4
3. Status of Applicant: Owner ,,.Contract Purchaser Lessee
Other (explain):
4. Job Location: t - y Aeo Al 7Le q, e/as--
Parcel Id: Zoning Map# `/ Parcelt' (PG, District(s): ,../
(TO BE FILLED IN BY THE BUILDING DEPARTME T)
5. Existing Use of Structure/Property a '
^6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary): n
• ( d a ,�P A i f -• ' dMin�'�L' " IA i
Ar
. _di . N)-
AT
7. Attached Plans: S jrh PI• _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 DONT 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:
51 L . , (FORM CONTINUES ON OTHER SIDE) '
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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)
# pf -Parking Spaces
it-Of Loading Docks
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Fill:
(voi-ume--& location)
13 . Certification: I hereby certify that the information contained herein
G is true and accurate to the best of my knowledge.
DATE: 9 APPLICANT s SIGNATURE �, ...` :
NOTE: Issuance f a zoning permit does not relieve an applioants burden to oomply wltl ,,� t
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 #
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•
9 o4c11nMP .aFi..;),
0 l'1 QlQZIta11Ytttt1Q21 =*__.
9% .s% ii" 7 j lasaitcE(ntcctle =` =
`b!�- mac! --l -_
—� DPART?vfENT OP BUILDING INSPECTIONS '
KEPT OF 8UILD!MG INSPECTIONS�+'ORTFfr",44FTQ�!, ;1�A f?,(FC 212 Main Street ' Municipal Building '
— Northampton, Mass. 01060 r'� ,��OR}ER'S COMPENSATION INSURANCE AFFIDAVIT
•
i) / dip _-) cl,f)
(licenseeipermittee) ,
with a principal place of business)residen t:
X,4; �J e /JA% ' 7 - 77s—
( city/state/zip) e5 _Q 3%j
do hereby certify, under the p ' 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 Comp:my/Policy Number) (Expiration Date)
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(attach additional sheet if necessary to include infonnatior,pertaining to all cc-Mr-actors)
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 while bomeowncra who employ persons to do tnsintm+nrf,commtctioa or repair work on a dwelling or
not more than three units in which the homeowner resides or on the grounds appurtenant thereto are not generally 000sidered to be
employers under the worker's conxpcusatice Act(GL152,ss 1(5)),application by a homeowner for a license or permit may evidence the
legal ctanie of an employer under the Worker's Compensation Act.
I understand that a copy of this ctntrmr,:t may be forwarded to the Depertmcnt of Industrial Accidents'Offioo of Insurance for the
coverage verification and that failure to secure coverage under section 25A of MOL 152 can lead to the imposition of criminal penalties
aioaisti g of a fine of up to S 1,300.00 and/or imprisomne t of up to one year and civil penalties in the form of a Stop Work Order and a
fine of S100.00 a day against me
Si this day of 7 For drpartmmtal use only
Permit Number
Map# Lot ti
ignatyre of iccnsec/Pc ttce
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�/�/��� Zoning
7'
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. ' T 7 Alterations
S
%r. NORTHAMPTON, MASS. ( YCri• /� 19 Additions
'��� ` Repair
t r ` ;,-, APPLICATION FOR PERMI TO ALTER
. � Garage
1. Location c 9 e,% rS -) ASS , . Lot No.
2. Owner's name // `'-Address Ley Velje ss . O/io3. Builder's name lJ( ie�d � Address ny./:(4/f�.e1 ! ¢,z..� .k d i9
Mass.Construction Supervisor's License No. C.SC)/o S'-� f'� Expiration Date 4/ i 3 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 �,,/ c .
12. Type of roof /e-- '+ �y- L L./i-7 e `
13. Siding house .eiv�-v�o ?/� )e. `�` -C Ora ' na..4,- L4oçiJ
-1.-tief i/..,,,,-- .
14. Estimated cost- ��� f _.
C.
0 The undersigned certifies that the above sta mcnts are true to the best of his, her
�ji . d�-5 - a knowledge and belief.
Signature ofresponstb(e app�icon! S
/�� 'e / / o a
Remarks , A.� ��► .�. f/mot /// /_i. Jm AO L ._ �i. .0... _ ��//.:i-/
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