23D-003 23 NONOTUCK ST BP-2000-0183
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map:Block:23D-003 CITY OF NORTHAMPTON
Lot:-001
Permit: Building
Category:roofmc
BUILDING PERMIT
iCti
Permit# BP-2000-0183 1
Project# JS-2000-0292
Est.Cost: $4800.00 v.)
Fee:$25.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: CDT CONSTRUCTION 003666 ■
Lot Size(sq. ft.): 12806.64 Owner: LONGTIN ROBERT T
Zoning:URB Applicant:_ CDT CONSTRUCTION
AT: 23 NONOTUCK ST
Applicant Address: Phone: Insurance:
158 NORTH MAPLE ST (413) 585-8677
FLORENCE 01062 ISSUED ON:8/19/1999 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 $i$nature:
Fee Type: Receipt No: Date Paid: Check No: Amount:
Building 8/19/1999 0:00:00 $25.00
212 Main Street,Phone(413)587-1240,Fax:(413)587-1272
Building Commissioner-Anthony Patillo
i. . At 1 91999 File No... i 0/0
nz
,ZONING PERMIT APPLICATION (§10 . 2)
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant: Q t \ C_SZi`c\ (,
Address: t fQ Y ( C Q , Telephone: y)3 J �J —CC Li fl
2. Owner of Property: Gam`° ?' *1-(
Address: 01:5T\1406c Telephone:
3. Status of Applicant: Owner Contract Purchaser Lessee
Other(explain):
4. Job Location: -1M4v �
Parcel Id: Zoning Map# 3 Parcel# 3 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):
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 column to be filled in
by the Building Department
Required
Existing Proposed By Zoning
Lot size
- a ,
Frontage
Setbacks - front
- side L: R L: R:
- rear 1
Building height
Bldg Square footage 1 \
\11
%Open Space: ,4
(Lot area minus bldg
&paved parking)
# of -Parking Spaces
t of Loading Docks
Fill:
.(voi-ume--& location)
13 . Certification: I hereby certify that the i ormation contained herein
is true and accurate to the best of my k owl -dge. I'
DATE: APPLICANT'S SIGNATURE - V- -
NOTE: Issuanoe of a zoning permit does not relieve a VZIF ioa r.e ' \ oo with.all
zoning requirements and obtain all required permits from the =-rd of Health , --ervtttion
Commission, Department of Publio Works end other applioable • rmit granting authorities.
FILE #
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�"" AUG 7 9 �J� EPARTMFN T OP BUILDING INSPECTIONS =_`_i=
• } r r,- 212 Main Street ' Municipal Building '
Northampton, Mass. 01060 'V _''s�
WORKER'S COMPENSATION INSURANCE AFFIDAVIT
I-, X57 0c).
(liIermittee)
with a principal place of business/residence at:
D O e� ". \kite..,y‘�. ((bone#) . —Z�.
A
(street/city/stale/zip)
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 leso propnet�general contract r homeowner(circle one) and have hired
the contr. ors JA • w 0 v Ie allowing 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 Dale)
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(attach additional shect ifnaccirsary to include information pertaining to all coalractors)
aI 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'Milo homeowners who cruplay persona to en n e,corshvctioa'or repair work on a dwelling of
not morn than three units in which the bomoow ocr resida cc oa the grounds appurtenant thereto arc not generally considered to be
employers under the workers compensation Act(GL152,sa 1(5)),application by a homeowner for a license or permit may evidcaee the
legal statue of an employee under the Workers Compeocat.ion Act
I understand that a copy of this statement may be forwarded to the Department of Industrial Accident?Ofoo of Imuraooe forth.
coverage verification and that failure to secure coverage under section 25A of MOL 152 can lead to the imposition of criminal penalties •
consisting of a fine of up to S 1,500.00 andlor imprisonment of up to one ye and civil penalties in the form of a Stop Work Order and a ,.
fine of 5100.00*day against me.
For dcpartmertal use only .
\ Permit Number _
ma Lot#
Signature ofLicensec/P mail. s°
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Zoning
Miscellaneous Additions,Repairs,Alterations.etc. Tel.No. Alterations
44 NORTHAMPTON, MASS. — 1 I °\ 1 99 Additions
t 4 . ,APPLICATION FOR PERMIT TO ALTER Repair
Garage
1. Location o Lot No.
2. Owner's name \II ok , h ■. % Address \ U c - )
3. Builder's name C._—:e\c C___Eilr`S- — Address
Mass.Construction Supervisor's License No. C' C"). Li? D Expiration Date /a///, /
4. Addition pp----T 5. Alteration Q"C—°c �.,52-��.v-(--
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 ,t
14. Estimated cost- .2 WAc
The unde . ned certifies th t the above statements are true to the best of his,
knowle e an 1. f.
./
Signature res onsible appicant
Remarks