36-280 (2) f
r
ot
QS gig �
C' /6i� C' e- i'll T4'u-C7(qff P/'/L)-(' C",IliAj'
J WX
ids
axycol�e� �ics
0 3
fe
1 � O
N
ow.-_
,�Ct�t�J SC1�rr�J �crvr+� �r•�N
SAC.
_ I
fit
i Y
a
-
i < k
• + 1 '� �lasaac4asclb z•
9 �r.PT(IF
_DEP�BT NT OF BUILDLgG INSPECTIONS
212•Main Street a Municipal-Building '
Northampton, Mass. 01060
WORKER'S COMPENSATTON INSURANCE A.FMA.VTT
(licens�permittcc)
with a principal place of business/residence at:
I 5'S —(Phone#
(sti=t/city/staldap)
do hereby certify, under the pains and penalties of perjury, that:
( ) T am an employer providing the following worker's compensation coverage for my
employees working on this job:
(Insurance CQmpany) (Policy Number) (Expiration Dale)
( 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:
07/6 lel-
(Name of Contractor) (Insuranoc Compary/Policy Numbcr) / (F—� do atc)
(Name of Contractor) (Insuuancc Company/PoUcy Number) (Expiration Date)
(Name of Contractor) (Insurance Company/PoUcy Number) (Expiration Date)
(Name of Contractor) (Insurance Company/Policy-Number) (Expiration Date)
(anath additiomr:beet ifnooeacry w iachsde inrocmatioo pertia;a;ng to all Coat a )
I am a sole proprietor and have no one worlang for me.
( ) I am a home owner perforraing all the work myself.
NOTE please be awue that while homcowacn wbo cc3ploy pazoss to do e ;H _. a 0=3tm ioo•or repair work on a dweWag of
not meta thaw throe unit:in which the bomoowarr rtsida a oa tbo pv.w6 VVlr caajod tbacto arc Cot Ec oasny ooasidcrcd to ba
employes under tbo wockeel oompcasatioo Act(GL152,=1(5)x,AMUclDon by a homeowner for a Gecax oe permit may evidcaoe tbo
Iega1 etatva of as eaeployet uodartbs Wcckcea Comaeosation Act
I undaw.*:nd that a Copy of this ehtemcnt may be forwerd.d to the Dey.ctmaot of yodu,tria!Aoeidearif Office of lopm moe foe the
C°vaage.va'ifieatio°sad that failure to rocure oovesaso coder saxion 25A of MoL 131 cut lad to tad im�ition of aimiaxl•peaaltia - ,
ooait>aa g of a fine b1 t:p to SI�S00.00 tmd/or impevoomeat of tip to Coe year and civ�pcu4d in the form of a Stop W«lc Order nerd a
Sao o(S100.00 a day against me:
. gordcpoatmmtaltsseooy -
Permit Number
<t n uticc Mps Lot
Si t�f LioensedPu
1•���• ��.E-�.�� LOAN INSPECTION
THIS I'I.AT IS 1'011 II)BNTIFICATION PUIIIPOSI`.S ONLY AND UOI?S NU'.0 CONSTITUI.6 A 1'It01'liit'hY SUI1V1?Y
`f
JUL 2 J X999
111 C 11;1 A QEPjOF
v 1
mPy
P I�t� .5
t:- vIIr-
J
7r --_ - - - - _l 0
CaAI
/ 1vF
,(UE JEC V 'R) U)SC IA PAT -V)
1111115. f(I: r'IRIC cpM('�)NY
1'00k 3W)rS IAGE 25(n
Sc,!l3Jl r'i lb (111(iTy
E-PSUMP10T "10 Owvp-S
M)K X315 P)G>= 4-7
S&W 3532 P1-)6E-Z51
`"URCE' MIF MOR'I'CA(T CORP• I•'I R';I' MEM I CAN '1'I'I'L.r. INS. co.-oNl.v
Itt 111E—' _— --
AND 'II11i
11rlhrlv-1,4 m)-IoifI wIcdge,iI I for Ina Iitmarnlltrlit•f•IIIncItytrlmiilllaIIIIll ;t Ili Iw(Ill it'I)trmi"wri mIII:dihininsltcciinnIIlm;httwslhr
i Ilp(Im<•orcnt or hnlrtovcnu•nls a.z lncticcl of I I w InrIIIkvs dc�-,ctiltcd,lhal lire irnhnn•rmrnl or imIII(wemr)Is.1 If!crdi10y Witt lit tlot tit cs,rhal
thrtr'a ir tit rmrma rlit If(,osuponIlseitr ell I:e:.dr•xtitredbyIhc•Intlnovenrentorlmlxovcrnrnlsof anyadjoin ing III cntiscs,ant Ill al11 rcI carc
I,)rx�rmvoh-of wcotcl abetting the ltaci shocs•n hcuon,except as shocvn.
T�S�p`ctt or a��
1 futtln t t••l r.tt that lhr lxrmires shown on thi:ld:ut j-,nut Iocaled willdn a Flood I Lund Atea as shown oil DAVID 4c
7 c*
ih•iattntrotollLU.1),1'rdccallnsuanccAdminisuation ftalc. T.
NUNTLEY � ,
O mmonilyrltmiller 250167 0002A 1135401
A P R I I. '1, 19 111
IdrntiliralionDate - t.,_.�..__..
HUN J`1 11 LEY rnrrNrit Inrtr,s r. h rnTrtrcrn novi,r
AI.11lF.t1 111LINTL,EY, JR. & ASSOCIATES, INC.
Snr�t yrtr•R • Linuinccrs• Lrruclsc:cjtcArclrticcls
Lacn'r'roN 15 WOODS ROAD NORTIIAPIPTON
•
10 httlo,clrial Drive Past
Nottlt:IolIIIcm,AIA 01061 r'?t
r'tdr x(113)5fl( 71"11 flX013)511(,-9159 1011 NO. SCALE
> o
t�7 ty
m
3 -ti a
rA
Z m
o M r :0 p '7 cn Z
s > 3 u O
41LUm ::C-
Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. ` 94 Alterations ZW,
NORTHAMPTON, MASS. 19- 7 Additions
' APPLICATION FOR P MIT TO ALTER Repair
Garage
1. Location /� (1��,�15 �1.Wit✓ /}'ri Lot No.
err
2. Owner's name V Address,/
3. Builder's name Address
Mass.Construction Supervisor's License No. „L� /-_2 3 Expiration Date n
4. Addition ,(G 0S.
5. Alteration
6. New Porch P(OlJ / .y� ���?V- / C3G
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:- �J�
The undersigned certifies that the above statements are true to the best of his.
knowledge and belief.
Signature of responsible app icon! 1
Remarks/� ( /�2•w df/ / ��i�- .��h /
2
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 cols to be filled in
by the Building Department
Required
Existing Proposed By Zoning
Lot size
Frontage
Setback - front
� . ,�
- side L: R: L: R:
- rear
Building height
Bldg Square footage
%Open Space:
(Lot area minus bldg
&paced parking)
# of -Parking Spaces
f of Loading Docks
Fill:
(vol-ume--& location)
13 . Certification: I hereby certify that the informatio ontaine herein
is true and accurate to the best of my know edge.
DA'L'E: �� '7 APPLICANT's SIGNATURE 1L.� LucC
NOTE: 1 an e o a zoning permit does not relieve an pplioan burden to oomply witl)_au
zoning requir ments and obtain all required permits from the Board of Health, Conservation
Commission, Department of Publio Works and other applioable permit granting authorities.
FILE #
Klectric UL 2 3 1999
umbmg, &Gas ! Fil e No.121P�1n;1 �� -
ZONING PERMIT APPLI CATX ON (§10 . 2
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant. 4't 1004'Ao-jh-A-
Address: P® Id+ �s'o (.�I�� C r z/ 4} Telephone„ `7/ -22,,e' SA,�
2. Owner of Property:
Address: _ Telephone: !' "�
3. Status of Applicant: Owner Contract Purchaser_ Lessee
Other(explain):
4. Job Location:
Parcel Id: Zoning Map# 310 _ Parcel# District(s):
(FO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/Property d:2L11
6. Description of P,,oposed Use/W -k/Project/Occupat n: (Use additio[ial sheets if necessary'):
y(G
7. Attached Plans: Sketch Plan Site Plan _ Engineered/Surveyed Plans
Answers to the folloZPrmit/Variance/Finding ns may be obtained by checking with the Building Crept or Planning Department Files.
8. Has a Spe ever been issued for/on the site?
NO DON'T KNCA' 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 Do ent#
9. Does the site contain a brook, body of water or wetlands? NO li_ 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)
File#BP-2000-0075
APPLICANT/CONTACT PERSON Tom Dawson-Greene
ADDRESS/PHONE P O BOX 556 (413)296-4421
PROPERTY LOCATION 15 WOODS RD
MAP 36 PARCEL 280 ZONE SR
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Buildina Permit Fill out
Fee Paid
Typeof Construction: NCLO E EXISTING 12 X 16 DECK
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Buildiniz Plans Included:
Owner/Statement or License 013633
3 sets of Plans/Plot Plan -
THE LLO
WING ACTION HAS BEEN TAKEN ON THIS APPLICATION:
:Approved as presentedibased 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 Hea h Well Water Potability Board of Health
Permit from Conserva' n ommission
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,Department
of public works and other applicable permit granting authorities.
15 WOODS RD BP-2000-0075
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map:Block:36-280 CITY OF' NORTHAMPTON
Lot:-001
Permit: Building
Category: alteration-addition BUILDING PERMIT
Permit# BP-2000-0075
Project# JS-2000-0122
Est.Cost:$7500.00
Fee:$50.00 PERMISSION IS HEREB'V GRANTED TO:
Const. Class: Contractor: License:
Use Group Tom Dawson-Greene 013633
Lot Size(sa.ft.): 30274.20 Owner: WEIR ROBERT E&EMILY H
Zoning: SR Applicant: Tom Dawson-Greene
AT: 15 WOODS RD
Applicant Address: Phone: Insurance:
P O BOX 556 (413) 296-4421
CHESTERFIELD 01012 ISSUED ON.7/28/I999 o:oo:oo
TO PERFORM THE FOLLOWING WORK.-ENCLOSE EXISTING 12 X 16 DECK
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 7/28/1999 0:00:00 $50.00
212 Main Street,Phone(413)587-1240,Fax:(413)587-1272
Building Commissioner-Anthony Patillo
, �
f ,
;_
15'WOODS Rid BP-2000-0075
GA 0. COMMONWEALTH OF MASSACHUSETTS
.36-280 CITY OF NORTHAMPTON
Lat.Al
P alllidina
� -
BUILDING PEMIT
�.. BR2t1bt1-�75
FAAC90:000'00
fee:SN.OO PE"ISSIONIS HEREBY GRANTED TO.
QQA 0,3 Cuss -5/ Contractor; License;
use tam; !�'""'1 Tom Dawson-Greene Q136333_
IW1 jg ft fQ: 30274.2Q, f!►, ne7—WEIR ROBM E&EMILY'H
sR t r kant_,..Tom Damon-Greene
AT; 16 WOODS RD
' t Address; Phone; Insurance
P+ 0 (413)296-4421
CHESTERFIELD 01012 ISS ADQ ON;=84 L.00-,00
TO PERFORM 2WE FOLLOWING WORK.-ENCLOSE EXISTING 12 X 16 DECK
THIS CAN SD IT IS YLSAU MQN STREET
Inspector of Phum6lag Inspector orwIring D.P.W. Inspector of Buildings
Underground: Service: Meter:
Footings:
Rough: Rough: Home# Foundation:
Find: Finale
Rough Frame:
Gas Fire gDWar nt Fireplace/Chimney:
Rough: t, :, Insulation:
Final. S +me: Final Or -7-o t?-qty
i
THIS PERMT MAX BE REVOKED BY THE CITY NOR "W"VVIOLATIONOF
ANY OF ITS RULES AND REGULATIONS.
Fag e: Receipt No: Date Paid:, Check No: Acno�t:
Building 7/28/1999 0:00:00 $50.00
212 Main Street,Phone(413)587-1240,Fax.(413)587-1272
Building Commissioner-Anthony Patillo