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25C-136 (4)
owl 3 o a CtD to Z .� to o a z o � Z C `O Y Zoning Miscellaneous Additions,Repairs,Alterations,etc. Tel.No: Lf Alterations NORTHAMPTON, MASS. ✓ L� 19 Additions • Repair L ' APPLICATION FOR PERMIT TO ALTER _ Garage 1. Location SY ` C �/ 71 c I- S ✓IJU/ ='al��)i f�'J�� Lot No. 2. Owners name ,�`O%� S!2 ) f' Address Sc�(F//Z21-0 1t 5 WW 3. Builder's name� ✓'� ,,� , �i yS�/V Address-5 AJC.-'r1'J"Y,►^.(j,�C�✓�� Mass.Construction Supervisor's License No. c)0 2 20 Expiration Date /f 6r-2— 2,000 4. Addition 5. Alteration 6. New Porch 7. Is existing building to be demolished? 8. Repair after the fire /V y 9. Garage No.of cars Size 10. Method of heating 11. Distance to lot lines 12. Type of roof 13. Siding house�� v�"d 14. Estimated cost:- 4 The undersigned certifies that the above statements are true to the best of his, knowle a and belief. Signature of responsible appiit:ant Remarks �Gv h C�k'x--ifAll �- r`e Ir` • �/ � ' �/`� NOV 81999 �lassscllusctts e DEP ENT OF BUIIDWG INSPECTIONS P,,i'! 212 Main Street a Municipal Building Northampton, Mass. 01060 WORr{EWS COMPENSATION INSURANCE AFFIDAVTT I, JV J/-ice✓ (licMSC&p=nittee) with a principal plaice of business/residence at: ±22/CO(pbone#) (strrei/city/=&2ip) do hereby certify, under0e 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 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/Potiicy Numbcr) (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) (E)piration Date) (aaadt additioaal zhoa ifnooemzry to ioohide kdoemarioa pertaining to all ooatrnetots) (C) 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 vihila bomcowoors who employ persons to do*+mbde=D-, suction or repair wodc cc a dwdit of not mom than dM waits is Wbkh the bomoovt=residn oc oa the grounds sppurteaaattba cto are not taxmily o =Wand to be empioym under the worker's compcwxa oa Act.(GL152ys1(5)),apptimdon by a homoowoct for a borate cc permd may evid—the 1e8d status of stn eePloyac vodwthe Workers Compaawdioa Act I undemsiad that a copy afa is sutema t may be focwardad to the Depuft a t ofladustrid Andre&Offs-of lnsasaaoe for the oovccaV VUiSC2110n sad that fa IUM to scarce oovewgo under section 25A of MGL 151 em kad to the imposition of a W-d pasal$a eoasist. of a!me ofup to 31.500.00 and/or kVrjsom�of tip to one ym and civil pemltia in the facm of s Stop Wodcoe dw and a ' fine of 5100 00 a day against toe For depiatmmhl��y Permit Number /�-�-�� M tat Cfi iccnsedPtxmittce ; Zd 10. Do any signs exist on the property? YES NO t� IF YES,describe size,type and location: Are there any proposed changes to or additions of signs intended for the property?YES NO V' IF YES,describe size,type and location: 11. ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE DENIED DUE To LACK OF INFORMATION. This cols= to be �ill«3 i by the Banding DeparCment Required Existing Proposed By Zoning Lot size Frontage Setbacks - frnnt - side L: R: L: R: - rear Building height Bldg Square footage %Open Space: (Lot area minus bldg &paved parking) # of -Parking spaces # of Loading Docks Fill: {vol.-UMe--& location) 13 . Certification: I hereby certify that the information contained herein is true and accurate to the best of my knowledge. DZTE: /J/FI J APPLICANT'S SIGNATURE -,,� - � NOTE: lesuanoe of a zoning permit does not relieve applioanYs burden to oom wit - zoning requirements and obtain all required PIY all q permits from the Board of Health, Conservation Commission, Department of Publio Works and other applicable permit granting authorities. FILE # ..... _.......................... ---° Rm �� ,x$ NOV U .. Fi 1 e No. 4 DEPT Of �'� ._ni � ,PERMIT APPLICATION (§10 . 2) i --PLEASE TYPE OR PRINT ALL INFORMATION 1. Name of Applicant: Address: G ` ✓�YU r/UC'n., ' 2. Owner of Property: Address: 5;�-- c//? '� 11 ./l/�j���4&-2//4elephone: �, y 3. Status of Applicant: Owner 'Contract Purchaser Lessee Other(explain): 4. Job Location: f7//?, /)J`� } P D2- /12c-,) I &102 Parcel Id: Zoning Map# GR�� Parcel#_ 13 �P District(s): (TO BE FILLED IN BY THE BUILDING DEPARTMENT) _M.... 5. Existing Use of Structure/Property_ , (/ "✓�/ 1 6. De nption of Proposed UseNVot-WRwject/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 Permit/Variance/Finding ever been issued for/on the site? NO L/ DON'T KNOlN' 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_L.ZDON'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-2000-0488 APPLICANT/CONTACT PERSON James Dawson ADDRESS/PHONE 56 Market Street (413)586-2108 PROPERTY LOCATION 56 ELIZABETH ST MAP 25C PARCEL 136 ZONE URB THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out Fee Paid 5 G� Typeof Construction: REPAIR PORCH&CEMENT STEPS New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included• Owner/Statement or License 002701 3 sets of Plans/Plot Plan THE F9j.LOWlNG ACTION HAS BEEN TAKEN ON THIS APPLICATION: pproved 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 Conservation Commission Signature of Building fficial 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. 56 ELIZABETH ST BP-2000-0488 GIS#: COMMONWEALTH OF MASSACHUSETTS MM:Block:25C- 136 CITY OF NORTHAMPTON Lot: -001 Permit: Buildinq Category:Non structural interior renovations BUILDING PERMIT Permit# BP-2000-0488 Project# JS-2000-0839 Est.Cost: $2000.00 Fee: $100.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: James Dawson 002701 Lot Size(sq. ft.): 4704.48 Owner: GRAIFF J014N G&GEORGE V GRAIF Zoning.URB Applicant. James Dawson AT. 56 ELIZABETH ST Applicant Address: Phone: Insurance: 56 Market Street (413) 586-2108 NORTHAMPTON 01060 ISSUED ON.1118199 0:00:00 TO PERFORM THE FOLLOWING WORK.-REPAIR PORCH & CEMENT STEPS 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 Sillnature: Fee Type: Receipt No: Date Paid: Check No: Amount: Building 11/8/99 0:00:00 $100.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo �5 0 s ...� Vn. f x 56�i.mb�HETH ST BP-2000-04$8 COMMONWEALTH OF MASSACHUSETTS i ok:25C- 136 CITY OF NORTHAMPTON Lo_ t:-Oq1 Permit: BU ldina CatgM:Non§M&UMI interior enovations BUILDING t Permit'# BP-2 4-©4B8 h:Qject# JS--2104-(1839 lst. ast:52000.00 .Pee:$100.00 ` PE"ISSION IS HEREBY GRANTED TO. Coast,G.Iaks: Con&actar: License: Use Group: James Dawson 002741 Lot SeC .ft): 474.4$ UWE „+G +iIFF4)H1V G&GE01GE V GRAIF zonin -UN -ImLicant., Jamel Clawson dT 6 ELIZABETH ST a ' ,,t f4dr Phone: Lnsym 56 Mir„„1fteet 413)586-2108 NORTHAMPTON 01460 ISSUED-0—N Q TO PERF©R THE FOLL007NG WORK.-REPAIR PORCH & CEMENT STEPS PQ-ST M&CARD SO U IS 31§MLA FROM=STREET Inspector of riumbing Inspector of Wiring D.P.W. Inspector of Buildings Underground: Service: Meter: Footings: Rough: Rough: House# Foundation: _ Final: Final: Rough Frame: Gas Fire Dep dawn Fireplace/Chimney: Rough: Insulation: Final: Final:6 k �t-l� THIS PERMIT MAY BE REVOKED BY THE CITY F NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. C rtifi t of S a re: Fee Tyne: Receipt No Date Pa 1: Check No: Amotitnt: Building 11/&"0:06:0 $100.00 212 Main Street,Phone(413)587-1,'.40,Fax:(413)587-1272 Building Commissioner-A nthony Patillo