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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations
NORTHAMPTON, MASS. 19 Additions
APPLICATION FOR PERMIT TO ALTER Repair
Garage
1. Location / 00 i, lej ;c5'10 yr n0c e- Lot No.
2. Owner's name 1-,,A,,ail Lo m 1 42.J Address /53 0 ,gr C;Iee la,.
3. Builder's name --D2u A S. Y6-v r,rJ Address X,4
i
Mass.Construction Supervisor's License No. b 3 7- Expiration Date tft i/04,0a
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
12. Type of roof
13. Siding house li/ t +,y S
14. Estimated cost:-
6 0 The undersigned certifies that the above statements are we to the best of his.
knowledge and belief. G&1
Signature of responsible app4icant
Remarks
U.
<. �tassacgttsrats i
DEPARTMENT OF BUILDING INSPECTIONS
212'Main Street ' Municipal-Building
Northampton, Mass. 01060
WORRER'S COMPENSATION INSURANCE AFMA.VIT
1; ( S . T C e-c—,rtj
with a principal place of business/residence at:
(phone#) 113--367-�I lPa
(t�t/city/stalr/ap)
do hereby certify, under the pains and penalties of perjury, that:
( ) L am an employer providing the following worker's compensation coverage for my
employees working on this job:
(Insurance Company) (Policy Number) (Expiration Date)
( ) L 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) (Insuranx Company/Policy Number) (Expiration Date)
(Name of Contractor) {Insurance Company/Policy Number) (Expiration Date)
(Name of Contactor) (Instuancc CompanyiPoUcy Number) (FA,-piration Date)
(Name of Contractor) (Insurance Company/Policy Number) (E)piration Date)
(.Mach additaomr shed irneocasry to iochscte iafoctnitaoa pcx;hiniag to.n ma}j d )
4'J L ani a sole proprietor and have no one working for me.
( ) L am a home owner performing all the work myself.
NOTE:plisse be awzm that wbDo bomcowocrs wbo ca:ploy p==to do rr•i�w.,:ry *o-or rryair work on►dwelling of
act mono thsa throe units is wbich the bomoawaar midcs or oo tbo pounds apoxkawA th=w arc oat ccoa&tly oo=Wcrtd to be
employers under tbo%—k-'s c0aVcnI4ea Act(GL152ts i(5)).applicntioo by•homcowair for a Gecox or peraraz tmy evidcaoe tho
Ievi stabn of as employer uadee tb o warkaes eompem.6m Aet.
I aodasts;d that a copy ofthia roalemcc t may be forwwrded to the Depatoocat of la&Luj 1 AcMac&Offioe of lftvw nos foe the
oovaage Vaifiedioa sad that fiihmc to coact cov=v trader sactka ZA of UOL 152 as lad to the impoattioa trfcrim'aA Pca'r>tia -
oomi>Qag of a!'metat tsp to S1 X00 00 mdior iialatvootoea(of tip to ooe ytw sad.aura peatatlia is the forts of a Stop W-k Ocdcr and a :'
Sao of 5100.00 a day against
�� /� � \ Facdcpatmaotaltwooly '
Permit Number ..
Mapl Lot S'
n
10. Do any signs ebst on the property? YES NO f,-'
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 COMPLE'T'ED, or PERMIT CAN BE DENIED DUE TO
LACK OF INFORMATION.
This cola to be filled in
by the Building, Department
Required
Existing Proposed By Zoning
Lot size
Frontage
Setbacks
- side L• R: L: R:
- rear
Building height
Bldg Square footage
%Open Space:
(Lot area minus bldg
&paved parking)
# of -Parking Spaces
f 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.
DA'L'E: APPLICANT's SIGNATURE
NOTE: Iss awn a of a zoning permit does not relieve an appiioanta burden to comply witty all
zoning requirements and obtain all required permits from the Board of Health. Conservation
Commission. Department of Publio Works and other applioable permit granting authorities.
FILE #
Fi 1 e No. *-a
ZONING PERMIT APPLICATION (§10 . 2)
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant: To-u--A'
Address: L"PV44 J)l/ Telephone: -11Q6'1,6
2. Owner of Property: 41 N O r4 Z-a N 6 T/A)
Address: / 90 Hs-i 4Ipe /2cl �vitw=K Telephone:
3. Status of Applicant: Owner Contract Purchaser Lessee
Other(explain):
v
4. Job Location: / B� B��d � , F�c�r z-,y:e-
m
Parcel Id: Zoning Map# Parcel# District(s):
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/Property /t.?,c5'd�,--e.)
6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary):
iv 54CA" nzt Cew�l �J /�c .�cL i , -r C) nJ 1Icr U s
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 l/ 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 V 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)
180 BRIDGE RD BP-2000-0099
GIs#: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 17A-045 CITY OF NORTHAMPTON
Lot:-001
Permit: Building
Category: CLAPBOARD SIDING BUILDING PERMIT
Permit# BP-2000-0099
Project# JS-2000-0151
Est.Cost: $6000.00
Fee:$50.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group DAVID BORON 114643
Lot Size(sq.ft.): 11238.48 Owner: LINDA LONGTIN
Zoning:URA Applicant: DAVID BORON
AT.• 180 BRIDGE RD
Applicant Address: Phone: Insurance:
14 SPRINKLE RD (413) 367-9966
LEVERETT 01054 ISSUED ON.'7/27/1999 mom
TO PERFORM THE FOLLOWING WORK.-INSTALL CLAPBOARD 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 7/2711999 0:00:00 $50.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Building Commissioner-Anthony Patillo