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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations
NORTHAMPTON, MASS. 19 Additions
4
APPLICa ATION FOR PERMIT TO ALTER Repair
Garage
1. Location / 6,eA71p& -r �`Ld�e VGE Lot No.
2. Owners name J&A&IR- C'l�/llii-Al Address
3. Builder's name /WCff#fZ_ ffE:_6tA7- Address
Mass.Construction Supervisor's License No. Y 3 Expiration Date :
4. Addition
X 5. Alteration 9b)TOVE I' 962021t C#1 41/1eY 5ffiW6L-4�_
6. New Porch&21A
7. Is existing building to be demolished?�i.ZA
8. Repair after the fire &Ie!q
9. Garage No.of cars Size
10. Method of heating .a
11. Distance to lot lines 1111,14
12. Type of roof
13. Siding house
14. Estimated cost:- y3 rfs
. Dv
The undersigned certifies that the above statements are we to the best of his,
knowledge and belief.
Signature of responsible app,tcont
i
` , Remarks CffllftL—/ " ACOF &OEPI-f-e—W&_A..r
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CEzf� of Wart4amptou M
a 6 �
OCT
6lassaci<ttsrths .
DEPARTMENT OF BUILDWG INSPECTIONS
'EFT OF RLK0!t t
212 Main Street a Municipal Building '
_ .... Northampton, Mass. 01060
WORKEWS COMPENSATION INSURANCE AFFIDAVIT
(licenscc/permitiee}
with a principal place of business/residence at:
/06 6` (c'//1/14//yCS 3c> � c�I6&hone#)
(strx t city ap)
do hereby certify, under the pains and penalties of penury, that:
( ) I am an employer providing the following worker's compensation coverage for my
employees worlang on this job:
(Insurance Company) (Policy Number) (Expiration Date)
( I am so liste general contractor or homeowner(circle one) and have hired
the contr ors d below who have the following worker's compensation policies:
s
e 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 Daze)
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(attach additioml sheet if neoenary to include informaIIon pertaining to all oowrsdon)
l 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 awam that while homeowners who employ persons to do mainteumce,canshmaioaor repair work on a dwelling of
not mote than throe units in which the homeowner resides or on the grounds appurtenant therdo are not&crAmlty w=dered to be
employers user the workeft oompeasatim Ad(GL152.ss 1(5))�application by a homcownw for a license or peYmd may evidence the
legal statue of an employer under the Warlrels Compensation Ad.
I understand that a copy oftbis statemeat may be forwarded to the Depmumcat of 2d ustrisl Accidaots'Oboe of Insurance for the
oovemp verification and that failum to secure covemp under zmdoa 25A of MGL 152 can tad to the imposition of Cninmat pemlties
cocsiating of a fine of up to$1,500.00 mdfor imprisonment of up to one year and civil pcoa tics in the form of a Stop Wahl Order and a
fins of$100.00 a day against t»a
For dgmftm al nse�y
t Ntunber
Lot#
�'Signature of Licensee/Pt:rmittce
10. Do any signs ebst 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 colamm to be filled in
by the Bedding Departmeat
Required i
Existing Proposed By Zoning
Lot size
Frontage
Setbacks
- side L: R: L: R:
- rear
Building height
Bldg Square footage
%Open Space:
(Lotarea minus bldg
&paved parking)
# of -Parking Spaces
t 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.
DATE: fl �' APPLICANT's SIGNATURE
NOTE: Issunnoe of a zoning permit does not relieve an applioanva burden to oornpty Wlt"-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 #
File No.
P `4q'
BERT OF BUI�D'idG'
ZONING PERMIT APPLICATION (§10 . 2)
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant: 1)1(Cttf1•EL f EBeZT l 69 J5-/7WG7DAj
Address: /bb 6047W ST. b)/4 ift5aU4&- Telephone:'-
2. Owner of Property: .O/JA/# COWL]
Address: J / 67 Qzmq s7: 4X-4.14115Aa96- Telephone: a6,f
i"�Db-7/5=074/ k 007.2 4)0--k-
3. Status of Applicant: _Owner Contract Purchaser Lessee
Other(explain):
4. Job Location: 14#76 CT. t�l 2t:ojLe M'+ '
Parcel Id: Zoning Map# /?�Parcel# 01763 District(s):
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/Property ;
6. Description of Proposed Use/Work/Project/Occupation: (Us additional sheets if necessary):
S7�i iP � R��►4e� ��o�
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/Vadance/Finding ever been issued for/on the site?
NO DON'T KNOWS 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)
r h
I BRATTON CT BP-2000-0443
GIS#: COMMONWEALTH OF MASSACHUSETTS
Man.Block: 17C-203 CITY OF NORTHAMPTON
Lot:-001
Permit: Buildina
Category:roofing BUILDING PERMIT
Permit# BP-2000-0443
Project# JS-2000-0767
Est.Cost: $4345.00
Fee: $25.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: MICHAEL HEBERT 015843
Lot Size(sq. ft.): 1960.20 Owner: COWAN DONNA
Zoning:GB Applicant: MICHAEL HEBERT
AT. 1 BRATTON CT
Applicant Address: Phone: Insurance:
106 SOUTH ST (413) 585-9229
WILLIAMSBURG 01096 ISSUED ON.io/26/1999 o:oo:oo
TO PERFORM THE FOLLOWING WORK.-REPLACE CHIMNEY, 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 Signature:
Fee Type: Receipt No: Date Paid: Check No: Amount:
Building 10/26/1999 0:00:00 $25.00
212 Main Street,Phone(413)587-1240,Fax:(413)587-1272
Building Commissioner-Anthony Patillo
j
;�..
3
BRATTON CT BP-2000-0443
I COA MONWEALTH OF MASSACHUSETTS
Map:$locle: 17C-203 CITY OF N{3R�' OBI
Lot: 1
Permit: Building
Category:roofing °
BUH ING PE-..,. T
Permit# BP-290Q:0443
Project# ,1S- Qaa-Qs7
Est.Cost:54345.00
Fee:$25.00 PERMISSION IS HEREBY GRANTED TO:
Coast.Class: Contractor: License:
LTse Croum: MICHAEL HEBERT Q15843
Lot Sizefgg ft,) 196x.20 0 Ater. CQWAN DDNNA
AT* 1 B AUDN CT
ntA Ph2 : Lnstrance
106 SQM�ST (413) 585-9229
WIL.LIAMSBURG. 01096 T D ON-'1012 i 299wU 011;_0
To P. FOLLOWVNG WORK.-REPLACE CHIMNEY, STRIP & SHINGLE ROOF
POST" SO TT LS YI&MX FROM THE STREET
.Inspector of Wag : Inspeetor ofWiriing D.P.W. Inspector of Buildings:
Underground: Serviee Meter:
Footings:
Rough; Rough; Houuse# Foundation:
Final: Final:
Rough Frame:
Gas Fire RVartment Fireplace/Chimney:
l as t; �,fBl• Insulation:
THIS PERMIT MAY BE REVOKED BY THE CITY O ORTILkWTON UPON'VIOLATION OF
ANY OF ITS RULES AND REGULATIONS.
re.
Fee e: Rece t No Date Paiici• heck No: A a 0 t:
Building 10/26/199910:00.-00 $25.00
212 Main Street,Phone(413)587-1240,Fax:(413)587-1272
Building Commissioner-Anthony Patillo
s