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18D-040 (43) U , Department: Reference No: BP-1999-0385 Building,Electrical & Mechanical Permits Fee Type: Receipt No: demolition REC-1999-000997 Paid By: Paid in Full On: Pride Convenience Inc Tue Oct 13,1998 Received By: Check No: Linda Lapointe M03303 DEPARTMENT'S COPY Amount: $10.00 DEPARTMENT FILE COPY 17 Damon Road (Pride Convenience) CITY OF NORTHAMPTON BUILDING PERMIT Owner's pulling their own permits or dealing with unregistered contractors for applicable work do not have access to Guaranty Fund(MGL 142A) Issued: Permit No: Inspector: Tracking No.: Fee: BP-1999-0385 $10.00 GIS #: Map Block: Lot: Address: Zoning: Use Group: Lot Size: 8944 18D 040 001 17 Damon Road(Pride Con HB 42209.64 Contractor: License Type: Insurance: Pride Convenience Inc CSL Workers Compensation Address: License No.: Insurance No.: 246 Cottage St 038811 WC29734-013 City: State: Zip Code: Phone: SPRINGFIELD MA 01104 (413) 584-9485 Project No: Category of Work: Const. Class: Cost Estimate: JS-1999-0729 demolition $5,000.00 Description of Work: Demo Canopy over pumps GeoTMS®1997 Des Lauriers&Associates,Inc. Signature: File#BP-1999-0385 APPLICANT/CONTACT PERSON Pride Convenience Inc ADDRESS/PHONE 246 Cottage St Sprfld 01104 737-6992 PROPERTY LOCATION 17 Damon Road(Pride Convenience) MAP 18D PARCEL 040 ZONE HB THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out Fee Paid m0 13/6 — Type of Construction: New Construction Non Structural interior renovations !� Addition to Existing Accessory Structure Building Plans Included: Owner/Occupant Statement or License# li 3 sets of Plans/Plot Plan THES,PrLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION: Approved 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 " ac Approva4Board of Health . Well Water Potability Board of Health Permit from Conservation ission a/7 Signature of Building 4115cial 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. Oc't 06 98 02: 56p p. 2 '5 V 15 U N II' 6 I i OCT 13 i998 li _ File No.� �/ r , tJ1G�r DEPT OF BUILDING INSPECTIONS. CA rIORTI�ar�PTora MA o>oso NING PERMIT APPLICATION (§10 . 2) PLEASE TYPE OR PRINT ALL INFORMATION 1. Name of Applicant: �� Address: 3 7 f(.�r ..5�"- Telephone: J ' ?7' 2. Owner of Property: "�-e-rc'e- Cer")...-^`��^-.s'v`--.._ Address: '2 V6,, Ce, /,-S/'1-G, Telephone: '/ 3 737 / e5' 3. Status of Applicant: . , Owner Contract Purchaser Lessee Other(explain): �7 ^'�)/� 4. Job Location: 1 t Y�l� _ Parcel Id: Zoning Map# Q Parcel# District(s): (T BE FILLED IN BY THE BUILDING DEPARTMENT) 5. Existing Use of Structure/Property G�t�uy ®`v'_ i,a_- 6. Description of Proposed Use WorkJProject/Occupation: (Use additional sheets if necessary): Dom„-7,- 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 PermitVariance/Finding ever been issued for/on the site? NO DON'T KNOW YES V IF YES,date issued: _ 11- 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 DONT 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) , Oct 06 98 02: 57p p. 3 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 sons 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 tilled is by the Duiidi.ag Doper town t Required Existing Proposed By Zoning Lot size Frontage • Setbacks - frrint ' I - 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. DATE: < 2—l' "l, APPLICANT'S SIGNATURE NOTE: tasuanea at a zoning permit does not rellere an applicant's burden to comply with ail zoning requirements and obtain all required permits from the Board of Health, Conservation Commimsian, beparti lent of Publie Works and other applioable permit granting authorities. FILE # . Oct 05 98 02: 57p p. 5 • b�STO En 'M r.c ' t i Err �l2TIT LITT 't '�' OCT 13 998 „ raeechttsetls MRT NT OF EUII22f.to INSPECTIONS �_ �'�:-'�"" DEPT OF BUILDING 1N�P g NORTHAMPTON M...00 . �- Main'Street • Municipal 2uilding ~�\ Northampton, Mass. 01060 WORICER'S COMPENSATION INSURANCE AF IelDAtiTT -- (linear ecipermi tt ee) with a principal place ofbusiness/residenc-e at: (phone#) 772--6 yjoL .C.-1(P)rteici /sue 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: .w c 7 3 via (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 or Contractor) (Insuraocc Conrpany/Policy Nurticc:) (Expiration Date) (Name of Contractor) (Insurance Company/Policy Nwnber) (Expiration Date) (Name of Contractor) (Insurance Compaay/Policy Num►yr) (Expiration Date) (Name of Contractor) (Insurance Company/Policy Number) (Expiration Date) (attach additional alxct ifom-n=rym ioelode infrXmAtioe perairc;,I.g to all rxatradora) ( ) 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 aware that while boctteoween who employ perums to do w w•"•+- caatructioa'ar repair work oe i dwelling of not morn than three units is which tba homeowner residci oc m the gmunat avpurt :Sado arc col etn..alty matidacd to be esnploycra under the worker's o -x.lim Act(GL152.,s3 I(5)),application by a bcmmwvir for a lionise or pm-mit may cvidcnoc the legal rtuua of en employ«.under the Worker's Compomiiioa Act I aadctstaad that e.Dopy of thla aateme to shay bo farti ordoi to taw t>apar tmeart of tom,.cial Ascickeza.OfSoo of Ina r.aoa for tb. eoventgo nai@caiion amid thal railcar to so ure covcrago under sc caeca 25A of MOL 152 estl 1a+d to t6d ieopasi ion of cri.mioat penalties Doesistleg eta'froa'of up to S1.5O9,00 aadlx i=prisoacoent of up to ore year and 0vil paaaltia is the foca of a Stop W eric order aid a fine of S LOO.00 a day eg teat me. '• For dcpasiinmtal txae mlY p Permit 2ltlmes b • • • t ' 7tdi�® • Mill _ Lott(' Signabnib o'I,iocnscc/Pcrmitcc Late Oct 06 98 02: 57p p, 4 a xi 1:1 cal el z y oa v b � aQ X D m H-9 1. -- _ g v f C i G mi w " C c r p,,,,,6 x Zoning Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. 23 7 6 P -)— Alterations '-,10 NORTHAMPTON, MASS. ( /a' 19. Additions �"`-� rI APPLICATION FOR PERMIT TO ALTER Repair - —Cr— arage I. Location 3 7 r O d"- Lot No. 2. Owners name '"^~ - 1..".0 `?___" "— Address c.)-�� C...-r-C � "c? f , i� 2 3. Builder's name t `( Address e'( Mass.Construction Supervisor's License No. 62 2e f// Expiration Date CS:2-" "tom 'L 4. Addition 5. Alteration b. New Porch 7. is existing building to be demolished? V --("' 8. Repair after the fire 9. Garage No.of cars Size ID. Method of heating 11. Distance to lot lines 12. Type of roof 13. Siding house ¢� 14 Estimated cost- `�rc4..sv The undersigned certifies that the above statements are true to the best of his, her knowledge and belief. 122.7,.___Q y Siyeotyre of responsible appucant Remarks NOV-03-98 04 :56 PM PRIDE r,_,,_ R g M 4 k37315852 P. 01 n ail ow 4a13 hiii 1r) DEPT_ iONS 246 Cottage St., Springfield, MA 01104.4002 Tel. 413-737-6992 • Fax 413-731-5852 November 2 , 1998 Northampton Building Department Via: Fax 587-1272 Attn: Stan Re: 375 King Street , Canopy Demolition This wi11 confirm that electric power to the canopy being removed has been turned off . Ma Randy Heath, Electrician