23D-052 (4) 63 RIVERSIDE DR - LEGION HALL BP-2000-0682
GIS#: COMMONWEALTH OF MASSACHUSETTS
; . CITY OF NORTHAMPTON
Lot: -001
Permit: Building
Category: BUILDING PERMIT
Permit# BP-2000-0682
Project# J S-2000-1024
Est. Cost: $30000.00
Fee: $50.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: EARL F. ROLLAND 062404
Lot Size(sq. ft.): 10410.84 Owner: AMERICAN LEGION POST#28 HOME,
Zoning:URB Applicant: EARL F. ROLLAND
AT: 63 RIVERSIDE DR - LEGION HALL
Applicant Address: Phone: Insurance:
285 PROSPECT ST (413) 584-1361
NORTHAMPTONMA01060 ISSUED ON:2/1/00 0:00:00
TO PERFORM THE FOLLOWING WORK:RENOVATE BATHROOMS
HANDICAP,HANDICAP RAMP,2ND FLR EGRESS & INSTALL VINYL SIDING
MOST THIS CARD SO IT IS VISIBLE FROM THE STREET
nspector 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:
3uilding 2/1/00 0:00:00 3627 $50.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Building Commissioner-Anthony Patillo
File#BP-2000-0682
APPLICANT/CONTACT PERSON AMERICAN LEGION POST#28 HOME,
ADDRESS/PHONE 63 RIVERSIDE DR ma obi, 5?' - 2Y7b
PROPERTY LOCATION 63 RIVERSIDE DR - LEGION HALL
MAP 23D PARCEL 052 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 L.3k.V Tc —
Typeof Construction: RENOVATE BATHROOMS HANDICAP,HANDICAP RAMP,2ND FLR EGRESS&
INSTALL VINYL SIDING
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/Statement or License
3 sets of Plans/Plot Plan
TH OLLOWING ACTION HAS BEEN TAKEN ON THIS AP 6(
proved as presented/based on information presented.
Denied as presented:
Special Permit and/or Site Plan Required under: §_
PLANNING BOARD
Received&Recorded at Registry of De
Finding Required under: § w/;
Received&Recorded at Registry of De
Variance Required under: § w/
Received&Recorded at Registry of Deeds Proof
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 Commissio
2—//_<XD
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.
. To 6 (e 6 11 r, i.
bill 4'
� 82000 /R I �]
^FAT ._,,/ File No, / of 1 —or- - I
!gar
ZONING PERMIT APPLICATION (§10 . 2)
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant: _ /Z /_ /,7aczLisii)4, /
Address: . ..7 (// �s0�'ff/ 9-167i0.111‘);') Telephone: .��9 a 4-(7C
2. Owner of Property: /21,4-'/G c-d _X.f c�,,�v ��S r �/- ---
Address: C /4/ rJ-/-c// ,Vie Telephone: -5---8 S..,//
3. Status of Applicant: Owner - Contract Purchaser Lessee
Other(explain): / 7 ' �rGC,,,C
4. Job Location: ‘. ,//e u/C �/'
Parcel Id: Zoning Map# 23D Parcel# 5 3- District(s):
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/Property /fc-c-Xl -z /717.7�L:9 /464/7
6. Description of Propose Use/Work/Project/Occupation) (Use additional sheets if nece ary): �f
G(,t.G' c C.c� .4.G.E--f "57.?l/l7, i � 4_C s/t-1 p(l- /
4if: /`// 4 . /t,V 2(4= ice•' „,,/t./ /,,%_,,e,i,-7— A/f e,,,e. jo
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 PermitNariance/Finding ever been issued for/on the site?
NO X DON'T KNOW 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 x 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)
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 coin= to ba fillad in
by the Building Department
Required 1
Existing Proposed By Zoning
,
Lot size
Frontage
Setbacks Mont
- side L: R: L: R:
- rear
Building height
Bldg Square footage
%Open Space:
(Lot area minus bldg
&paved parking)
____
# of Parking Spaces
~
it of Loading Docks
-Fill:
{volume -& location) .
4
13 . ertification: I hereby cprtify that the information contained herein
L.7 is true and accurate tp--the best of my knowledge.
DATE: /ATE7O ' APPLICANT'S SIGNATURE �i -
NOTE: Iss//uanoe of a zoning permit does not relieve an applioant's burden to 000mp y with ell
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 I
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Zoning L"'/§
Miscellaneous Additions,Repairs,Alterations,etc. Tel.el N."'1 58 If .�) q Alterations
%r. NORTHAMPTON, MASS. O '//�/t•J ��� Additions
igir
t'} � APPLICATION FOR PERMIT TO ALTER Repair
4 :'' Garage
1. Location ‘$ 44.6Sip` sg , Lot No.
2. Owner's name n.
%rG G /��'CC (7S . c,Address iit/3. Builder's name%//� vh.0c c" Cu., n 7 Address Z- �/t/ �d • j / ��
J
✓IGfass.Construction Supervisor's License No. Expiration Date
4. Addition /fo 1/ /�X- /a` ��
5. Alteration �'/C/ ✓, !�//Zy/ /a/Ti/ ,&/h�4l' 5 i /✓c�i /
6. New Porch / /?/C°ei4 4. /4,i d i ACG451 i 11/1;7{4<OE%eeoitJe44.0,e 3ZZ..55
7. Is existing building to be demolished? /-2
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_ 3 o c O
The undersigned certifies that the above statements are true to the best of his,
knowledge and belief.
J
,-r-R-.--. .--7-L�
Signature of responsible app,icant
Remarks
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basahnsra�% `; �: E^T— - __1_,---=_-=1__. "� . DEPT OF 8E°°^' f1N"SF
aT�` NORM tt 'v4 DEPARTMENT OF BUILDING INSPECTIONS
•
212 Main Street ' Municipal Building
Northampton, Mass. 01060 NW'
WORKER'S COMPENSATION INSURANCE AFIi'LDAVIT
CC; I F ii(c,, ii -Ai . *- C .c
(upermittee)
with a principal place of business/residence at:
O'S Pr GJP F c 1 S '7)- Q A*11/4o11 /I- 1 (pboner#) ,.5 ` \.I ' 13
"/ (sti tzt/city/stateJnp)
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:
(Insurance Company) (Policy Number) J (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/Policy Number) (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) (Expiration Date)
(attach additional sheet if necessary to include information pertaining to all ooatrectors) .
XI am a sole proprietor and have no one worlang fOr me.
( ) I am a home owner performing all the work myself.
NOTE:please be aware that whilo homeowners who employ persons to do wwamtensprr construction or repair work on a dwelling of
not more than throe units in which the bomoowner resides or oa the grounds appurtenant thereto arc not generally considered to be
employers under the worker's comp ,,tion Ac (GL152,a 1(5)),application by a hotneowar for a license or permit may evidenoe the
legal status of an employer under the Workkor'a Compensation Act_
I understand that a copy of this statement may be forwarded to the Department of Industrial Accident?Ofoe of Insurance for the
coverage verification and that failure to secure coverage under section 25 A of MOL 152 can lead to the imposition of criminal penalties
consisting of a fine of up to S 1,500.00 and/or imprisonment of up to one year and civil penalties in the form of a Stop Work Order and a
Imo of S 100.00 a day against tee.
For departmental use only
Permit Number
r•---"7 -4\-/A4,/4/ Map# Lot#
Signature of Licensee/Pernuttee LTe