39-039 (4) 182 MT TOM RD BP-1999-0873
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 39-039 CITY OF NORTHAMPTON
Lot: -001
Permit: Building
Category:Non structural interior renovations BUILDING PERMIT
Permit# BP-1999-0873
Project# JS-1999-1520
Est. Cost: $7800.00
Fee: $40.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: Larry Paquette 100679
Lot Size(sq. ft.): 21780.00 Owner: AMO EDWARD F
Zoning: SC Applicant: Larry Paquette
AT: 182 MT TOM RD
Applicant Address: Phone: Insurance:
40 East Green Street (413) 527-6375 Workers Compensation
EASTHAMPTON 01027 ISSUED ON:4/22/99 0:00:00
TO PERFORM THE FOLLOWING WORK:INSTALL VINYL SIDING,ROOF, INSTALL
ENTRY DOOR & STEP
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: 0 6C, �� .--9Qr 44-
Gas Fire Department Fireplace/Chimney:
Rough: Oil: Insulation:
Final: Smoke: Final: ®IC r.zi
THIS PERMIT MAY BE REVOKED BY THE CIT OF NORTHAMPTON UPON VIOL• TI I N OF
ANY OF ITS RULES AND REGULATIONS.y — zo"
Certificate of Occupancy ® Si nature:
Fee Type: Receipt No: Date Paid: Check No: Amount:
Building 4/22/99 0:00:00 $40.00
212 Main Street, Phone(413)587-1240, Fax: (413)587-1272
Building Commissioner-Anthony Patillo
File#BP-1999-0873
APPLICANT/CONTACT PERSON Larry Paquette
ADDRESS/PHONE 40 East Green Street (413)527-6375
PROPERTY LOCATION 182 MT TOM RD
MAP 39 PARCEL 039 ZONE SC
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out ��y
Fee Paid ,2 0 f a(jt�T
Typeof Construction: INSTALL VINYL SIDING,ROOF,INSTALL ENTRY DOOR&STEP
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/Statement or License 100679
3 sets of Plans/Plot Plan
THE LLOWING 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
Septic Approval Board of Health Well Water Potability Board of Health
Permit from Conservation Co ission
Z9 1;‘ a
Signature of Building O 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.
tdU[ R29240\
Mi
File No. �' i / 12_3
oF^T OF SIJ ,�dSPF_CTI '",
ZONING PERMIT APPLICATION (§10 . 2)
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant: IA 4 Y
Address:4tl Erd"- iN ecxrlicvwieRcricTelephone: b" ,Y)"
2. Owner of Property: ettir.." . .ef £ ...- '•r 0
Address: 7 6 n k yze Telephone: 5 3 3 - 211. b
3. Status of Applicant: Owner Contract Purchaser Lessee
Other(explain):
4. Job Location:
Parcel Id: Zoning Map# 9 Parcel# 7 District(s):
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/Property
6. Description of Proposed Use/W rk/Project/Occueation: (Use additional sheets if necessary):
V-4...rvur
,: s h n k e_
3by° 4-tsrnQ-, cx-tip a -- icawiv s kt,
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 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 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 s
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 column to be filled in
by the Building Department
Required I
Existing Proposed By Zoning
Lot size
r
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:
(volume -& location)
13 . Certification: I hereby certify that the information contained herein
is true and accurate to the best of my knowledge.
DATE: 11— a20 — 5' 7 APPLICANT'S SIGNATURE fc.Lvtt' �' /cT o —
NOTE: Issuenoe of a zoning permit does not relieve an applioanrs bur en to comply with-all
zoning requirements and obtain all required permits from the Board aft Health, Conservation
Commission, Department of Publio Works and other applioable permit granting authorities.
FILE I
•
�rvurp i,
?� , APR 2 I I999 'ill Gift; taf i tI antptann ► -
e3 yh••tj assttc usctts
fol
=. DEPARTMENT OF BUILDING INSPECTIONS
•
212 Main Street • Municipal Building
Northampton, Mass. 01060 r
WORKER'S COMTENSATION TSURANCE AFFIDAVIT
(licen� Jpermittcc)
with a principal place of businessiresideuce at:
• Q—� .21 _IA (Phone ) 6t/3 —
(street city/s-t tci- p)
do hereby cc..-fy, u.... r the pains and rites of penury, that:
) I a111 an en1DLo' ao': n the .iollov ,na
CIUl)loyeC'S „oi:;in .n this
es -mac Company) (Policy Nu ni:.z;) rat or Dare)
( ) 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 Numl•cr) (Expiracon Date)
(Name of Contractor) (Insurance Company/Poticy Number) (Expiration Date)
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Dale)
(actath additiocdl red if necc 1 ry to inch d iaformaticc Fettering to all coc±radors)
•
( ) I am a sole proprietor and have no one working for me.
( ) I am a home owner performing all the work myself.
NOTE:plese be aware that while hcm.owncra who employ persons to do m*ire,a n eon ruction or repair work on a dwelling of
not moco than throe units in which the bomooaver reside or oo the grounds appurtenant tbrcto arc not filly oomidcrcd to be
employers under the workees c r -raring Ad(GLI51 s3l(5)),application by a homeowner for a license or permit may cvtdcmc the
legal status of an employee under the Wockola Compemation Act
I understand that a,copy of this etatemem may ba forwo tied to the Dapertmcad of Industrial Aorirkaite Ofoo of Imutwoo for the
coverage vuificanon and that failure to scant covcrago under section 25A of MOL 152 an lad to the imposition of criminal penalties
eomisting of a fine of up to S 1,500.00 andfoe impruo®cni of tip to one year and civil pantiles in the form of a Stop Work Order and a
lino of 3100.00 a day a$aim tnt•
• For dgxr hurl tuo Doty
Permit Number
• t •ee,C kcc ez- c (C�}f / � > to t Ma I;ot i
Simon nfUi ermittcc
: . >
,, 'v
< so
o'
i 3 o z n
' § EC.... 1 R Nv S
Z! r; Z
iTE1
Z m
....„......j
Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. 5' 2?- J l Alterations,
iikiis NORTHAMPTON, MASS.c La 1.17'h 14-d�__ 19? Additions
}-: ,:.A' APPLICATION FOR PERMIT TO ALTER Repair
r Garage
1. Location ! 0 Z -/r_/ ` t � r`' / L Lot No.
2. Owner's name -Gf n.V a--c,c-Cp Q/Y► J Address 7 6 - .p � 'RI 64
3. Builder's name k - / Address /6e�' -.* ,,e'Le�-4.�- ca-�+ Nw„t
Mass.Construction Supervisor's LicNo. J GO — 6 'I `1 Expiration Date 46.—2 a..— O v
4. Addition
5. Alteration nl y.J/4-/ ( crn-e_ 6 ��l e- �o —' G -. .,0_,_7f
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 d� /,
12. Type of roof V-N 1^c o of' S ( =& Tu-c A-Pc, � i.G —re- A d-,
6 % e
13. Siding house .e ,iLe��iAA-S
14. Estimated cost:- A 8 0-0 t
The undersigned certifies that the above statements are true to the best of his, her
knowledge and belief.
Signal a of responsible applicant
Remarks
II