16B-008 r •,
119 BRIDGE RD BP-1 999-0841
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 16B-008 CITY OF NORTHAMPTON
Lot:-001
Permit: Building
Category:Non structural interior renovations BUILDING PERMIT
Permit# BP-1999-0841
Project# JS-1999-1487
Est.Cost:
Fee: $20.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: All Star Insulation & Siding Co Inc 101858
Lot Size(sq.ft.): 10018.80 Owner: HEBERT MARK A
Zoning:URB Applicant• All Star Insulation & Siding Co Inc
AT: 119 BRIDGE RD
Applicant Address: Phone: Insurance:
56 Franklin Street (413) 527-0044 Workers Compensation
EASTHAMPTON 01027 ISSUED ON:4/13/1999 0:00:00
TO PERFORM THE FOLLOWING WORK:INSTALLATION OF TRIM
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 4/13/1999 0:00:00 $20.00
212 Main Street,Phone(413)587-1240,Fax:(413)587-1272
Building Commissioner-Anthony Patillo
„,fliz\---•-i--(-t----.-in / ii \--A
APR 13 igaig
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\.\\ ��, File e No.
OEPT OF a INSPECTIO”
. f�r`+Otc�F
--- ONING PERMIT APPLICATION (§10 . 2)
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant: ALL STAR INSULATION & SIDING CO., INC.
Address: 56 FRANKLIN STREET, EASTHANPTON Telephone: 527-0044
2. Owner of Property: MARK HEBERTR 'r
Address: 119 BRIDGE ROAD, FLORENCE Telephone: 586-5735
3. Status of Applicant: Owner Contract Purchaser Lessee
X Other(explain): CONTRACTOR
4. Job Location: 119 BRIDGE ROAD FLORENCE, MA Q'
Parcel Id: Zoning Map# Parcel# Z.- District(s): 6,/�/"
B— D IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/Property
6. Description of Proposed UseNVork/Project/Occupation: (Use additional sheets if necessary): •
INSTALLATION OF TRIM
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 .en issued for/on the site?
NO DON'T KNOW YES IF YES,date issued:
IF YES: Was the permit recorded at the Regist 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)
•
PrtP { ►+`yiri
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 cols to be filled in
by the Building Department
Required
Existing Proposed By Zoning
Lot size
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
# fof Loading Docks •
Fill:
.Avol-tune--& location)
13 . Certification: I hereby certify that the information contained herein
G1 is true andnd accurate to the best of my knowled e .
DA�'E: --I a- 1 1 APPLICANT'S SIGNATURE C'}�R1-+(� ALIttattrd-
NOTE: Issuance of a zoning permit does not relieve an applicant's burden to comply with all
zoning requirements and obtain all required permits from the Board of Health. Conservation
Commission, Department of Publio Works and other applicable permit granting authorities.
-;' FILE #
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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. 586-5735 Alterations
iikr•t NORTHAMPTON, MASS. April 12, 19 99 Additions
"•}ir-, APPLICATION FOR PERMIT TO ALTER Repair
� � Garage
g
1. Location 119 BRIDGE ROAD FLORENCE, MA Lot No.
2. Owner's name MARK HEBERT Address 119 BRIDGE ROAD FLORNCE, MA
3. Builder's name ALL STAR INSUATION & SIDING CD., INC. Address 56 FRANKLIN STREET EASTHANPTON, MA
Mass.Construction Supervisor's License No. 101858 Expiration Date 6/00
4. Addition
5. Alteration
6. New Porch
7. Is existing building to be demolished?
S. 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 INSTALLATION OF TRIM
14. Estimated cost-
The undersigned cenifies that the above statements are true to the best of his, her
knowled an belief.
-,,,,,--„,, A...a,. i
Signature of responsible appicant
Remarks INSTALLATION OF TRIM
•
}o�„HAMPTQy •
s•_ ; o f Northampton ► _*
ti is )i;Ll
„:• �,`_�fj• C �iaeaschasctle = �`
`'rt a • APR 131999
"�4' DEPARTMENT OP BUILDING INSPECTIONS•
OFF OF RU ' INSPE(�'22"Main Street • Municipal Building w`v,`'
Northampton, Mass. 01060
WORKER'S COMPENSATION INSURANCE AFFIDAVIT
ED LOSACANO, OWNER OF ALL STAR INSULATION & SIDING CO., INC.
(licensce/permittee)
• with a principal place of business/residence at:
56 FRANKLIN STREET, EASTHAMPTON, MA (phone#) 413-527-0044
(street/city/state/zip)
do hereby certify, under the pains and penalties of perjury, that:
. (X) I am an employer providing the following worker's compensation coverage for my
employees working on this job:
EWER 3l-1042527-00 8/12/99
(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 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 mooesaary to include information pertaining to all contractors)
( ) 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'that witilo homeowners who employ persons to do maintenance,construction or repair work on a dwelling of
not more than throe units is which the homeowner resides or oa the grounds appurtenant thereto are Dot generally considered to be
employers under the worker's comp—malice Act(GL152.ss l(5)),application by a homeowner for a lictnx oc permit may evidence the
legal status of an employee under the Worketea Compensation Act.
I understand that a copy of this statement may be forwarded to the Depererucot of industrial Accidents'OfEoe of Imurusoo for the
coverage verification and that failure to secure coverage under section 25A of MOL 152 can lead to the inxposition of criminal penalties
consisting of a Eno of up to S 1,S00.O0 and/or imprisonment of up to one year and civil penalties in the form of a Stop Work Order and a
fine of 4100.0O a day against tine.
For dcpartmcdil use cob,
clj
Permit Number 1% . - I fl,d�L(�t, Lj..J 7 9 Map# Lot#
Si • L'vr. of Licertc/Pe ttee Date