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16A-020 (2) a z z 'v A szt X D J CD = R Nz F a 5 yo C ° vz a 1 Zoning �,, Miscellaneous Additions, Repairs, Alterations, etc. TeL No.��'S` �I — ' Alterations '=r NORTHAMPTON, MASS. ktAC- � �� 1 9 Additions ?�` +. Repair `r� = �` APPLICATION FOR PERMIT TO ALTER .99( c 4 t r.5k .M A — � `` ., t -� M Garage 1. Location z � ,, f ` 7`"` �4Z.� v I ` K ` &1� . I " I **-Ci Lot No. 2. Owner's name 4- CV-NA' t1 -71:1 _ i J Address Z Z- ��1 ' (ILLa 6 14 1M ,. � 3. Builder's name �k( _ti = 6 --� ' � '- r— . I- _.L ' ' �J , • ddress i c tilt —�to1 Mass. Construction Supervisor's L No. �' Expiration Date t 4. Addition 5. Alteration 1i t.Stf. . ` [1 _Ai 6. New Porch t 7. Is existing building to be demolished? No 8. Repair after the fire 9. Garage No. of cars Size 10. Method of heating - V ,L T 1C tC.. -• =,• S - ' 7 11. Distance to lot lines 12. Type of roof 13. Siding house 14. Estimated cost: - lk C Scrc C%� The undersigned certifie that the above statements are we to the best of his, her knowledg be t Signature ofre onsible applicant Remarks • �'t ttiV f p 8�, f, i Crzf Jai Nazi l . _°*=1, • � Q azanch ns ctla eF`� DEPARTMENT OF BUILDING INSPECTIONS t • = _- C 212 Main Street • Municipal Building Northampton, Mass. 01060 to WORKER'S CO NLPENSATION fNSURANCE AFFED AVTT (li permitter) with a principal place of business/residence at: 1 , — o OX 90 i, fk }M A.0106 (- 161 .5 -- - Li5 f (scit /stairJzip do hereby certify, under the pains and penalties of perjury, alai: ( ) 1 am an employer providing the following worker's compensation coverage for my employees worldng on this job. • (Insurance Company) (Policy Number) (Expiration Date) ( ) 1 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) QI.nsuuanc Company/Policy Number) ( Expiration Date) (Name of Contractor) (Insurano Company /Policy Number) (Expiration Due) (Name of Conn - actor) (Insurano Company/Policy Number) (Expiration Dale) (Name of Contractor) (fn_suranca Company/Policy Number) (Expiration Date) (rnich additi Dart rat ifncoc,iry to in cur inrocrn.1Eoo pesti"� to al crdr. .on) (Vdam a sole proprietor and have no one worl;sng for me. ( ) 1 am a home owner performing all the work myself. NOTE: please be aware that wbilo bomcowocn wino employ persona to do rr. rn..Y, -, coantrvcuoovor repair work on a dwrlling of not more them throo unlit in which the bomoowner reside cc co the grounds sppurtea+ut thereto ere Oot gcncrvlly considered to be employs under tbo workcxk oecapcascien Ad. (GL152fs 1(5)), application by a bomcowocr for n lioroe oc perms may evidence the lava rtshsa clan employx wades-Ma Workelt Comp•ma.tion Ad' • 1 undaztaad that a Dopy of this eatcmmt may bo focvrard<d to tho Depertmcor oflnduseriel Accidents' OfSoo of lanuraoos for tho oovc rige vaifieaiioo and that feilure to scorn eovcrngo under aloe 25A of MOL 132 can lord to tbd impocitioa of criminal penalties eoasisiing of a •tmc of up to 51.500,00 m:/oc imprisonment of up to one year and dvul penalties in tine form of a Stop Wort Order and a fine 0( 5100.00 a day agni nt j t> . . S igned this . " = day of 199 7 Fordepatmil only Permit Number �\ Mapli Lot ii . \ Sign_aturc o � iocnscdPcrmi.. • . , . .. . _ . _ . . . ... . . .. • . j../DIzm. --- ,00.1-Kc.,_ 2 _ __ -r-p tuAG , ALG I 4 199 1-\A-ce_. Q3NAST, No v M '6--s . . . . ' ,. _ECD>.. of 0 I M '161/N1 . MA 1 t z .6 7 `1 0 (c,0 '' —1-_ . 1 : 65" — 4 - 6 i o iGo I MNALS l - V.A :>4\ Tric - r" IN ) ._- -I 1-- c ___k....., ..kistp c.. \, • te...x...117-mr.Litl.izmo- pcv..57-Nre_et‘..sg_s ... , . . _ .. . • . , , n" isktoi _ c , I c. t-Lic.(34,s■e\ , - ' A ' i ) 1 , 1 / 7 _ . . \ , . / ..._,,, ' / 517Asta-c t....t...cr . • \ Lt 4,A041:::>0.-uas Mec_tiAtqc:A- \ i st,..cc--kA(.1-i • • \\ - i ------- - <" ' - i - tr grit . . . . . . . . . . • I - • . • - - cl_csa.7-„‘ A 16 .1 pr /Cf-5 1 i II • / 4 1 . 1 3 1 1 (c) N. , --1 10. Do any signs exist on the property? YES NO Y 9 P 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 colt to be filled in by the Building Department Required Existing Proposed By Zoning Lot size Frontage Setbacks - frnnt ( 1 - side L: R: L: R: - rear Building height Bldg Square footage %Open Space: (Lot area minus bldg &paved parking) # pf - Parking Spaces it of Loading Docks Fill: (volume -& location) 13. Certification: I hereby certify that the information contained herein G is true and accurate to the best of my kn dge DATE: L 1 I 1' - i t APPLICANT'S SIGNATURE NOTE: Issuanoe of a zoning permit does not relieve an a lioant's urden to oo ly with - all zoning requirements and obtain all required permits from the Board of Health, C nervation Commission, Department of Publio Works and other applioable permit granting authorities. FILE AUG 4 I(, File No. 96A14V , ZONING PERMIT APPLICATION 2) PLEASE TYPE OR PRINT ALL INFORMATION j` \�� � -fit �l► 1. Name of Applicant: a it " i tow ' Address:? d TD>C rOM CACt I Telephone: - 8>L'511' 2. Owner of Property: L— CAZItr 15L( ._- Address:(9.1 a►� v (t- cam..„ 1\1 IG 4 . J �I ik . Telephone: ,618 - 361 3. Status of Applicant: Owner Contract Purchaser Lessee pl —�-�� V Other (explain): M O NO CC1C\1�'F\�' -1U ' , 4. Job Location: J) GGC. 21e )teez L 12 L t Parcel Id: Zoning Map# /1 /9 Parcel# "40 District(s): �' e J r (TO BE FILLED IN BY THE BUILDING DEPARTMENT) Existing Use of Structure/Property ( ,R . 6. Description of Proposed Use/Work/Project/Oc (Us ad 1 sheets if ecessa ): • N r� Ps M��\t 1 �Cizr C' (a . �-� fi� x In t I Nile) kat R f -- N 3* 7. Attached Plans: 'I,/ 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 been issued for /on the site? NO V 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 V 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) 15 !1 FILE # 96 61 • AUG AP T; /CONTA T PERSON: AP2!/ � / j/1. /.s, aft" 1i' I r� " / ADDRESS/PHONE: / i2 B G PROPERTY LOCATION: d. v ! . e4 / 11G= MAP /Z, /4 PARCEL: ZO f f .JL , Lt v THIS SECTION FOR - OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FTTT.F.T) OTTT Fee Pa id t/, Building Permit Filled nit '� f/ � ''// ,�.� Fee Paid AP 4 hf.;40 Type of Cnnstrurtinn- New C nn. trurtinn {4C Remndeling Tnterinr a4.e./f°32W Additinn to FYisting Arressnry Structure Building Plans Incliude& Owner /Orr ant Statement nr T,ieenee i 643 Sets <plane Pint Plan TKpro LLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION: • 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 -Bd of Health Well Water Potability -Bd Health • fro o:rat' Co Signature of Building ector Date NOTE: Issuanoe of a zoning permit does not relieve an applioant's burden to oomply 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. i !A � ' °,�'. C it of Northampton REQUIRED y 1 � i lki 1'il l 1. Footings and Walls '" • BUILDING DEPARTME '= , 2. Structural Components in Place * (z ,�,� 3. Complete Building* No. 779 Office of the Building Inspector - Zoning Form No. 962661 E ate 8/20/97 Fee $40.00 check # 1243 Page, 16A Parcel 20 ,Zone URA /WSP /WP Section 127 ❑ Yes © No B 11, DING PERMIT * Plumbing and Electrical Inspections required THIS CERTIFIES THAT Heartwood Constr /Arthur Silver before Building Inspections has permission to finish basement Inspection on Site — Foundations situated on 212 Fairway Village - Lorna Blake Inspection of Plumbing —Rough provided that the person accepting this permit shall in every respect Inspection of Plumbing— Finish conform to the terms of the application en file in this office, and to the Gas Inspection �� . provisions of the Statutes and the Ordinances relating to the Construction, Inspection of Wiring —Rough , .4.1.-..E/ � 7 , G f' Maintenance and Inspection of Buildings in the City of Northampton. Any violation of any of the terms above noted is an immediate revocation Inspeztion of Wiring — Finish /15 2/'P9 ill / ` - of this permit. Expires six months from date of issuance, if not started. Building Inspection — Rough 6 6 , - .,, , { '' �/7 Note: A certificate of occupancy will be issued by this office upon return Insulation Inspection of this card signed by the Plumbing, Wiring and Building Inspectors.j� fC� °?� r Building Inspection— Finish -�� Smoke Detectors (Fire Department) Other THIS CARD MUST BE DISPL I , h A CONSPICUOUS PLACE ON �i � ISES Certificate of Occupancy --- ,r ,,, Building Inspector