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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. 5: � �t j Alterations
Z-2
Additions
NORTHAMPTON, MASS. X19
APPLICa ATION FOR PERMIT TO ALTER Repair
/� Garage
1. Location Yd .1 /7 Ac c- i,o J k 'e, Lot No.
2. Owner's name Pa ,el �r-m S fe-o Address ti��� /�t C4,- F 0 V&r✓C
3. Builder's name �0�. U4"AlAj /1 Address
Mass.Construction Supervisor's License No. b /v� $`� Expiration Date 21LO J
4. Addition
5. Alteration
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 /I
12. Typeofroof �., d r%"S{9/� `9S� ���t LrSta�� otSfc,�'fci��-tna �`i:f► Clrc
13. Siding house d � j� C'b1 Sd-:^��` �ee+� �-+ a � g�•.� S/�-S
14. Estimated cost:-��,2 0 .
The undersigned certifies that the above statements are we to the best of hi,
knowledge and belief.
Signature of responsible appicant
Remarks
Is CritR of Wart ainptau z
$ APR 2 0 1998
c +' �'E557IChltSttt3
'l {; DEPARTMENT OF BUILDING INSPECTIONS
_ � t
INSPECTOR 212 Main Street • Municipal Building '
Northampton, MA 01060
Applicant Information
Name L�G.d—rte'---------------
Location --
❑
lam a homeowner performing all work myself
lq'-1 am a sole proprietor and have no one working in any capacity
❑ I am an employer providing workers' compensation for my employees working on this job.
Company
Address
Phone City------------------- Phone #----------
Insurance Co._------------_—Policy#------ --_
Company Name
Address
City Phone#
Insurance Co. Policy#
Failure to secure coverage as required under Section 25 A of tvtGL 152 can lead to the imposition of criminal
penalties of a fine up to$1500.00and/or one years'imprisonment as well as civil penalties in the form of a STOP
WORK ORDER and a fine of$100.00 a day againstme. I understand that a copy of this statement may be
forwarded to the Office of Investigations of the DIAfor coverage verification.
I do hereby certify under the pairs and penalties of perjury that the information provided above is true and correct.
Signature - �Ze•�� Date LJ A
Print Name 7X 0 vt— 14 11)f,4,J Phone#
L.ContactPerson Only Do not write in this area to be completed by city or town official
Permit(License# ❑ &UncDept
❑Liming Bond
mmediate response is required
❑Selectmm'Dept.
Phone#
Health Dept.
M �
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.
Thin cols to be filled in
by the Bnildiag 7Sepurtment
Required
Existing Proposed By Zoning
Lot size
Frontage
Setbacks
- side L: R: L: R:
- rear
Building height
Bldg Square footage
%Open Space:
(Lot area minus bldg
&paged parking)
# of -Parking Spaces
# (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 knowledge.
DATE: y��g/C��j APPLICANT's SIGNATURE J
NOTE: issuance of a zoning permit does not relieve an applioant' urden to comply with all
zoning requirements and obtain all required permits from the Bo rd of Health, Conservt2tion
Commission, Department of Publio Works and other applicable permit granting authorities.
FILE #
r
Winn '41
APR `�. File N0 9P-77 o
PERMIT APPLICATION (§10 . 2)
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant: �,,�„ �, c "j/'It�
Address: '? 11 i LIC A 01 i Telephone:
2. Owner of Property: &4 t P tvC e X-V'h
Address:_ 9a.2 &i-C- Jvuo 0,- Telephone:
3. Status of Applicant: Owner P" _Contract Purchaser Lessee
Other(explain):
d. Job Location: — � � �Crc �r cr � 1"L 0- lCs.-e- Cie
Parcel Id: Zoning Map# Parcel# District(s):
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
Existing Use of Structure/Property �� as s
6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary):
C-"� l}n�A-4e dtAt 4
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.
S. Has a Special Permit/Variance/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 v 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)
422 ACREBROOK DR BP-1999-0860
GIs#: COMMONWEALTH OF MASSACHUSETTS
Map-Block:29-302 CITY OF NORTHAMPTON
Lot:-001
Permit: Building
Category:roofing BUILDING PERMIT
Permit# BP-1999-0860
Project# JS-1999-1508
Est. Cost: $1300.00
Fee: $20.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: Quinlan Builders 011289
Lot Size(sq. ft.): 10497.96 Owner: ARMSTRONG PATIENCE A
Zoning.URA Applicant: Quinlan Builders
AT: 422 ACREBROOK DR
Applicant Address: Phone: Insurance:
5 Hillside Dr (413) 585-0949
HADLEY 01035 ISSUED ON.•412111999 0:00:00
TO PERFORM THE FOLLOWING WORK.-SHINGLE ROOF OVER 1 LAYER & INSTALL RIDGE VENT
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 4/21/1999 0:00:00 $20.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Building Commissioner-Anthony Patillo