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Miscellaneous Additions,Alterations,etc. Tel.No. 913-25- �Q° Alterations
NORTHAMPTON, MASS. v 19 / 7 Additions
% ~t Repair !f-
' APPLICATION FOR PERMIT TO ALTER
// J Garage
1. Location 3 rev�`d/ .t �r • Lot No.
o i4ft �.v �iZ SrS 1�4,G . 7--,Y.
�tarCc.
2. Owner's name Address 7--
3. Builder'sname i�r+vt� i �,tti�i�illf�tSj�rayc�v�T Address /300./6.4, oo
Mass.Construction Supervisor's License No.. 630 Expiration Date
4. Addition
5. Alteration
6. New Porch
7. Is existing building to be demolished? �''
8. Repair after the fire 216116
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:-
t
The undersigned certifies that the above statements are we to the best of his.
knowledge and belief.
Signature of responsible pPicant
Remarks
o�
JUN 1 6 19%
T
a �- _ .. tt �iSa;tairfftt5
t Ol PUILIPPiG fie:•�. Cj
,OR fN/ 7r'' ...DEPARTMENT OF BUIMING INSPECTIONS _
212'Main Street a Municipal Building '
Northampton, Mass. 01060
WORKER'S COMPENSATION INSURANCE AFFMAVTT
(4 mace)
with a principal place of business/residence at:
(phone#)
(&t=Ucity/stair zip)
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) (E(piration Daze)
( ) I am a sole proprietor, general contractor or homeowner(circle one) and have hired
the contractors listed below who have jhe following worker's compensation policies,
L�yv, l� Tj�`��c�)
XceeI5 ep2
(Name of Contractor) (—_Company/PoUcy Number) on Date)
(Name of Contractor) Gnsurance Company/Policy Number) (Expiration Date)
(Name of Contractor) (Iasurmce Compaay/PoUcy Number) (Expiration Date)
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(atlac h additional sboct if noccuxry to include infxmiitioa putnining to all ooatm n)
( ) 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 whilo hoa=wncn who employ person to do mxinicnancc,coauru cc-or repair work oo i dwelling of
not an"than throo units in which the homoowncr rt=dcs or oa tho grounds xM rtcaant thtr t ate not wally oo=dcrcd to be
employ=under tho workcex.comptas4oa Act(GL152,m 1(5)�applicaEoa by a homeowner for a license or permit may evidcooc the
legit claw of an omployot under rho Workoet Compemation Act.
I undavAnd that a copy of th x shtcmmi may ba focwarded to tbo Dtpartnxtd of Indushial Accidta&Moo of Inn-for the
ooverago vaifioation and that failure to t cure oovango under section 25A of MCIL 132 can lead to tbo imposition of aimiaal peach c:'
oominiug of a fine of up to S 1,500.00 xnNc c impr6ovmatt of up to one year and avil prnattia in the form of a Stop Work Order and a
fino oCS100.00 a day against ma:
For• xl tsw mty
r' t Ntunber
Lot N
Sit,l,r of Li crnutfco Date
x.:
10. Do any signs exist on the property? YES L/ NO
IF YES,describe size,type and location: �.%%r
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 MAST BE COMPLE'T'ED, or PERMIT CAN BE DENIED DUE TO
LACK OF INFORMATION.
This col== to be filled is
t by the Building Department
(Required l
is sing Proposed By Zoning
I Lot size
Frontage
Setbacks - frnnt
- side L: R: L: R:
- rear ---
Building height
Bldg Square footage
%Open Space: _
(Lot area minus bldg
&p?iced Gam king j
# of Parking Spaces
ht 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 knowledcrp-
DATE: l� -� _ APPLICANT's SIGNATURE i%�
NOTE: Ins an a of a zoning permit does not relieve( pliomnVa burden tCing mpty with all
zoning ui ements and obtain all required permits from the Board of Hea Conservation
Commission. Department of Publio Works and other applioable permit gran authori ties.
FILE ,
JUN 1 6W
File No. 1
oEr'T o�a;il t7± aG NO PERMIT APPLICATION (§10 . 2)
LEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant: ,- N"),e" '-�
Address: �fJ 302S ` ` "/C—Af �/ "c+' //r' Telephone:
2. Owner of Property: C.oj y,pw. A�- �c .
Address:-2 �t'1,f --`tS4-,-/ 5 /-/elm Telephone:
3. Status of Applicant: Owner 4, Contract Purchaser Lessee
Other(explain):
4. Job Location:
Parcel Id: Zoning Map# Parcel# �l/•' District(s): U&6"
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/Property
6. Description f Proposed Use/Work/Pr. ct/Occupation: (Use additional sheets if necessary):
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/Varianc /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)
File#BP-1999-1107
APPLICANT/CONTACT PERSON James Marley
ADDRESS/PHONE P O Box 168 (413)253-2798
PROPERTY LOCATION 23 RANDOLPH PL
MAP 32C PARCEL 163 ZONE URC/WF
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid '
Building Permit Filled out
Fee Paid _i-Ino
Typeof Construction: REPLACE TERMITE DAMAGED TRIM,DECKING BOARDS,
SKIRTBOARDS,CORNERSTOCK&CASINGS
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/Statement or License 030787
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 Comm' n
Signature of Bui ding 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.
f
23 RANDOLPH PL BP-1999-1 107
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map.Block: 32C- 163 CITY OF NORTHAMPTON
Lot:-001
Permit: Building
Category:Non structural interior renovations BUILDING PERMIT
Permit# BP-1999-1 107
Project# JS-1999-1837
Est.Cost:$5000.00
Fee:$40.00 PERMISSION IS HEREB Y GRANTED TO:
Const.Class: Contractor: License: y
Use Group: James Marley 030787
Lot Size(sa.ft.): Owner: CONGATE ENTERPRISES INC
Zoning:URC/WF Applicant: James Marley
AT. 23 RANDOLPH PL
Applicant Address: Phone: Insurance:
P O Box 168 (413) 253-2798
BELCHERTOWN 01002 ISSUED ON.6/17/1999 mom
TO PERFORM THE FOLLOWING WORK.-REPLACE TERMITE DAMAGED TRIM, DECKING
BOARDS, SKIRTBOARDS,CORNERSTOCK & CASINGS
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 6/17/1999 0:00:00 $40.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Building Commissioner-Anthony Patillo