29-366 d
. t
f
C .. D
7n Z
Z
I O �
If e
Zoning
Miscellaneous Additions,Repairs.Alterations,etc. Tel.No. Alterations
NORTHAMPTON, MASS. 19 Additions
APPLICATION FOR PERMIT TO ALTER Repair
a
Garage
1. Location ]L%i e Lot No.
2. Owner's name_ C1 'F' t hf ' y (.�)sE%J �'G? Address_
3. Builder's name_ Address /C1 Cl'Ir�e3l�W S
Mass.Construction Supervisor's License No. 0 012 7.'7 Expiration Date
4. Addition
5. Alteration
6. New Porch
7. Is existing building to be demolished?
8. Repair after the fire
V t
9. Garage rC,,� I � 1 No.of cars Size.
10. Method of heating Oz &
11. Distance to lot lines �we Ljl7 �JL� 4lC�rE, l5 za �2 9
12. Type of roof
13. Siding house 11 1,&2, 1.4
14. Estimated cosL-
The undersigned certifies that the above statements are true to the best of his, her
knowledge and belief.
rJ �
Sgnaiure of res nsibfe app scant
t / .
Remarks -r/ ')
-c. r _ r
-74 �1 fr�l/J %✓z� Cf fv� l�a! 'la _
MW
r .
---.''�� ! i'�i
4�
� ' O� r
�, f
��
_- L
I T
+(--"_._
I
. �
— ,� _ lam' �
; i
- ,� '
-- -� � C- ,�.� � �� ,-,,�� � �—— a
. _ �
------ -� " ` �ti�,,�, ��i� �, '�'� C �L :_'C��i-'/� � `tip%" ,%i ..
�� �
,. ,� _ .
� � �
----- -�
v ,.
f
O O _
9 ME55ar4 its ctte
DEPARTMENT OF BUILDING INSPECTIONS /
11NSPECTOR 212 Main Street Municipal Building n 4
Northampton, Mass. 01000
Square Footage Amount
Basement @ .10
lst Floor @ .40
2nd Floor @ .20
1/2 Floors, Attic, Gaffe .10
Deck, .Porches .10
TOTAL
f 10
Patnddo puv p-,no fjAW (bpu/
Looio siiasngousow`umoiaag)iag`laaaiS uiuw ginoS of `OOoi Xog'Od
,UTM IIJYd kVg
A'dO,tl1N b3AOi18
.M1 j U&ilV1`8 iN
O
Kil
=04�ttvfp�0d U
a � 1 01997
Gt J !xf 'Na rfilailtptoll
9� � �asaxchrtsclta
�-m nFp[t0 fit, � 11�EPr!1RT?vfENT OF BUILDING INSPECTIONS
212 Main Street ' Municipal Building 'o
Northampton, Mass. 01060 y
WORrCER'S COMTENSATION INSURANCE All t AVIr
(li cinser/pc Tin i tier)
with a principal place of business/residence at:
✓I%v(phone,' ) q>! �%/-�? ( ;
do hereby certify, under idle pans a-,-.d pe aloe of perjury, that.
O I am ao employer providing the follo%vin, compensation coverage for rnv
employees working on this job;
(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 CompaM,/Pohcy Numbc-r) (Expiration Date)
(Name of COIILMCtor) (Inure-- CompanyfPo!icy Number) (Expiration Date)
(Name of Contractor) (Lri w nc�t Company/Pohcy Numlxr) (Expiration Dale)
(Name of Contractor) (Laurance Compauy/Policy Number) (Expiration Date)
(coach additioml s3soct if noccnary to inrudc infoctnsa oa pertairnng to all oodrncton)
( am a sole proprietor and have no one working for me.
( ) I am a home owner performuig all the work myself.
NOTE:plea=be awarc that vwhilo hoaxxwnxn.who crap!oy pcaam to do,n,�coa5nic6on or repair work on a d-cll of
not mom than thrco tmi in tvh c h the bomoowncr sides cc oa tlw grounds xppurteaaat thrnto arm no(wally comidcmd to be
employers under tbo worker's,o=p=sziiccx Act(G Li 52,a 1(5)},application by a homoow=for a lions=oe permit may evidcn=the
Iegal rt>tus of an employee under tho Workces Cocopooaatioa AcL
I ua<cs d that a copy of thin rIItemcat may bo forwarded to tb� Dcportm of of tndustri d Acd&m.&OfSoo of Ia:uc.nco for tho
eovesxge verifieszioa and that fAhure to&ecru-=coverago under soetioa 25A of MOL 152 can lead to tba imposboa of Mlinsl pcnA,61:1
oocn3tmg of a fine of up to S1,500.00 andlor bnpris ® of up to ooc year and civil pa a tics in the form of ix Stop Work Ordcr and a
find of S 100.00 a day tg&inst me
Sign.- this day of 1 ,/ 1997 For d.P.-bmcor&l u—oaly
r Permit Number
�,�' //�G 1 Map- Lot 4
Signature of Lic(nser1Pcrm.i
REALTY
'e ®
e'li WORLD
M I,II1 BROKER NETWORK
Ar
BAY PATH REALTY
P.O.Box 1000, 10 South Main Street,Belchertown,Massachusetts 01007 413.323.7295 Fax 413.323.4549
lndependendy Oumed and Operated
s
t O1
a
i
i
Y
l '
i
t
390 !
r
I
JL
/ • i
e
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 cola to be filled in
by the Building Department
I IRequired I
Existing Proposed By Zoning
Lot size
Frontage v
Setbacks - ��
- side L: R: L: 5— R: /3
- rear
Building height `
Bldg Square footage 74 il`r�b ��� 9,5 7 0--
%Open Space:(Lot area minus bldga
&p?Ved parkingi
t 2 l r
# .pf Parking Spaces ,,,;It h Z+O18 �vua
#' %f Loading Docks
Fill:
(voZlime -& location)
13 . Certification: I hereby certify that the information contained herein
is true and accurate to the best of my know ge.
DME: /� APPLICANT`s SIGNATURE � ��'
?" NOTE: tssuanoe of a zoning permit does not relieve an a iioanra burden to m
zoning requirements and obtain all required pp PfY erva ti i
q permits from the Board of H�eaith. Conservt�tioi
Commission. Department of Publio Works and other applicable permit granting authorities.
FILE it
m ' »
AL 0 97
\
Eile Nu'
^� (§10 . 2)
,���`~° =-°��"�^�^'� �=^ ^^ ��~�~"°°^^��~�^,
PLEASE TYPE OR PRINT ALL ZNFORMAZ10N
1. Name of Applicant:
Add -
2. Owner of Property:
Address: Telephone:
3. Status mfApplicant: Dwnwr —Contract Purchaser Lessee
Other(explain):
^ 7
4. Job Location:
Parcel Id: Zoning Map# Parcel# District(s):
(TO 8E FILLED |NBYTHEBU|LD|NGDEPARTMENT) v
5. Existing Use ofStructure/Property '
G. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets ifnecamoory):
7. Attached Plans: Sketch Plan Site Plan nginoenad/8unmyedP|una
Answers to the following 2 questions may be obtained by checking with the Building Dept or Planning Department Files.
8. Has o Special PernniUVahunoa/Finding ever been issued for/on the site?
'
NO DON'T KNOW YES |F YES,date issued:
IF YES: Was the permit recorded odthe Registry ofDeeds?
NO DON'T KNOW YE
IF YES: enter Book Page and/or Document
8. Does the site contain a brook, body of water orwetlands? NO DON'T KNOW YE
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs tobe obtained Obtaineddate issued:
'
(FORM CONTINUES ONOTHER S|OB
'
-
Li ll !� j FILE #— q?f G
1
A'PEDQ W ,
NT/ q NTACT PERSONtp� �
A G
r,i _ zgldt
PROPERTY CATION: W leJ�
MAP PARCEL'J (� f0ft
THIS SECTION FOR.0FFICI4,L USE ONLY:
PERNUT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING F01RM EMI ED 0111
Fee Paid
$uildina Permit Filled mit
Fet. Pnirl
Tyl3e of C onatmirtion-
J
Addition to Existing
A rressnrV Strnrtlrre
0,yner/Orrnonnt Statement 7-7
✓..
3 Sets of Plane /Plan
TEE FOLLOWING ACTION HAS BEEN TAKEN ON THIS AP ICATION:
Approved as presentedfbased on information presented
M
XDenied as presented:
x Special Permit and/or Site Plan Required under: § icy•(0 10, 1 ' ( G . 16 ')
PLANNING BOARD ZONING BOARD ' 1L(0 Lta� 'rv►pr is
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
Permit from Conservatio ommission
Signature of Bui dmg or lYabf
NOTE: Issuanoe 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 applioable permit granting authorities.
�f .. FILE # ot✓ L->";L,�Y�
JM 2 3%1997
APPLICANT/CONTACT PERSO N
tt' o�
-,
ADDRESS/PHONE: 2�' d D/�,.� 3
PROPERTY LOCATION:-- ,��
MAP _ PARCEL: 3,,1, ZO
THIS SECTION FOR-OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
7ClTYfNG MR FTT,TY'D ()ITT
Fee Paid
fiuilding Permit Filled nut
FeePairl 206S It 1-
1V nTr of C-nnctwrtinn-
Addition to Existing 49
Arretenry Strnrture
Rrrildi a Plane TnC nded- ✓. _
J7 2Ci
Sett of Plane nPlan
THE�OLLOWING ACTION HAS BEEN TARN ON THIS APPLICATION: `
Lool Approved as presentedfbased 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
I/
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 App roval-Bd of Health Well Water Potability-Bd Health
iCo on ssion
Z
Signature of Building for to
NOTE:Issuanoe of a zoning permit does not relieve an applloanYs burden to oomply with all
_ zoning requirements and obtexin all required permits from the Board of Health. Conserverti
Commission. Department of Publio Works and other applioable permit granting eauthoritle<
r '
Y r X`S 4M,
�� �
y_
I ens � 2 �'
", �.. '' i
,.
',
ti w 3
k
11 I
�K! - t.0 RS *,
.a< _ ,.e
.. + t �:,a!s ., of 11 Yg«
�,
,:. 114 1,"' .
v 'z
,%. _ -
- - '., �;�
.. -. .. ,
a ,
k .AFl�g, A :: si^uL S y rev
'„ i 't a �x'n 'k .
I ,, A ;,
^� 5 k Y Y3 @> 4Wk .
'a , e x3` a* 7 � a ,
ast. ' 3 a
7 I , Ak�t'�1 ^¢y�°" °
�, ,a t u
t
r u, .t',� Via'I'll
s s , r ; #
r„ i at '.' ' a x , 1 r*i j.., x< t-. ia"«x - ° M a s' b3"�' � 'fi A Y 'S"'h' +1i I
?,. ` era ag � s
_.
x F. a '.'ye yx'C' �a acv , 3 r° s xa-.. : ._
,.�,•rrw......r" - ,,.s'. n 'n�'+ .. Gr; ''. F4"` "&`5, k fi saw`
11.�ad .w'°' ..ua-1,E ?+nw..u..."-nMWi � �„�,,.�„' '.Prof', _ `.v x s`
r
..� s .r...0 - ,
^e,,
y.. v.
11 ,' �1't
A , ,
,�, _ ..,.,
t
x
3,
.
F I 11 `l x
I,, f � �
,f �� `
, �� €�E
1.'$� {, r
e
F
r a s ,� � 11 -
b
CD O +awes
•�
Vo
b n RA y �
Qn
N
[a• o ° °,
9 g oIQ m
I. i
no
F ►-..� 5' y ° (P R 0 y o 0 a ro 0
1 y _. 3 L m
rl
tD
OQ
y a ID O
? c �.+
ED
ft
r
4. �.
(� IQ Qq Q 0
CA 110
►� �y a CrJ W N ;-+
� T
qQ
�r � �l �% ,� r"� rT r�•�• rT "r'� r� rT CQ/� �r y (➢ �^
® �