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29-366 (2) FAI 413 467-2260 R W-BAY PATH GRB PO? *-4L. �6 FAX 413 4672:61) R W-BAY PATH GRB P03 8, •w v* G F= 413 467:260 AX R tG-BAY PATH GRB Pil i C� r, c� 1 • z c > i < n 77 ^� V) L4 Z rn --_�U L p > r� Zoning Miscellaneous Additions, Repairs,Alterations,etc. Tel.No. Alterations NORTHAMPTON, MASS. 19 Additions APPLICATION FOR PERMIT TO ALTER Repair Garage 1. Location /IX? Lot No. 2. Owner's name -( F 1' kn?'-I' Address S ✓�? /�^ 3. Builder's named��� r�/��/i�S �- Address f IU,.S�C�<<v DiUro S G��� Mass.Conswction Supervisor's License No. Q 612 72 Expiration Date 4. Addition S> 'a,2 �Z � ccW���' y�1,�cf � �,✓1G`���/' [:�.�i?/�GG� 5. Alteration 6. New Porch 7. Is existing building to be demolished? 8. Repair after the fire 9. Garage V No.of cars Size V X�' 10. Method of heating 11. Distance to lot lines 1 /?6 �/ 5 JCS /�lC� '- /5 a /` ei'9/Z 9 12. Type of roof, S 13. Siding house n) ll 14. Estimated cost- j C The undersigned certifies that the above statcments are true to the best of his. knowledge and belief. Signature of its nsible appicant Remarks - -�, c 12 oQ`T `a Crz# j Of NJaz � � �8S6ACh 1[H Ct�H DEPARTMENT OF BUILDING INSPECTIONS - 212 M �Alain Street AZunicipal Building INSPECTOR Northampton, Mass. 01000 Square Footage Amount © O Basement @ .10 lst Floor @ .40 �1 'Q --....�,,,� 2nd Floor @ .20 1/2 Floors, Attic, Gaffe 10 Deck„Porches .10 TOTAL __ `/ CD G Kj\ Nz� 0 t 0 1997 t U C�i-4 Jaf#Ij�llt}� II11 [8 ,V EPJUTMENT OF BUILDING INSPECTIONS 212 Main Street ' Municipal Building ' Northampton, Mass. 01060 WORSCEIR'S CONeENSATION INSURANCE Ar,MAVIT z sA (li�nseJperuli flee) with a principal place of business/residence at: (s�Uat}'/stztcJ p) do hereby certify, under the pains and penalties of perjury, that. ( ) I am an employer providing the following Nvor ker's compensation coverage for my employees wor-�ng on this job: (Insurance C:omp2my) (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 Compar<yfPoticy Number) (Expiration Date) (Name of Contractor) (Lns uanct- CompanyiPoucy Number) (Expiration Date) (Name of Contractor) (Laa any CompanyfPolicy Number) (Fxpiradon Date) (Name of Contractor) (LasuranC-- Compaay/Policy Number) (Expiration Date) (attach additional shock trnocc=.ry to incWc mfonnxtioo periairaag to a oodradon) ( am a sole proprietor and have no one worming for me. ( ) I am ahome owner performing all the work myself- NOTE:please be aware that vebilo homcowaa3 wbo cmp!oy pczso=w do m iTd��..,.-' aoa5ructioa or ripait work oo a duelling of act mcce th_n throe twits in tvtnch the homoowner rc=da or oa the grounds appurtenant tba-cto arc oo(gcocnaly ooandc cd to be cmploycn under tbo workcx o=pc=atioa Act(GL152,ss 1(5)1 appticaboa by a bomoowncr for a lio=c cc permit may evideoe the legal etahsa of an mployw undertho Wockoee Compomation AcL I undcmumd tint a copy of thu catcmmt may ba foewnrded to tbo Dcpartaxaf oflndiitsiel Aecd=&Of5oo of fa:ora000 for d- covcra gc vcrifitsiioa and that failure to scaue covcmV under scctioa 25A of M01,152 can lead to the impositioa of a-imiaal prnalties oomisting of a fine of trp to S 1,500.00 and/oc impris�of up to ooe year and civil pcaaltia io the form of a stop Work order and a Eno of 5100.00 a day tpiosi u3, Sign this. day of l//L 1997 F«-dcpu>mwsl u,e oaiy Permit Number Lot 9 Signature of LiccnscelPcrmi n Res•' '� '��� � � i I 1 p 5� r i t x-13 -� l2acM� �. i 1 � g be. . 1 10. Do any signs exist on the property? YES NO da 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 co?== to be filled in by the Building Department Required Existing Proposed By Zoning Lot size Frontage Setbacks -� 3 IS - side L: R: L: 5— R: - rear Building height ' Bldg Square footage %Open Space: 2 a �+ r)00 (Lot area minus bldg &paved parking) 2, a 1e # o.,f -Parking spaces f of Loading Docks Fill: (vol-ume--& location) - 13 . Certification: I hereby certify that the information contained herein is true and accurate to the best of my knows cge. . DATE: ,,.� � /� � APPLICANT'S SIGNATURE NOTE: issuance of a"zoning permit does not relieve an a licanYs burden to dom wit ~ PP PIY , .f1�,.all zoning requirements and obtain all required permits from the Board of Health, Conservation Commission. Department of Publio Works and other applloable permit granting authorities. FILE # 6 r7v, a-. i 01997 F' Fi 1 e No. .......................... 'ZONING PERMIT APPLICATION (§10 . 2) PLEASE TYPE OR PRINT ALL INFORMATION � I 1. Name of Applicant:_ Al{ j Address: ' 4, Telephone: 2. Owner of Property: .T Address:_j� G'St�.�° C°t%'4�l` Telephone: ~ 3. Status of Applicant: Owner Contract Purchaser Lessee Other(explain):__ �/; ,2.C?�'✓�1. 4. Job Location: (� S r//� z' ,2 C° Parcel Id: Zoning Map# Parcel# 3 (e District(s): .� �[?� (TO BE FILLED IN BY THE BUILDING DEPARTMENT) 5. Existing Use of Structure/Property /1Y 6. Description of Proposed UseNVork/Project/Occupation: (Use additional sheets if necessary): .51-1V 6 lW 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/Vadance/Finding ever been issued for/on the site? NO DON'T KNOW YES IF YES,date issued: 0 IF YES: Was the permit recorded at the Registry of Deeds? NO DON'T KNOW YES IF YES: enter Book Page and/or Document# i 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) r L. i; FILE # r 7 .A� I 0 1991 APPLICANT/ NTACT PERSON: of R SS/BO E: Z, ,¢ PROPERTY CATION: MAP PARCEL: ZO THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE Fee Pnid Building Permit Fillpflnut Fee Pgid Addition to J /y Existing tr/'_ -3 Sets of Plans 4X12—tPinn THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION- Approved as presentedfbased on information presented XDenied as presented: x Special Permit and/or Site Plan Required under: § 10.(0 10, ( (� , �(� ') PLANNING BOARD ZONING BOARD ' 1 r��(0 1�'i 'ru►� 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: § WZONING 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 duig or at NOTE: lasuanoe of a zoning permit does not relieve an applionnt'a burden to oompty with all zoning requirements and obtain all required permits from the Board of Health, ConaPrvation Commission, Department of Publio Works and other applicable permit granting authorities.