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Zoning
Miscellaneous Additions,Repairs,Alterations,etc.
Tel.No.5L Alterations
Additions
NORTHAMPTON, MASS. 19
APPLICa ATION FOR PERMIT TO ALTER Repair
Garage
1. Location C� �t C/I U J-7-e f C"c Lot No.
2. Owner's name ��� C�'T 1 I 6,Ad ess`
3. Builder's name 441 6� Address )00
Mass.Construction Supervisor's License No. -2 Expiration Date
4, Addition
5. Alteration
6. New Porch
7. Is existing building to be demolished?
8. Repair after the fire
9. Garage No.of czars Size
10. Method of heating
11. Distance to lot lines
12. Type of roof C--c y) /I'd l �'
13. Siding house
14. Estimated cost:- �c o o,
i The undersigned certifies that the above statements are we to the best of his, her
knowled a and belief,.
i Signature of responsible app,icant
Remarks
Oft iinJ{PTO
fi J(JA/ l
B ja:xct�LLSCtta
d, DEPARTMENT OP BUILDYNC; INSPECTIONS
212 Main Street ' Municipal Building _
Northampton, Mass. 01060 '
WORZCCR'S COMPENSATION MS(MA-NCE AY'FIMAVTT
�� (li ccnscrJperm�Ltrc)
vrith a principal place of busMcsslresidence it
do hereby cemf},, u-oder the pains aiid p,eaalties of pcijury, rbai
( ) I <m an employer the following :voti'.1:ei's compcnsaton coves ;-or my
employees v,'ortmng on tbl', job
(Ins uana Co.ni y) (1)011 cf Nt1�-, -} ( tiu rafon Datc)
O I am a sole proprietor general con��ctor of homeowDer (tide one) amd 7-VC hired
the contractors listed below who llav-- the follo",Pmg worke"s ccmlpensanon policies:
/i llic Oi Lo:lmC cl ('[ I[�_ �. .ic C 0 1
GN,-une 0! OIif7.C1pC) (11151 d!7C� COlhJ . )'�O� C� Nl1I �Cf) AFL<<._.O �2(e}
(Name of Contr2ctor) (Ins trance Compas}•lPotjcy Numb--T) (E."I'm000 Date)
(Name of Contractor) (lasunuce Comoanyfl'oLicy Null)b�r) (Ltp.r2non Dom)
(_t L,dL s�ihccx!i-`.-ct if nccz.pry[o�ac]�Ki.:enlcrza.r ti o<� �-1�_�rE to�ll cccir:c_on)
( ) I arrj a sole proprietor and have no one v.,orking for me-
( ) Z am a home owner peffor-m mg all the work fnysdf.
NOTE plcsc be am C thzt v Hilo b'CY`}�J�1Y�X'17 vto ploy per.om w d, i i,• �c ut oa of rtp�-r work on a cf vcll rig of
not-o"th=Lhmo tntt]III wt2 ch tb,wµ,n�,r,, 7Cdcs Or ,Lbo O tpd]'YY ^��tbdo,DO t oa ally ooa Z=d to bC
cmploycn utxSer[bo w ockrt's ooh Len Act °pplicaocro by a 6omcown�t fore Gcty-e cc permi1 nvy cvi&—Lb-
legit vt-b of an omployor under do works e.Cocap<c..iioa Acc
I uadcsritaa th,i a copy of t4u cbd.c cc t may bo fo,,v to Lbo Dcp�of L.&L ri el Aacid�tf Olfioo of fawrznou for tb4
oovaxgc vtri cation and that t inure to tcalrc cw,'C o undcr soction 2JA of MQL 132 C29 I-d to tbd impo"60a of aimiaA pco--LWcs
s g oCa&ne oCup to SU00.00,wdloe imprisooaicui of up to 015C year end civta pa,.lbca in the foan LiC A Step Wos1c OnScr.iod•
fine of S10A:00`i 4y i�tdsl me
Foi-,dcputmr-day`s'°°°ty '
- _ Pcrmit2ltunhcr _ -�
`z tgn��rre°£x-j�srclPcrzria i
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 colas to be filled in
by the Handing Department
I 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
' &paved parking)
# .pf Parking spaces
f 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 knowledge.
DATE: l C� APPLZCANT's SIGNATURE tit %` .
NOTE: 1 uanoe air a zoning permit does not relieve a a PP Iioant's burden to oom P I wit
1p,.p11
zoning requirements and obtain all required permits from the Board of Health, Conservation
Commission, Department of Publio Works and other applicable permit granting authorities.
FILE #
JUN 1 8 1998
File No. ja4,
ZONING PERMIT APPLICATION (§10 . 2)
PLEASE TYPE OR PRINT ALL INFORMATION
,�
�I
/
1. Name of Applicant: JTIG'v2_�� �� q/ L',
Address: � �� `� /U 4- Telephone: �/� Y 15
2. Owner of Property: P'eV't1n1 Z--
Address: e7(c�l SG Telephone:
3. Status of Applicant: Owner Contract Purchaser Lessee
Other(explain):
4. Job Location:
Parcel Id: Zoning Map# Parcel# i District(s):
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/Property
6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary):
�„� �'�''�� L ,� �`S , 1,�{cal ,� • ✓�-��.-- � �'/
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/Variance/Finding ever been issued for/on the site?
NO DON'T KNOlti��_ 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
APWA RONTACT Vf.RS N:
ADDRESS/PHONE: G'l vW
PROPERTY LOCATION:
MAP ' PARCEL: ZO
THIS SECTION FOR-OFFICIAL USE ONLY:
PERWr APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZllNHN!' FORM EH T JED OITT _
FPQ Pnid
Iguilding Permit Filled olit
'New Constriirtinn
-Rerandelin2 Interior
Addition to Existing
G�3f
ArrP,,,,ory Strurtnre
$„ildina Plan,,Tnchiderl-
3 Sets of PInns I Pint Plan
o?
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION-
Approved as presentedlbased 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
Permit from Conservation Commission
Signature of Building Inspector Date
NOTE:Issuanoe of at zoning permit does not relieve an applioant's burden to oomply with all
_ zoning requirements and obtain ail required permits from the Board of Health, Conservation
Commission, Department of Publio Works and other applioabie permit granting authoritles.
Department: Reference No: BP-1998-0069
----------------------------------
Building,Electrical & Mechanical Permits
•-- -----------------------------------------•--............ ............................
Fee Type: Receipt No:
Roofing REC-1998-000074
....................................... ......................................
Paid By: Paid in Full On:
Ronald Mistarka Thu Jun 18,1998
......................................................................................... ......................................
Received By: Check No:
Linda Lapointe 573
......................................................................................... ......................................
DEPARTMENT'S COPY Amount: $20.00
...........................
DEPARTMENT FILE COPY 961 RYAN RD
CITY OF NORTHAMPTON
BUILDING PERMIT
Owner's pulling their own permits or dealing with unregistered contractors for applicable work do
not have access to Guaranty Fund(MGL 142A)
Issued: Permit No: I W Inspector: Tracking No.: Fee:
18 Jun, 1998 BP-1998-0069 963696 $20.00
GIS#: Map Block: Lot: Address: Zoning: Use Group: Lot Size:
6869 35 052 001 961 RYAN RD SR 31188.96
Contractor: License Type: Insurance:
Ronald Mistarka HIC
Address: License No.: Insurance No.:
P O Box 205 118693
City: State: Zip Code: Phone:
NORTHAMPTON MA 01061 (413) 584-5140
Proiect No: Category of Work: Const. Class: Cost Estimate:
JS-1998-0069 $7,000.00
Description of Work:
strip & shingle roof
GenTMSO 1997 Des Lauriers R Associates.Inc_ C:(snwfi