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35-126 (2) ' a 2 �n ,...,.._..., O cpO < O T w� T � m N L 3 ° m CL LLJ CM- z o Z „� p ..1 m ° ° y r� I � Zoning Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. ��� ' Alterations NORTHAMPTON, MASS. !74g0 19V Additions APPLICATION FOR PERMIT TO ALTER Repair--tea _ Garage 1. Location ��5 i qysL 7P'ra 11a t j C Lot No. 2. Owner's name Cto Address iwt 3. Builder's name Ke� & +yti F� Address del +1i�A�2 Mass.Construction Supervisor's License No. C7 ly I �� � 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 cars Size 10. Method of heating 11. Distance to lot lines 12. Type of roof ! vtc>S l 1 Von t 13. Siding house 14. Estimated cosL- e The undersigned certifies that the above statcmc are we to the best of his. knowledge and belief. Signature of responsible app icant Remarks 4-ttl/uiP�. _ �1Z Dfi> �j�11TIIIYT II� _ A xs$xc4usctlt SEP 2 1. 1999 _ m p DEpAkk ENT OF BUILDING INSPECTIONS �T OF 4 ' 1 t Ft T38�8 atn Street Municipal Building �„ _�. !'�lt� -• orthampton, Mass.• 01060 WORKER'S COiYLPENSATTON INSURANCE AFTIDAVIT with a principal place of business/residence at: C 11' r} N4 . (phonelr) ��3 ��'J�� ( city/sta2rJap) do hereby certify, under the pains and penalties of pegury, that- ( ) I am an employer providing the following workers compensation coverage for my employees working on this job: (Insurance Company) (Policy Number) (Expiration Date) ( ) f am a sole proprietor, eneral contracto f r homeowner (circle one) and have hired the contractors listed below v o ve the following workees compensation policies: (Name of Contractor) (Insurance Company/Policy Numhcr) (Expiration Date) (Name of Contactor) (Insurancc Companv/Poiic+Number) (Expiration Date) (Name of Conmctor) (Insurance Company/Polief Numbtr) (E.1-pim6on Date) (Name of Contractor) (Insurance Company/Policy Numb-u) (Expiration Datc) (sttztl zd4rtioosl zbccr ifnc czs_.ry to cx.'uc4 infocvz.aoo pertaining to.0 ooatr- on) (><'I am a sole proprietor and have no one working for me. ( ) I am a home owner performing all the work myself. NOTE:please be aware that tvfiilo 6omr�+�cn wbo rzz�rloy pctzous to do ,"-,-,,,,�c�7trciioo'ot repair work on a dwcllyrg oC not morn than threa units is which the homoowncr raidea of oa th.o grounds rypurtraaat tbacto arc oct gao sv11y oocz i rcd to be cmploycu undet the%ockces oompcwxdca Act(G Li 52,33 1(5))'applira6on by a homcow=far a Gass-«perm;i may evideooe the legal st:bta of&*employer under die Woriccla C,ompom.tion Act I understand that a copy of thin s fa A may be forw.ud.d to the Dopsrcmrcd of Indumisl A-;d�Office oC Imuranos f«tb. coverage vaificatioo and that failtuc to scauc covas�o trndci section 2SA ofDIOL 152 un la.d to the ion oCcriminal pcnal$c� oomisIIaa oCa fine ufup to SI�00.90 ancy«cn{u000anexd oCup to ooe ycr and avr7 pranriin ie the f«m of a Stop WocieAder sad a fuw 0t5100.00 a day again;ma For dcyatin� uao ooly PcrmitNtun ..WraP�.__�___.—. . -- Ssguahun of I.iatmscc/Perznitxce - • 10. Do any signs ebst 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 color= to be filled in by the Building Depaxf­nt 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) # of 'Parking spaces it of Loading Docks Fill: vol-ume--& location) 13 . Certification: I hereby certify that the information con ined herein is true and accurate to the best of my knowled e. DATE: q dZ© APPLICANT's SIGNATURE NOTE: lssuanoo of a zoning permit does not relieve an ptioantse urd comply witall zoning requirements and obtain all required permits from the Board of Health, Conservation Commission, Department of Publio Works and other applioable permit granting authorities. FILE # !Fjq, � File No �� v� ��� �� � � ~~~-�"���"~� °^°��~=°�~^� �=^°~ ���~~�°�°^��~��~ x �r���� ° ��� PLEASE =E OR PRMT ALL ZNFORMATXON 1. Name of Applicant: A ddress �phmmm 2. Owner of Property -4 fftei-4444 3' Status of Applicant: Owner Contract Purchaser Lessee Other(explain): 4. Job Location: Parcel Id: Zoning Map# Parcel# District(s): (TO OE FILLED |NBY THE BUILDING DEPARTMENT) 5. Existing Use ofStruoture/Pnopodyl3 G. Description 7. Attached Plans: Sketch Plan Site Plan nginemnad/8un**yedP|ans Answers mo the following o questions may uwobtained by checking with the Building Dept p,Planning Department Files. 8. Has o Special PornnitVahanoe/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 myDeeds? NO DON'T KNOW YE IF YES: enter Book Page and/or Document 9' Does the site contain a brook, body of water orw»dands? N DON'T KNOW YE IF YES,has a permit been or need to be obtained from the Conservation Commission? Needs tqbw obtained Obtained— .date issued: (FORM CONTINUES ON OTHER SIDE) 45 CAHILLANE TERR BP-2000-0316 GIs#: COMMONWEALTH OF MASSACHUSETTS Map:Block:35- 126 CITY OF NORTHAMPTON Lot:-001 Permit: Building Category:roofing BUILDING PERMIT Permit# BP-2000-0316 Project# JS-2000-0504 Est.Cost: $2200.00 Fee: $25.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: KEITH HAMILTON 074129 Lot Size(sq. ft.): 10541.52 Owner: DICARLO ALBERT&VICTORIA M Zoning: SR Applicant: KEITH HAMILTON AT.• 45 CAHILLANE TERR Applicant Address: Phone: Insurance: 27 CAHILLANE TERR (413) 587-0763 FLORENCE 01062 ISSUED ON.•o9/21/1999 o:oo:oo TO PERFORM THE FOLLOWING WORK.-STRIP & SHINGLE ROOF 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 siiinature: Fee Type: Receipt No: Date Paid: Check No: Amount: Building 09/21/1999 0:00:00 $25.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo