35-157 (2) a
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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. �rC33, ' Alterations
NORTHAMPTON, MASS. � `� 19! Additions
' APPLICATION FOR PERMIT TO ALTER Repair
y� Garage
1. Location T,�A RI M° Lot No.
2. Owner's name Address P
3. Builder's name Address 7 3 0 ��
Mass.Construction Supervisor's License No. 4 S:� V2 Expiration Date 1 St
4. Addition / 17 ,, 17 — gl- q'9
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. Di ;1i lines
12. hype of roof Cpvtr.C' "- - / -!!:I 4-,�� je AP
13. Siding house
14. Estimated cost-
The undersigned certifies thbt the above statements are we to the best of his, her
knowledge and belief. t
Signature of responsible app,icant
Remarks
4-t ttAM p�,
=O O�
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a e ',A'' 2 9 ',998 x=axc4nsrtla
m DEPARTMENT OF BUILDrNG INSPECTIONS
-- - m^.-=.. 212 Main Street ' Municipal Building '
Northampton, Mass. 01060
WORS{ER'S COMPENSATION INSUR.ANC t AVIT
with a principal place of business/residence at:
� j S� i1(G hone# i/
(str�City/slmlP/ap)
do hereby certify, under the pains and penalties of perjury, that
( ) I am an employer providing the follo%ving worker's compensation coverage for my
employees working on this job:
(Insurance Comparry) (Policy Number) (Expiration Date)
. 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:
(NiL21C of Contractor) (Insurance C0mpan)'/P0GCY NI=IDCT) (Expiration Date)
(Name of Collmactor) _ (Insurance Company/Poticy Number) (Expiration Date)
(Name of Conrractor) (Insurance Company/Policy Number) (Expiration Date)
(Name of Contractor) (Las-L=, ce Company/Policy Number) (Expiration Date)
(attach additi oozl vhcci if�cc .ry to inch3cSc infocmitioo PcYta.g to all oc,,,clors)
I and a sole proprietor and have no one working for me.
( ) X am a home owner performing all the work myself.
NOTE_plcaae be awa.-e chit whilo bomcownera�*to employ pu som to do jotcajnocr,eoWructioo ar rrpau work on i dwelling of
not mgco than lbtno arias in tctr ch the kw,Qoowocr redo or oa tbo grounds appurtca thacto arc oot gczvarralty comidacd to be
cmPtoyrsa under tba worker's cation Au(GL152,s31(5)),application by e bomcowncr far a liccax cc Parma may cvrdcnoc the
lcgxl rtsrhtx of an amp Ioyoc under dh Work ex compm iioma Act
I undazUnd thst a oopy of thin r t.temmt may bo focwardod to rbo DcpermxoC of L,&S i e A�adms�Qff o0 of Innu.noo for tba
covezxge vaificaiioa and that failure to t,==oovcrngo uodcs soctioa 23A of MoL 152 caA lead to tbd imposition of aimm-s1 pcaaltica
ooaiiltmg gx-finc of up to S 000.00 aad/ot imPruoarncat of riP to.onc year and avil pcmltia in the form of a Stop Work Ocdcr and a
fim of 5100.00 s.day tVdnsi¢x.
For dcpatma;bd uPo CalY
Pcmlt Number
lot __---
Y S1�gaEurc of Liacnscr7Pcrmitt6-- — $
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 colu= to be filled in
by the Building Department
Required
Existing Proposed By Zoning
Lot size
Frontage
Setbacks - frnnt
- side L: R: L: R:
- rear
Building height
Bldg Square footage
%Open Space:
(Lot area minus bldg
&paved F""" 9)
# of -Parking spaces
# of Loading Docks
Fill:
-(volume -& location)
13 . Certification: I hereby certify that the information contained herein
G is true and accurate to the best of my knowledge.
DATE: / `�/9� APPLICANT's SIGNATURE
NOTE: lasuano of a zoning permit does not relieve an npplioan t urdevr o oomply wit4 +111
zoning requirements and obtain all required permits from the Board of Health. Conservation
Commission. Department of Publio Works and other applionble permit granting authorities.
FILE #
MAY 2 9 ,1998
Fi1e No. ✓ " t
ZONING PERMIT APPLICATION (§10 . 2)
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant:/
/
Address:
TeA2— lephone: .S,/
1 Owner of Property:
Address: 2 YA AI �� . Telephone:
3. Status of Applicant: Owner >< _Contract Purchaser Lessee
Other(explain): (�
4. Job Location: _ J� 61
Parcel Id: Zoning Map# Parcel,( _ District(s):
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/Property j2� S_C , l 1. EA M
6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary):
?-�-J? i
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 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 'D�_ 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)
i
',r FILE #
_ MAY 2 9 i;
y APPLICANT/CONTACT PERSON:
:{FADDRESS/PHONE: � i�' k , c)/D
PROPERTY LOCATION: /yrL� �
N AP .5� PARCEL: Xr7 ZONE �
THIS SECTION FOR-OFFICIAL USE ONLY:
PERMIT APPLICATION.CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM M.I,F.n ALIT
Fee Paid
Tliiil ing Permit Filled 011t
a d z/
Type of Constuirtion-
Addition to Existing
Owner/Ocrupant Statement or Lirensp;Y
3 Set-, nf P)nns /Pint Plan 117 o `
T OLLOWING ACTION HAS BEEN TAKEN ON THIS AP ICATION-
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:
t .h ` Water Availability Sewer Availability
Septic Approval-Bd of Healt Well Water Potability-Bd Health
i se ion 11Q8
Signature of Building Inspector D to
NOTE: kmuanoa of a zoning permit does not relieve an applioant'a burden to oomply 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 authoritles.
' Reference No: BP-1998-0031
Department: ...................................
Building, Electrical & Mechanical Permits
..---------------------------------------------------------------------------------------
Fee Type: Receipt No:
Roofing REC-1998-000034
.........................................................................................
... ... ... .. .. ......
Paid By:
Paid in FuII. ...On:..........
Steven Olihan Mon Jun 01,1998
.........................................................................................
- - - ------ ------
Received By: Check- - No: ------------------
Linda Lapointe 585
.............................................................................--------....
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DEPARTMENT'S COPY Amount: $20.00
...........................
DEPARTMENT FILE COPY 824 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: )(A-1 Inspector: Tracking No.: Fee:
01 Jun, 1998 BP-1998-00311 Stanley Szewczyk 963596 $20.00
GIS #: Map Block: Lot: Address: Zoning: Use Group: Lot Size:
6973 35 157 001 824 RYAN RD SR 47044.8
Contractor: License Type: Insurance:
Steven Olihan
Address: License No.: Insurance No.:
84 South Loomis St
City: State: Zip Code: Phone:
southwick MA 01077
Protect No: Category of Work: Const. Class: Cost Estimate:
JS-1998-0032 $6,800.00
Description of Work:
strip& shingle roof
GeoTMSID 1997 Des lauriers&Associates.Inc. C:.rno+..rP•