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35-179 (3) j A o C n• Piz Al v b D m ac ^ > O r � Z O m ::E O X v y I � Zoning Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations NORTHAMPTON, MASS. 19 Additions ' APPLICATION FOR PERMIT TO ALTER Repair Garage 1. Location Lot No. 2. Owner's name Address 3. Builder's name Address Mass.Construction Supervisor's License No. 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 13. Siding house 14. Estimated cost:- The undersigned certifies that the above statements are true to the best of his, her knowledge and belief. Signature of responsible app,icant Remarks OR�tiMfP�-O a 1 �:s:acgniitl� e m DEPARTMENT OF BUILDING INSPECTIONS 212 Main Street ' Municipal Building Northampton, Macs. 01060 WOMCER'S COMPENSA'ITON INSURANCE AY t A= with a principal place of business/resideoce at: w• lr�r ? 0/orb 7 (phone,',') stTr..Uci h/st�.icl�p) do hereby ccr-dff,, under the pains and peoJ6es of perjury, Lh_. ( ) I am an employer providing the followui)g %vor­�ce s cornpensauon cove `oe for My employees wor�_ing on this)& n � ( 36111 GO�2 ce CoMPzay) (PoLicy Number) (Expiry on Date) ( ) I am a sole proprietor, general contractor or homeowner (c].rcle one) and have hired the contractors listed below who have the following worker's compensation policies: (Name of Contractor) QInsuranc_- Compzny/PoLicy Number) (Exp> ation Datc) (Name of Coatrzetor) (Iasunancz Company/Policy Number) (Ex-pira600 Date) (Name of Con>z mor) (lnsumnc_- Compajuy/Poky NusbLf) (F_xpira000 Dale) (!Fame of Contimctor) (Lnstuancc Company/Poky Nuraks) (Expirzoo❑Datc) (cn-nth>Cditioml�+.-c.-� it ocoa,ry co o:..'i�d�;arcYm��co pc--._�r.¢g to�u o«tr-inn) ( ) I am a sole proprietor and have no one worEng for me. ( ) I am a-home owner performing all the work myself. NOTE,plc be amrc dhxt vwt Jo bocca% n wbo cc,lay p<no=w& cow c-o'or r<p�work on L Cwcll rig of oat m«c t6_n thtmo traits in whz ch tbt hoc orvcr Q do or cn Ll :ppurtcn:n rhea n uc o �crolly me idcro�to be cmploym under tbo wociccfiz a c5nim ALt(G r 152y�l(��cpplr�Doo by hoc m for n L anx cc perm i m.sy cvidcrc Lh legs!rtn't .of as enploy>c under rho VJor L Conzponiiiion A<L I undcrztrnd tb.d a Dopy a Chu catcmmt c y b.+fo.w t'd to the Dopunncol urin 4i:�'i cJ l and &Offioo or 1a uu e rot t'. cova-'g vaificstion and thn,t flouTc to ccou covcrnbo under sot on 25A of MOL 152 an lead to tbd imposiflca of criminal pautldcs 000sisIIng of a,-fine bf UP to S1_500.60=,Yor imprao nor orup to oo ycr and ciQ panitio in the f«m of n Stop Work.Ordcf and finoo(Sl00.00&Arf L&C-A-mc Signcd this day of 1997 Ford©otvc-W LL-_ly Permit Numbcr w `._.,.e.. M2 pi Lot 11 Sig)aab=of Liccvscc/Pc-3itt- 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 is by the Bni24iag Department 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) Parking Spaces 4­6f Loading Docks Fill: 4vo1-ume--& location) 13 . Certification: I hereby certify that the information contained herein is true and accurate to the best of my knowledge. r ' j Ja DME: ~- — %'� APPLICANT's SIGNATURE l^ j NOTE: issuance of a zoning permit does not relieve an appiioants urd o comply.Vatft, i. zoning requirements and obtain all required permits from the Board of eaith. Conservation.. Commission. Department of Publio Works and other applioable permit ranting authorities:=- �! - FILE # File No. ZONING PERMIT APPLICATION (§10 . 2) PLEASE TYPE OR PRINT ALL INFORMATION 1. Name of Applicant: Address: Telephone: r Q./ '- 2. Owner of Property:j Address: !o(.mac n� 1�� Q�,c� _ fi��Telephone: 16' 3 7� 3. Status of Applicant: Owner Contract Purchaser Lessee Other(explain): C 4. Job Location: 5= y Parcel Id: Zoning Map# '3-5 Parcel#�_ District(s): (TO BE FILLED IN BY THE BUILDING DEPARTMENT) 5. Existing Use of Structure/Property 6. Description of Propose Use/Work/Project/Occupation: (U e additional sheets if necessary): e a Jp�' a-- C W 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 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) c � i �. FILE if APT 1UNITIC ONTACT PERSON: � ,ADD�SSJPHON�:_ ' PROPERTY LOCATION: yc V C�'�=� PARCEL:__7 ZONE THIS SECTION FOR_�OFFICIAL USE ONLY: PERMIT APPLICATION..CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FULED MIT Fee Pgid a v' New Cnmqtriirfinn Arressnry Structure fh��npr/Ocriivnnt '�tntpment or License ®� T LLOWING 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: er.Availability Sewer Availability v Septic Approval-Bd of Health Well Water Potability-Bd Health P r se o in Signature of Building Inspector ate NOTE:Issuanoe of at zoning permit does not relieve an applioant's burden to comply 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-1998-0067 .................................. Building, Electrical &Mechanical Permits ...............................................................................•......... Fee Type: Receipt No: Vinyl siding & replacement windows REC-1998-000072 ......................................................................................... ...................................... Paid By: Paid in Full On: Larry Paquette Wed Jun 17,1998 •..........................................................................•............. ...................................... Received By: Check No: Linda Lapointe 2106 ......................................................................................... ...................................... DEPARTMENT'S COPY Amount: $20.00 ........................... DEPARTMENT FILE COPY 7 PINE VALLEY 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: Inspector: Tracking No.: Fee: 17 Jun, 1998 BP-1998-0067 963684 $20.00 GIS #: Man Block: Lot: Address: Zoning Use Group: Lot Size: 6995 35 179 001 7 PINE VALLEY RD SR 93218.4 Contractor: License Type: Insurance: Larry Paquette HIC Address: License No.: Insurance No.: 40 East Green Street 100679 City: State: Zip Code: Phone: EASTHAMPTON MA 01027 (413) 527-6375 Project No: Category of Work: Const. Class: Cost Estimate: JS-1998-0067 $3,550.00 Description of Work: install vinyl siding left side of house& 5 replacement windows GeoTMS40 1997 Des Lauriers&Associates.Inc. Ci�snwfi�rn•