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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations
NORTHAMPTON, MASS. -S'��. f 9,2y Additions
APPLICATION FOR PERMIT TO ALTER Repair
Garage
1. Location �f//'��/ �3 dJ 1-4 Lot No.
2. Owner's name K�t l �C^;_�dUt Address ` ,f
3. Builder's name ' +U � f--J C---,- l Address AM 0 S T
Mass.Construction Supervisor's License No. /`�� = f�� �Ofj7eo Expiration Date
4. Addition
5. Alteration —. rSl t O c�, a I (� 1(-r'`1 ,/L) � �r t c�tJ Sit
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- `jn
The undersigned certifies that the above statements are true to the best of his, her
knowledge a,,5 belief.
!` Signature of responsible app,tcant
Remarks
r
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DEPARTMENT OF BUILDWG INSPECTIONS
212 Main Street ' Municipal Building '
Northampton, Mass. 01060
WORKER'S COMPENSATION INSURANCE AF'F'IDAVIT
(liceasee/permittfx}
with a principal place of business/residence at:
0,0,6 (phone#) – �}X - -Fe 7
do hereby certify, under the pains and penalties of pegury, that:
( ) I am an employer providing the following u'orlter's compensation coverage for my
employees working on this job.
(Insurance Company) (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 Company/Policy Number) (Expiration Date)
(Name of Contractor) Oiisumc,- Company/Policy Number) (Expiration Date)
(Name of Contractor) (Insurance Compaay/Policy Numlxr) (Expiration Dale)
(Name of Contractor) (Lnsuranct-Company/Policy Number) (Expiration Date)
(attach additionl shod if no«=j-ry to iodisdo infwmatioa pcujnjng to all o.ti.ctom)
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 wbilo homcowo=who cap lay perso=to do—inim mce coazuctiou or repair work on a dwelling of
not mote than throo units in Which the homeowner mucks or on the gvunds appurtenwf thetdo are not gcacally 000sidcred to be
employers under the wm ct's.oompcns4on Ad(GL152,=1(5)),application by a homec>vmcr for a lictnse or permit may cvid—the
legal et—, of an omployor underth.o Wockces Compoonation AcL
I undestand that a copy of this tfatancai may bo fo wnrded to tbo Doputmm of todurtriel Accidead Offioo of la=rsnco for tbo
coverage vuificaiioa and that failure to scarce coverago undo section 25A of MGL 152 can lead to tha imposition of-iminal penalties
coos isting of a f nc of up to S1,500.00 andlot impriso® of up too=year and civil pcnaltim in the form of a Stop Work Order and a
find of 5100.00 a day agsinsl me
Signed his G( da Of �--� V – 1 For dq l urtzntnt use only
+ Permit Number
Mao— Lot#
Si of L ccnsce/Pcrmitiee
10. Do any signs exist on the property? YES NO *p;
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 colic 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
&paired parking)
# of Parking Spaces
# 'of Loading Docks
Fill:
4vol-ume--& location)
13 . Certification: I hereby certify that the information contained herein
G, is true and accurate to the best of my knowledge.
DATE: APPLICANT'S SIGNATURE
}" NOTE:lssuanoe of a zoning permit does not relieve applioanYs burden to comply witlr,.all
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 #
JM 9
,,r BtJll_
File No.
R ZONING PERMIT APPLICATION (§10 . 2)
PLEASE TYPE�OR� PRINT ALL INFORMATION
1. Name of Applicant: t� L_--ds r s e-l(
Address: S 7- & e j Telephone:_ -� f 5-2eo
2. Owner of Property:
Address: `T'( / Z �. "0'® Telephone: 6-3>�/e e'o- 3
3. Status of Applicant: Owner Contract Purchaser Lessee
Other(explain): /1
4. Job Location: C
Parcel Id: Zoning Map# Parcel# District(s):
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/Property � a IS;,E 17 c LL
6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary):
is;"k.) LAe-r--rti &-4.�—�Zc j,k C..c!�s
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/Vahance/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_j<_ 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 # 96366
APPLICANT/CONTACT PERSON:
ADDRESS/PHONE:
PROPER'T'Y O TION:
MAP cz PARCEL: ZONE
THIS SECTION FOR-OFFICIAL USE ONLY:
PERMIT APPLICATION_CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM Eff I.RD OUT
Fee paid
]Riiil ing Permit Filled ""t
_Remndelin2 Interior
A rressnry 'Strnctnre
3 Sek of Pinns /Plat Plan -1
T11 TI
US ACTION HAS BEEN TAKEN ON TS AP ICATION:
Approved as presentedfbased 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
eptic rb.'a Bd of Health Well Water Potability-Bd Health
Permit from Conservat' Commission
Signature of Buil ' ector D e
NOTE:Issuanoo of a zoning permit does not relieve an applicant's burden to comply with all
_ zoning requirements and obtain all required permits from the Board of Health, Conservation
Commission, Department of Public Works and other applicable permit granting authorltles.
Department: Reference No: BP-1998-0047
Building, Electrical & Mechanical Permits
..---------------------------------------------------------------------------------------
Fee Type: Receipt No:
replacement windows REC-1998-000051
------------------------------------..........--------...................................
...... ...............................
Paid By: Paid in Full On:
John Corbett Thu Jun 11,1998
•...........................................................•----........................
......................................
Received By: Check No:
Linda Lapointe 1108
.........................................................................................
......................................
DEPARTMENT'S COPY Amount: $20.00
...........................
DEPARTMENT FILE COPY 418 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: )&Q / Insyector: Tracking No.: Fee:
11 Jun, 1998 BP-1998-0047 963665 $20.00
GIS#: Map Block: Lot: Address: Zoning Use Grout): Lot Size:
4813 29 087 001 418 RYAN RD URA 12153.24
Contractor: License Type: Insurance:
John Corbett
Address: License No.: Insurance No.:
56 Dimock St
City: State: Zit) Code: Phone:
LEEDS MA 01053 (413) 584-5807
Proiect No: Category of Work: Const. Class: Cost Estimate:
JS-1998-0048 $2,300.00
Description of Work:
install replacement windows
GeoTMSQD 1997 Des lauriers&Associates.Inc. Cianwr..rn-