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31A-097 (8)
Location..................................................................... PermitNo. ................................................................. Application for other than a Dwelling PermitGranted........................................... 19......... To .............................................................................. NOTE:IN ORDER THAT THIS APPLICATION MAYBE ACCEPTED,THE DATA CALLED FOR BELOW MUST BE SO SET FORTH THAT WE CAN DETERMINE FROM THE APPLICATION AND THE ACCOMPANYING PLANS WHAT THE EXISTING CONDITIONS ARE AND WHAT THE FUTURE CONDITIONS WILL BE. Plans,in duplicate,must be filed with this application before a permit will be granted,one of which,upon issuance of the permit shall be kept at the site during the progress of the work. New...............❑ Addition........11 NO Ly... ......:.. D, Zone.................... Type..................., Map..................... Parcel..................... Alterations ....El Repair............❑ OLP 9199-( CITY OF NORTHAMPTON Demolition....❑ a ; e MASSACHUSETTS Application forotherthan a Dwelling Permit (To be filled out in ink OR on a typewriter) _ 0,9 To the Building Inspector: Date............... . ..�.................... 19 .l.7 Application for a permit is herepy made cccordin to e f owing: 1. Location, Street and No......&.3..... .4.!1' ............... ............................................................................... 2. Nearest cross street.. ................. Lot No.................... 3. Owner's name.......! ......... .............................. Address ......L; S...... ........................ °.... 4. Architect's name................... .T..........................�...................... Address ...... .....,.ry............................... 5. Builder's name ....:1...!..�......I'.�... '....................... Address .. ..... .... 6. Use of building, ..................................... Proposed .�"5.T .. . � .�...... g .... 7. Building fronts on how many Sveets?.....'.............................................................................................................. 8. Is building in fire district?...... D. •.••••.••• ...................................................................................................::......... 9. Size of building,Width in ft. .../...2K..................... Length in ........... Height in ft.... .7............... 10. Distance of building from Street Line................ left lot line..........., right lot line..........., rear lot line........... 11. Type of construction(check one): 1—A.......... 1—B .......... 1---C .......... II.......... III.......... IV.......... V .......... Stories B 1 2 3 4 5 6 7 Roof Story heights in ft. r Thickn's of walls in ins. Material of walls Material of floor/roof ' / M Design live load Design dead load Occupancy or Use vt M_AG&- No.of persons/families No.of stairs l �' 12. Soil under footing is... 1. ................................................... .......................................... 13. Depth of footing below grade........�..................... ft. /Will piles be used?. 0..................... 14. Area of entire building(Present plus new) ...........�.9..! ....................................................................... sq.ft. 15. Type of roof—flat....................... pitched..... ......... Material of roof covering 16. No.of elevators.............. Method of heating.............. System ................................. Fuel ................................. 17. Are live loads noted on drawings? ............... Are all other structural conditions noted on drawings?................... 18. Building(will be)(is)equipped with sprinklers?................................. With sprinkler alarm?.............................. 19. Is building to be used as a factory,workshop or mercantile or other establishment employing 10 or more persons? ................................................................................................................................................................................... 20. Is building to be used as an office building,dormitory,hotel,family hotel,apartment or boarding house,lodging house or tenement house having 8 or more rooms above the second story? ........................................................... 21. How many exits(per floor)to street? ...................................................................................................................... 22. Is building a"Place of assembly"as defined by the General Laws? .................................................*C/ 23. Will building conform to the General Laws? ..q.elS........... Building and Zoning Ordinances?.....r, .......... +" f 24. If a garage,distance from nearest building? ............1. ........................................................................................ 25. If an addition,alteration or demolition,when was building erected?...................................................................... 26. Estimated`costs:— The undersigned certifies that the above statements are a to the best General$ ........... of his/her kn dge and belief. Plumbing......................................... ;. r .... ........................ ..................... . ... .. .. .. . .... .. Gas Piping S' nature of owner,architect or engineer Sprinklers........................................ WRI N DISCRIPTION OF WORK TO BE DONE Heating (Use blank half of reverse side,if necessary) Electric...... .j:.(1. .......... ...1.�":...... ..'..."' .............................................. Other. . ...... ................................ Total$ �.``J . . .��................. PA YNT SH P ;a of 'Narillalllpto-Il Q facssnchnsclls A w DEPARTMENT OF BUILDDIC INSPECTIONS 212 Main Street ' Municipal Building Northampton, Mass. 01060 WORICER'S COINTENSATION INSURANCE t t AVIT (Li pernvttc:) with a principal plact: of businesslresidcnc° at r- q (SUC�JJ i 1S12irJ P) do Hereby cer_u�),, u_oder the pins and oen-,16es of penury, Lh2i. ( ) I LM an employer providing the followu)i; :or'._er's c0u)DC0s2uo0 cove(2gc for My employees wor�ang on dais join. (Innuance Company) (Policy Number) (Fxpiraaon Dale) ( ) I am a sole proprietor,,k.."eneral coou-act or homeowner (circle one) and have hired the contractors listed below who�iavv o owing worker's compensation policies: kAkVS , (I'lcme of Conaaetpr) Q_n_nu-aoc_- Comp-am'Roky Number) Datc) UZ�S (Flame of Contactor) (Lasuranr Comp2ilylpolicf Nturiccr) (Expira6on Datc) (Name of Contractor) (1asu=c_- CoaMau),lPot;cy (Ex-pim6 n Daic) (Name of Connector) (LaSu mc:Compamy/Policy Numk_r) (E)cpiration Datc) �l 6 oml c!wc1 ..,, c L fc<n.j ca pc'_L.�nZ to.0 ax=r-won) I am a sole proprietor and have no one workZng for me. ( ) I am a home owner performing all Lhe work myself. NOTE_please be asruc Lb_t vb,j. arploy perrors to d7 '-.'. ,., m¢::ruuioa cc rc-Pz it work on.C..cllinz of not most th-o Lb—--ru in tr(?icfa the to�.:o:v�cr r d""co t`.v-.ff��:pputtcnint tbc.-cto u DA�cx-:1Yy coe:u;a'r<1 to F� �ploym under tbo woci�r4.cc�pc -tics Art(G L152.ss 1(5)�apptic DOa by&bcu-own r fa--licc�oc pe'�y cvie—L- lrgil rt�.cua of an«ploy>r under tho W«i c!c Compon.tioo A. c I uodctztrnd tivi a Dopy of thi,m r,...,.-r—y b.+f«wordy to t.bo Dcpvrcr_xut of lndu�-i cl��cidcnt�OC6 oo of[su<-�ow for c.'� eoveczse vaifieuioa and tb-t future to eeou covcr,ba under section 25A of MOL 132 c,"lead to 0-1d it o0 of er amt!p�!ties ' 000autcnz of•fine bf up t4 S 1,5 00.00 mUoe cvprisocmcat of up to oor ycr Lod ovd p�IU o n the form of M Stop W ak O der and ■ fin*of S i 00.00 a&Y me Signed J day " 1997 F«&q-CtMCO.t%�-Oaty Permit Number Malt Lot sigaa of ocnscclF'crmiacc 10. Do any signs exist on the property? YES NO I/ 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 colt= to be filled in by the Building Department Required Existing Proposed By Zoning Lot size Frontage n Setbacks - frnnt - side L: R: [ , L: f%1 R: - rear Building height 36- Bldg Square footage %Open Space: (Lot area minus bldg �( ' &paned parking) # .Pf -Parking Spaces i' # (of Loading Docks Fill: 4vol-ume--& location) 13 . Certification: I hereby certify that the information co tained herein is t d and accurate to the best of my kno d e. 1 DME: APPLICANT's SIGNATURE NOTE: 144ua oe o a zoning permit does not relieve an UkppfioanVe burden to mply witiv,oll zoning requirements and obtain all required permits from the Board of Health, Conservation Commission, Department of Publio Works and other appliomble permit granting authorities. FILE # i Fi 1 e No. f'? � ,J 1 ZONING PERMIT APPLICATION (§10 . 2) PLEASE TYPE OR PRINT ALL INFORMATION 1. Name o Applicant: Address: !�U� ""o e ephone: 2. Owner of Property: Address: r,2�? V�D J� Telephone: 3. Status of Applicant: Owner Contract Purchaser Lessee Other(explain): 4. Job Location: V7 Parcel Id: Zoning Map# r Parcel# District(s): (TO BE FILLED IN BY THE BUILDING DEPARTMENT) d 5. Existing Use of Structure/Property 6. Description of Proposed UseMork/Project/Occupation: (Use additional sheets if necessary): 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 Perm itNariance/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 1• 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) t; t, v.. FILE # ' SEP 91991 "PLICANT/CONTAC T PERSOP44? a l�4O��aAe / pRES, $/PHONE q 3' PROPERTY LOCATION: �.,a jx , l�� MAP 3 PARCEL: to THIS SECTION FOR-OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM VU,T,FD OUT Fee Pniti Rnilding Permit Filled ont Fee Paid / J, s 3 .5, Addition to Faisting �_. tf THE FOLLOWING 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: Curb Cut from DPW Water Availability Sewer Availability Septic Approval-Bd of Health Well Water Potability-Bd Health Permit from Conservatio ommissio Signature of Building for ate NOTE:Issuanoe of a zoning permit does not relieve an applioant's burden to oompty with all zoning requirements and obtain all required permits from the Board of Health, Conservation Commission, Department of Pubiio Works and other appiioable permit granting authorities. City of Northampton REQUIRED INSPECTIONS e1. Footings and Walls BUILDING DEPARTMENT 2. Structural Components in Place* 3. Complete Building* No. 868 Office of the Building Inspector Zoning Form No. 962763 Date 9/11/97 Fee $40.00 Check# 1132 Page, 31A parcel 97 ,Zone URB/WP Section 127 ❑ Yes © No BUI]LDINGPERMIT - * Plumbing and Electrical Inspections required THIS CERTIFIES THAT Phaneuf Construction before Building Inspections has permission to construct detached garage 18' X 22' Inspection on Site—Foundations situated on 63 Vernon St - Nancy Young Inspection of Plumbing—Rough provided that the person accepting this permit shall in every respect Inspection of Plumbing—Finish conform to the terms of the application on file in this office, and to the Gas Inspection provisions of the Statutes and the Ordinances relating to the Construction, Inspection of Wiring—Rough Maintenance and Inspection of Buildings in the City of Northampton. Any violation of any of the terms above noted is an immediate revocation Inspection of Wiring—Finish of this permit.Expires six months from date of issuance,if not started. Building Inspection—Rough Note:A certificate of occupancy will be issued by this office upon return Insulation Inspection of this card signed by the Plumbing,Wiring and Building Inspectors. Building Inspection—Finish Smoke Detectors(Fire Department) fr y Other THIS CARD MUST BE DISPLAYED IN A CONSPICUOUS PLACE ON TTO PREMISES Certificate of Occupancy n..:,. .,,, .., ... ,... _. c t � I r - a Fy l City of Northampton REQUMD INSPECTIONS 1. Footings and Walls BUILDING DEPARTMENT 2. Structural Components in Place* 3. Complete Building* No. 868 Office of the Building Inspector Zoning Fonn No. 962763 Date 9/11/97 Fee $40.00 Check# 1132 page, 31A Parcel 97 ,Zone URB/WP Section 127 ❑ Yes ❑ No BUI]LDINGPERM', IT *Plumbing and Electrical Inspections required THIS CERTIFIES THAT Phaneuf Construction before Building Inspectionsr� has permission to construct detached garage 18' X 22' Inspection on Site—Foundations situated or, 63 Vernon St - Nancy Young Inspection of Plumbing—Rough provided that the person accepting this permit shall in every respect Inspection of Plumbing—Finish conform to the terms of the application on file in this office,and to the Gas Inspection provisions of the Statutes and the Ordinances relating to the Construction, ion of Wiring B.au Maintenance and Inspection of Buildings in the City of Northampton. p/�/�tl" L 9 An violation of an of the terms above noted is an immediate revocation �M f tion of Wirun 1 sh fi p�Q Y Y ,(/D � � g of this permit.Expires six months from date of issuance,if not started. �a2 G Building Inspection—Rough o t i a-Z2 9 Z Note:A certificate of occupancy will be issued by this office upon return 1• . � Insuiation Inspection of this card signed by the Plumbing,Wirucg and Building Inspectors. Building Inspection—Finish p K /0,u7-1 Smoke Detectors(Fire Department) Other THIS CARD MUST BE DTSPL D IN A CONSPICUOUS PLACE ON PREMISES Certificate of Occupancy Building Inspector