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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations
a NORTHAMPTON, MASS. 19 Additions
APPLICATION FOR PERMIT TO ALTER Repair
Garage
1. Location i2)11). 6,FF_vS Lot No.
2. Owner's name uIL /jj�F/-L1ffF_'!Z Address - NO /��r/,7tt3cz.✓ � L����s.
3. Builder's name ,-1 Address y3 L &,,/TV
Mass.Construction Supervisor's License No. CS 66 !6 Fk Expiration Date 3,1,7S1.7o o 1
4. Addition
5. Alteration
6. New Porch
7. Is existing building to be demolished?
S. 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 &P,r ®yow-, .✓ .r l;.Z
14. Estimated cost_-
The undersigned certifies that the above statements are we to the best of t
knowledge and belief.
Signature of responsiblt appicam
Remarks
oafaz#4ttnttxn
. _ .. }�assariirrsrus
V�p ' c DEPARTMENT OF BUILDrNG INSPECTIONS
�'�11{ U 212 Main Street ' Municipal Building
Northampton, Mass. 01060
I�PT '
r �, tdta lHSPECT10 13
t � OiYLPENSAZION muizA_NCE Ar,mAvrr
with a principal place of business residence at:
y3 (t Z�n/rY Z? Il-17-IA14, (phone#) T Q U()
(strz~t/ci ty/stat e/a p)
do hereby certify, under the pains and penalties of perjury, that:
O I am an employer providing the following worker's compensation coverage for my
employees working on this job:
(Insurance Company) (Policy Number) J (Expiration Date)
()() I am a sole proprieto , general contractor or homeowner (circle one) and have hired
the contractors listed below who have the following worker's compensation policies:
1NS_ eg. FN R,J 9 �,�1 S)9`t
(Name of Contractor) (Insu-rance Compauy/PoLicy Number) (Expiration Date)
ogr,PIP 1,-xr 's (6. F6L)c S S3i `i����
(Name of Contractor) Unsumczz Company/PoLicy Number) (Expiration Date)
(Name of Contractor) (Insurance Compauy/PoLicy Number) (Expiration Date)
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(attach additiomi sho=t ifnco=L ry to inc}ude infvrutitioo pertaining to el]ooairndors)
O 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 wttilo homooKUm who amploy persons w do m__•_ __-._ cr,cons c ion or repair worst on a dwelling of
not taco then tb oo units is wf ich the homoowncr resides or co the grmrj�di appurtcn-tid thacto art not centrally 000aidacd to be
employers under the%Vm*cr`s,ocnpcamation Act(GL152,=1(5)},application by a homcowra for a licca3c or pc=m may evidenoe the
legal rules of an omployor undortho Woriccle Compmzation AcL
I understxad tint x copy of thin rtatemcni mxy bo forwarded to tho Dtpn tmcod of Indzutrid Oflioo of Iavu for the
covezxgo vaificstioo and that failure to&sort oovav-go under suction 25A of MOIL 152 can]cad to the imposition of criminal pcaaliics
ooausung of a fim of up to S 1,500.00 and/or unprisoamcnt of tip to one year and civil pearltia in the form of a Stop Work Order and a
fins 0(5100.00 a Any against mc.
For dial ttao only
�---� permit Number
Map# Lot#
Signahuux of Li ermittee
10. Do any signs exist on the property? YES NO X
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
I (Required I
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
ht of Loading Docks
Fill:
(volume--& location)
13 . Certification: I hereby certify that the information contained herein
(, is true and accurate to the best of my knowledge.
DATE: AIiC// /5-, W APPLICANT'S SIGNATURE
NOTE: Issuanoa of a zoning permit does not relieve an appliomnt's urden ta-Wompty witla��ll
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 #
d r MAR 1 619
................... Fi 1 e No. ! lr1?
?PPT uF SUS IG INSPECTIV'
ZONING PERMIT APPLICATION (§10 . 2)
PLEASE TYPE OR PR2NT ALL INFORMATION
1. Name of Applicant: I>;, o7
Address: 'VS f oc'-d —y k">> A4'7-1✓;r-rCA11 Telephone: t'6i- 6,23o
2. Owner of Property: /-Maui_ ,CF t_L 1 14 IC i-.
Address: S3 0 A va; Bv:v j2> L.kFD 5 Telephone: J,�r l/
3. Status of Applicant: Owner ;,/ _Contract Purchaser Lessee
Other(explain):
4. Job Location: _�' d
Parcel Id: Zoning Map# Parcel# District(s):
(TO BE FILLED IN BY THE BUILDING DEPARTMEN
5, Existing Use of Structure/Property l6r.SiV�cv77111
6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary):
KFc M!>!//� /-l.v-> .�iS i�CS.s r^1.� �'X/S Ti.c!G- /-�/a�2 JL36r9�2�7 5/tJ/�✓fi .
✓yuF� ,g,..r� FZF.Si r�r i,✓�T>-i / � 6 �i�P.Zir��� t�r7/a.�
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 _X_ 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 V_ 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)
Z
520 AUDUBON RD BP-1999-0763
GIs#: COMMONWEALTH OF MASSACHUSETTS
Mip:Block:04-004 CITY OF NORTHAMPTON
Lot:-001
Permit: Building
Cate&ory:AMI siding BUILDING PERMIT
Permit# BP-,1999-0763
Project# JS-1999-1 396
Est.Cost:
Fee:$20.00 PERMISSION IS HEREBY GRANTED TO:
Conti.Class: Contractor: License:
Use Group: TIMOTHY SENEY 127364
Lot Size(sq.ft.): 81021.60 Owner:_{,ELLIHER PAUL G&JOANNE F
Zoning:U Applicant.- TiMoTHX sENEY
AT. 520 AUDUBoN,RD
ApplicantAddress: - Phone. Insurance:
43 COUNTY RD
HUNTINGTON 01050 ISSUED ON.-311711999 o:00:o0
TO PERFORM THE FOLLOWING WORK.-RESIDE HOUSE W/CEDAR
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: OOl• Insulation:
Final: Smoke: Final:
THIS PERNUT MAY BE REVOKED BY THE CITY NORTILO:PTON UPO7V10;LATI N OF
ANY OF ITS RULES AND REGULATIONS.
Certificate of Occupancy SiLyn ature•
Fee Type: Receipt No: Date Paid Check No: Amount:
Building 3/17/1999 0:00:00 $20.00
212 Main Street,Phone(413)587-1240,Fax:(413)587-1272
Building Commissioner-Anthony Patillo