The URL can be used to link to this page

22D-006 (8) J). > z Lij -� a 3 0 ° Z I A Zoning Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. 32 7'.3S3f Alterations NORTHAMPTON, MASS. 1 fry/ g 19 Additions ' � APPLICATION FOR PERMIT TO ALTER Repair Garage 1. Location Lot No. 2. Owner's name Zv wk si Address i j ?LiiN pg(-to FX apiw(, 3. Builder's name —h tea P-hQ 6 nn.J-r1Q0 Address�3(Q 6AS i<ST-, 22 E 124-01Me1W Mass.Construction Supervisor's License No. 06"7372.2 Expiration Date_/I i 13 4. Addition --' 5. Alteration 2L,,t~Pr A:CSr (jtaD jcILt 6. New Porch 7. Is existing building to be demolished? MG 8. Repair after the fire_ 6 9. Garage No.of cars Size 10. Method of heating 11. Distance to lot lines LS-tT. 12. Type of roof �st'rf 13. Siding house W ax? - 14. Estimated cost- y d The undersigned certifieythe ve s tcments are to the be st of his, her knowledge' and belief. responsible app is Remarks 31`( t e- irk S D iv S dks Pbeft-T .,7404 is chi f a 15� ao'U'd CPY, �[ `� UyiE4 A eCCDr� LJ�ft �- D / - /Ml797z 1(X/1T! 7 Crs.#e14( ejW ttntZ=1 C`/ >f7 L6 1404-- A-i4e OQ�t1AMP�0 41 Of 'Nart4alliptlan e:` ,s�p ` giasartchnsctta �v DEPARTMENT OF BUILDrNG INSPECTIONS 212 Main Street a Municipal Building ' Northampton, Mass. 01060 WORKER'S COMPENSATION INSURANCE AFFIDAVIT (llcensee/permittee) with a principal place of business/residence at: a�? T re�.t;- �r ri-►a�rv,A l 062phone#) (strcet/city/state trip do hereby certify, under the pains and penalties of perjury, that: ( ) I am an employer providing the following worker's compensation coverage for my employees working on this job: (Insurance Company) (Policy Number) (Expiration Date) (XI 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 ontractor) (Insurance Company/Poiicy Number) (Ex6iratioa Date) (Name of Contractor) (Insurance Company/Policy Number) (Expiration Date) (Name of Contractor) (Insurance Company/Policy Number) (Expiration Date) (Name of Contractor) (Insurance Company/Policy Number) (Expiration Date) Ottach additional sled ifnecenary to include informsaon pertaining to an coatrz d ) ( ) 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 dul while homeowners who employ persons to do maiuicaarax,consdructlon or repair work on a dwelling of not more than three unit in which the homeowner raider a on the grounds appurtenant thereto an not generally considered to be employers under tbo wo&.ces oompenst4on Ad(GL152,,s 1(5)),application by a homeowner fora license or permit may evidence the legal status of an employee under the Worker's Compecutiou Ad. I understand that a copy of this twement may be forwarded to the DepwtmcaQ of Industrial Am&n&Office of Insraance for the coverage verification and that failure to seatre oovetnge under section 25A of MOL 152 can lead to the imposition of criminal penalties oomasting of a fine of up to S1,500.00 and/or imprison of up to one year and civil penalties is the form of a Stop Worst Order and a fine of 5100.00 a day against rue. Signed this��_day of 1997 For del—only Permit Number Map# Lot# Si of Li ermittee 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 wlumm to be filled in by the Building Department Required Existing Proposed By Zoning Lot size i A 3Z5' Frontage SetbacksS - side L: l i R: ?y L:—' R: - rear Building height ZS Bldg Square footage /moo %Open Space: Ldrs,zt_ 3s 7M (Lot area minus bldg LAIVR u341> -ti 3 z &paved parkingi of Parking Spaces f r6f Loading Docks Fill: 4voIdme-4 location) 13 . Certification: I hereby certify that the information contained herein G is true and accurate to the best of my knowled e. ,1 DATE: s��Ez/�/,�`��'pLICANT's SIGNATURE NOTE: Issuanoe of a z inn g permit does not relieve an a ant's "iKden to ooi6joy wit4_al1 zoning requirements and obtain all required permits from the Board of Health, Conservtstion Commission, Department of Publio Works and other appiioable permit granting authorities. FILE # SEP 9 1997 File No..? ZONING PERMIT APPLICATION (§10 . 2) PLEASE TYPE OR PRINT ALL INFORMATION 1. Name of Applicant: r�IQ IPJN 6--9-'rEN(3Z1)Q Address: '3(�LPs'S7' � ,✓/,�,eh/ Telephone: 2. Owner of Property: c�Lt/Zc_i� Address:_ Zev/ - Telephone: 3. Status of Applicant: Owner Contract Purchaser Lessee Other(explain): rr,•v7f2dgc rat 4. Job Location: a ,�►�/ / l Parcel Id: Zoning Map# ' �Lo Parcel# District(s): (TO BE FILLED IN BY THE BUILDING DEPARTMENT) 5. Existing Use of Structure/Property :/Nl zs- i/ K 6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary): Lisa/ '12 +t cry X PC y Otte 3sy 77e>" sufeAtte&- /-' r i f�CClrir£c7riTAr A-�tfr ,�— -ztj& yc,tA�- 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/Vadance/Finding ever been issued for/on the site? NO DON'T KNOhh ✓ YES IF YES,date issued: IF YES: Was the permit recorded at the Registry yof Deeds? NO DON'T KNOW, �/ of 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) r r, N FILE I C k: J t, SEP 1 91997 APPLICANT/CONT,ACT PERSON: �A.DDRESS/P1IONE:, D PROPERTY LOCATION: 1 u ' � MAP PARCEL: ZONE THIS SECTION FOR-OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DA ZONING FORM VELLED OUT --' Fee Pnid Fee Paid AcressnEyStrurtnre r THE 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: Curb Cut from DPW Water Availability Sewer Availability Septic Appl-Bd of Health Well Water Potability-Bd Health !Permit from Conservatio ommissio Signature of m g Da(e NOTE: Issuanoe of a zoning permit does not relieve an applicant's burden to comply with all zoning requirema.nts and obtain all required permits from the Board of Health, Conservation Commission, Department of Public Works and other applicable permit granting authorities. Cit y Northampton of REQUIRED INSPECTIONS BUILDINGDEPARTMENT 2. Footings and Walls *Structural Components in Place 3. Complete Building* No. 897 Office of the Building Inspector Zoning Form No. 962797 Date 9/23/97 Fee $20.00 Check# 2000 Page, 22D Parcel 6 ,Zone URA/WSP/WP Section 127 ❑ Yes 0 No Bul- ILDING PERMIT * Plumbing and Electrical Inspections required THIS CERTIFIES THAT Brian Greenwood before Building Inspections has permission to strip,& shingle house & porch Inspection on Site—Foundations situated on 81 Ryan Road - Beverly Wah 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 ** Install per Manufacturer's information: windows,vinyl siding,roofs Smoke Detectors(Fire Department) and woodstoves Other THIS CARD MUST BE DISPLAYED IN A CONSPICUOUS PLACE ON T RE ISES Certificate of Occupancy -0 Building Inspector �� "•� City of Northampton REQUIRED INSPECTIONS t; ! ri �� 1. Footings and Walls BUILDING DEPARTMEN 1j. 2. Structural Components in Place* 3. Complete Building* No. 897 Office of the Building Inspector Zoning Form No. 962797 Date 9/23/97 Fee $20.00 Check# 2000 Page, 22D Parcel 6 ,Zone URA/WSP/WP Section 127 ❑ Yes 0 No BUILLDING ; PER'J'�,N� M 1 * Plumbing and Electrical Inspections required THIS CERTIFIES THAT Brian Greenwood before Building Inspections has permission to strip,& shingle house & porch Inspection on Site—Foundations 81 Ryan Road - Beverly Wah Inspection of Plumbing—Rough situated on P� provided that the person accepting this permit shall in every respect Inspection of Plumbing—Finish conform to the terms of the application can 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. Builc.'.ing 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. Builring Inspection—Finish �w; d:r-�,O ** Install per Manufacturer's information: windows,vinyl siding,roofs Smoke Detectors(Fire Department) and woodstoves Other THIS CARD MUST BE DISPLA CONSPICUOUS PLACE ON RE ISES Certificate of Occupancy Building Inspector