32A-195 (5) 4
11.9••
a '2r
3'.4'/4 n
NO TES
CA, T9
P.ANTR7 HEAT ( WASNER!DR1 Ei
DUCT
UNIT:26 3/4"W x
EXISTING "° _
KITCHEN GEiLING HEIGHT
CAaMTWRK
Co
DOWN
UP EAT
T-3
1
DINING
ROOM
APR 1 01997
,F'O �:-Ms-1
'or
RELOCATE
HEAT DUCT
NOTU
NEW
UNIT:26 314"
1+ CEILING WEb
EXISTING NELU
KITCHEN HEAT 1)uCt
NEW 5T.4IR DOWN NEI DOOR
PROPOSED E34TI4 I
PLYNN RESIDENCE
ONING 24 PHILLIPS PLACE
ROOM
PROPOSED RENC✓ATIONe
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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. t% Z� y Alterations
NORTHAMPTON, MASS. ✓ 1� 19g� Additions
APPLICa ATION FOR PERMIT TO ALTER Repair
Garage
1. Location p 1�"�'e ��`R`v = 1!V a((fVjU,, Zl•J Lot No.
2. Owner's name ' ��V Address Q-- 4 P f L-C(Z s V P—,yu
3. Builder's name �e ct,-- v Address a L S `c C'—A-
Mass.Construction Supervisor's License No. 6Q Expiration Date (/A 4
4. Addition
5. Alteration
6. New Porch
7. Is existing building to be demolished?
8. Repair after the fire !j L
9. Garage N No.of cars Size
10. Method of heating N A
11. Distance to lot lines
12. Type of roof 3 S c J G C L5
13. Siding house
14. Estimated cost- �J
The undersigned certifies that the above statements are true to the best of his, her
knowledge and belief.
Signature of responsible app,lcan!
Remarks
4-tttAlfP� a
Boo 0
JLW 2 31997
�assachnsrtts � • .
m DEPARTMENT OF BUILDING INSPECfiok�'!'_'c';.
212 Main Street ' Municipal Building 'a,
Northampton, Mass. 01060
WOFUMR`S COMPENSATION INSURANCE AFM' AVTT
1, �-Z o Q Cz c
with a principal place of bu imess/residence at:
3 6 S e5pLQ t t L c'^(t 4 N Ud� 1 (phone#) ��y( z 2 Y
(strc- City/statehip)
do hereby certify, under the pains and penalties of perjury, that:
( ) I am an employer providing the folloVvulg workers compensation coverage for my
employees working on this job:
�6 c>j - v9411gI 'j-\JL17 q9�
(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) (la"nrauce Company/Poticy Nambcr) (Expiration Date)
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(Name of Contractor) (Insurance Company/Policy Nu mbzr) (Expiration Date)
(Name of Contractor) (Insurance Compauy/Policy Number) (E)cpiration Date)
(u2ach additiomi shod Snoarssry to include informiaoa pertaining to nll oec�acton)
( ) I am a sole proprietor and have no one working for me.
( ) I am a home owner performing all the work myself.
NOTE:plcaac be awue that whUo homcowo=who cmplvy pazons to do�Win+•=coasrructioa or repair work on a dHZlling of
not more than throe units is vdikh the homoowncr r=dcs cc on the gnands appurtenant tha cto arc not gwcrally comidcmd to be
employers under the woricc's compeasaiion Act(GL152-s 1(5)�application by a homeowner for a liccwe cc permit may evidence the
legal o-, of an employee under d w Woricoes Compomaiioa AcL
I understand that a copy of thix rsatcmmt may be forwnrded to tho Departnrai of Industri al Acrid Olfioe of Ins u nco for tho
coverage vcnfication dad that failure to secure coverage rmdcr seaioa 25A of MGL 152 can Icad to the imposition of criminal penalties
ooasistutg of a fine of up to S1,500.00 and/or impraoame of up to one year and civil pcmltia in the form of a Stop Work Order and a
firm of 5100.00 a day agnin:5t men
r d D
Signed this 1�`_day of "t 1997 For dcprrt n=n —only
Permit Number
�—y Map4 Lot#
Signature of Liccnsee/PcrmiU=
%0 2 31997
, 57�� �
10
58�=5d-4B'w . ?15 �'f� qr+;'W
Q QI 15
i
1,-1 1 N 4 - 1"JGNG�=
4
; .
10. Do any signs ebst 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 —7-m to be filled in
by the BCd1gAxn9r Department
Required
Existing Proposed By Zoning
Lot size o �c
Frontage �w v e(2
Setbacks < < r
.�� �
- side L: SR:_ L: R: S
- rear
Building height
Bldg Square footage
%Open Space:
(Lot area minas bldg
' &paved parking)
.pf Parking Spaces
f rof Loading Docks
Fill:
A vol-ume--& location)
13 . Certification: I hereby certify that the information contained herein
is true and accurate to the best of my knowledge.
.1
DATE: 6 APPLICANT's SIGNATURE
NOTE: Issuanoe of a zoning permit does not relieve an applioanre burden to oomply with',,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 #
J
3
? J
File No.
ZONING PERMIT APPLICATION (§10 . 2)
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant: 61a �e k' r--i
Address: S cy--3.1 ( (L_ cic Telephone:
2. Owner of Property: L=L" 4- 3 \L-)t -,j�w c
Address: Telephone:
3. Status of Applicant: Owner Contract Purchaser Lessee
Other(explain): C
4. Job Location: Z 11
Parcel Id: Zoning Map# 1 � District(s):
_s� Parcel# (s� 1.1
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/Property
< Q. C_
6. Description of Proposed Use/Work/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 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 �G 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)
n
FILE # �?rl
4.
2 31997 d
JUN s
LAPPLICANT/CON ACT PERSON: � v�
`-1'77',ADDRESS/PHONE• e /H r1�
PROPERTY LOCATION:
MAP PARCEL: ZONE a/2,6-
THIS SECTION FOR-OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
7,nNTNG FORM ER.T.F.11 OUT
Fee Pn6d
EP7�Piid �97.2-
New Cnnstrurtinn
�) 3
V
THE;XOLLOWING 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 Conservat' ommissi
7—
Signature of Building Oe for Date
NOTE:Issuanoe of it zoning permit does not relieve an applioant's burden to oomply with all
zoning requiramante and obtain all required permits from the Board of Health, Conservation
Commission, Department of Publio Works and other applioable permit granting authorttles.
; City of Northampton REQUIRED INSPECTIONS
e 1. Footings and Walls
BUILDING DEPARTMENT 2. Structural Components in Place*
3. Complete Building*
NO. 584 Office of the Building Inspector
Zoning Form No. 962429 Date 6/27/97 Fee$175.20 (heck#7472
Page, 32A Parcel 195 ,Zone URC Section 127 ❑ Yes ® No
BUI]LDINGPERMII
*Plumbing and Electrical Inspections required
THIS CERTIFIES THAT Bob Reckman before Building Inspections
has permission to add screen porch 16' X 24' & art studio 13' X 26' Inspection on Site—Foundations
situated on 24 Pilgrim Drive - Lori Devine 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)
Other
THIS CARD MUST BE DISPLAYED IN A CONSPICUOUS PLACE ON P MISES
Certificate of Occupancy
Building Inspector
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City Of Northam' p*on REQUWED INSPECUONS
BUILDINGDEPARTMENT 1. Footings and Walls *2. Structural Components in Place
3. Complete Building*
No. 584 Office of the Building Inspector
Zoning Form No. 962429 Date 6/27/97 Fee$175.20 Check#7472
Page, 32A Parcel 195 ,Zone URC Section 127 ❑ Yes ® No
BUI]LDE t.
t T PERMIT
*Plumbing and Electrical Inspections required
THIS CERTIFIES THAT Bob Reckman before Building Inspec ions
has permission to add screen porch 16' X 24' & art studio 13' X 26' Ins o on $Si�ttee��- oundations, .
24 Pilgrim Drive - Lori Devine � c.�f Plumbing—Rough�#r��� v
situated on 9 e spec o
provided that the person accepting this permit shall in every respect Inspection of Plumbing—Finish
conform to the terns of the application on file in this office,and to the Gas Inspection `�,P`97 �
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. Aar s?&,d« 9/ (, 11
Any violation of any of the terms above noted is an immediate revocation S4"A'l Inspection of Wiring—Finish � , r
of this permit.Expires six months from date of issuance,if not started. Building Inspection—Rough
�1.
Note:A certificate of occupancy will be issued by this office upon return Insulation Inspection CA
of this card signed by the Plumbing,Wiring and Building Inspectors. =
/e, / Building Inspection—Finish o t I ,":7-
V7 Rr_( t- S-; t,r (P.
Smoke Detectors(Fire Department)
Other
.y .
THIS CARD MUST BE DISPL C.Q.SPICUOUS PLACE ON P MISES
Certificate of Occupancy
Building Inspector