43-076 (4) to=, City of Northampton REQUIRED INSPECTIONS
! :"
r y .,r^i:a! 1. Footings and Walls
� BUILDING DEPARTMENT 2 Structural Components in Place*
�=r
ti' 3. Complete Building*
Office of the Building Inspector
No. 1523
Zoning Form No. 963463 Date 5/1/98 Fet§20.00 checks 1227
Page, 43 parcel 76 ,Zone Sit Section 127 Q Yes 0 No
BUILDING PERMIT
• Plumbing and Electrical Inspections required
THIS CERTIFIES THAT D E Shepard Ruing before Buildinglnspations
has permission to strips shingle root Inspection on Site—Foundations
situated on 65 Dunphy Dcive - Christopher Campbell 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
provisionsof the Statutes and the Ordinances relating to theConsmrction, 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 dale of issuance,if null started. Building Inspection—Rough
Note: A certificate of occupancy will Ix issued by this office upon return Insulation Inspection
of this card signed by the Plumbing, Wiring and Building Inspectors.
Budding Inspection--Finish
** Install per Manufacturer's information: windows, vinyl siding, roofs
and wtxxistoves . Smoke Detectors (Fire Department) ._
Other
THIS CARD MUST BE DISPLAYED IN A CONSPICUOUS PLACE ON Tf jE PREMISES
Certificate of Occupancy
Building Inspector
N (H � � UFILE / 9 �J i C.
J 193
2 91988 j
LAPPLICANT/QONTACT PERSON:' ,L J ZL /9* ,a/ —e/70
DEPT O DRESS/PHONE: t - - Lori
PROPERTY )CATION: c5 �..G/if't�JO-��c �- - a'•
MAP of PARCEL: rI(o ZONE >
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
70NTNfr FORM FT1J.F.D OUT
Fee Paid
Building Permit Filled tint
Fee Paid ice; SP°
Type of Conctntrtinn•
. .
. . . . I
Arrescnry Strut-hire
Building Planc Inrlmdrd&
Owner/Orrnpant Statement nrsrence) (566,F0(Q L-'
1 Sets of Pin Tic /Pint Plan
THE F9LLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION:
Approved as presentcdlbased 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 ofHealthWell Water Potability-Bd Health
it fr Co�yrv/aJlfyd CgpglefyE�t
S1 ?
Signature of Building for Date
NOTE:lsauanoe of a zoning permit does not relieve an applicants burden to oompy 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 authorities.
1WR I9%A.
L 9 File Na. 34(3
ZONING PERMIT APPLICATION (§10 . 2)
PLEASE TYPEOR PRINT ALL INFORMATION
1. Name of Applicant: lilt. S9: fn/(!.1 gaaf-/h-C /GwLlt-`PC—p/2
Address: /.1 ` 191Z /615 577 Telephone: Y13 527-070
2. Owner of Property: G flirt p siLC
Address: (i,c- Lln. 19 try /1/'7`4'✓ Telephone: 17 FG - 3956 7
3. Status of Applicant: Owner Contract Purchaser_Lessee
Other(explain): kDo c? it
4. Job Location: �c' c /2&+^1 "(A/
Parcel Id: Zoning Map# ( a Parcel# �Y District(s):
(TO BE FILLED IN BY THE BUILDINGDEPARTMENT)
5. Existing Use of Structure/Property .( +C/l /! ,c1.-1
6. Description of Proposed UseiWork/ProjecUOccupation: (Use additional sheets if necessary): •
76AIL- 01't ( o pc.y Ivry 0)
7. Attached Plans: Sketch Pian 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 PermitNariance/Finding ever been issued for/on the site?
NO DONT KNOW YES IF YES,date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO DONT KNOW YES
IF YES: enter Book _ Page and/or Document#
9. Does the site contain a brook,body of water or wetlands? NO DONT 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)
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-
T is echo= to be filled in
by the Baildin9 Depattment
'Required
Existing Proposed By Zoning
Lot size
Frontage
Setbacks -front
- side L: R: L: R:
- rear
Building height
Bldg Square footage
%Open Space:
(Lot area minus bldg
&paved par.king)
# of -Parking Spaces
# sof Loading Docks
Fill:
{vol-lime--& location)
13 . Certification: I hereby certify that the information contained herein
4 is true andaccurateto the best of my knowledge.
7
DATE: 4, [ ✓ _ APPLICANT'S SIGNATURE
NOTE: tssuano of a zoning permit does not relieve an a plloanra rden to comply with-all
zoning requirements and obtain all required permits from the Beard of Health, Conservation
Commission, Department of Public, Works and other applicable permit granting authorities.
FILE t
•
eilibek
• ." b' {:(rifg of dortham rfon '—_
ea APR 2 91998 .,..rhn.alla =
L. CEPAATMENT OP BUILDING INSPECTIONS `=
7EPi
212 Main Street • Municipal Building
Northampton, Mass. 01060 _...�
WORKERS COMPENSATION INSURANCE AFfiDAVIT
OI5Iv 5ljP652P O SrE/9)9dtO f OOT/a (O rr cr c7*
(licensee/permittee)
with a principal pint of bitsiness/residence at:
/71 1312. ( 66S Ojai tl✓�i /Ow- �(plonea) ) z?— O/ 2O
(strert/city/statrhip)
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 Nnmher) (Expiration Date)
( ) I am a sole proprietor, general contractor or homeowner(circle one) and have hired
the contractors listed below who have the following workers compensation policies:
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(Name of Contractor) (Insurance Company/Poticy Number) (Expiration Date)
(Name of Contractor) (Insuancic Company/Policy Number) (Expiration Date)
(Name of Contractor) (Insurance Company/Policy NumM() (Expiration Date)
(.nail eaditimil Mat ifnee-n try to oda initcu aioo permniu w.11 a5neon)
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 tint(tip nOcnnOWncin who employ pa,om tom main,am commudine a repair Koch on.dWling of
no mora than mice units m Which the homeowner leder a on the patindi appurtenant thereto ea o%gmcally mmi&rcd to be
=ploy,under tln„wka's wales Act(GLI51.nE(5)),arplimeon by a homwww for a Nara«pnmaway .idr.ax the
legal naau of employer underahe Waal.ennIptondina A4
I cad¢aod that a copy or this raises may pa fmwud.d to the Pepumom of!ahead Academe Office of Laurance for We
covaagveifimiea anti that[Au=to saw=coverage under,avow 25A of MOL I52 an Ind to the imposition of cement pearl.
«mismg oh feeofup to S1}o0.00 tadecaaposeansait of up to one year and tial pemlha in mel of a Stop Wha 014erada
fino o(Sl00.00 allay again(((st me
Signed this .' / day of 1997 For am.aaxnalume a,ly
/ Permit Number
Mapd Loth
Signature of Li.-.y- •=mittce
a > i
n
.-4891 z g
C 7 C
'n
N Frn
3 0
_ z .
E S H
.__Ju is •S E et v Z
:n O
- m
T C 84a C >
• n
Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations
) NORTHAMPTON, MASS. 19_ Additions
k,.;H APPLICATION FOR PERMIT TO ALTER Repair
.447C_ 1 Garage
1. Location l J pt'wP#\) 7--7-42/t- Lot No.
2. Owner's name C- 'tic CNwtf out. Address - Lc DLlvPiity
3. Builder's name F _ S/5/9/1F D /Q ooFAvI/Oa1f Address /7 if, /.3h€/66J ST yD$2/67N7P29'
Mass.Construction Supervisor's License No. n GG 36 6 Expiration Date 17.-e/y `7
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 /75fig, r ,3P/i F L.45-s-
13.
t -f13. Siding house
14. Estimateddccost--
}1
J 3-674 , The undersigned cenifies that the above statements are we to the best of his, her
knowledge and be 'ef.
L I-i
Signal of responshi appomans
Remarks `rf6/3-ri. Oil (x/o jLto-trop _