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17D-012 (19) re 13 b < t . , ,-',...1 S \ v v o w + = = m re r 3 0 0 m \ ti ''' - , -":1 0 r— R l c a t � "" 7C 1-'Y r r v O Zoning Miscellaneous Additions, Repairs, Alterations, etc. Tel. No. Alterations l-' %r NORTHAMPTON, MASS. 1 9 Additions APPLICATION FOR PERMIT TO ALTER Repair Garage 1. Location if e400 }P7 5 • /?) N P u ` Lot No. 2. Owner's name M 4 'ft)0` '' /)F /ix 4P)') Address h/9rl7(e AV • ,c,:APi1/1'7C,. 3. Builder's name L-A K , s c VN `iT 5(-rtv►et's //t• - Address 5-114 4/51 P: I 1y 4A4yj/lfir/Pjth 0,12,2 Mass. Construction Supervisor's License No. C75 7'1 `( Expiration Date 6/1/2e 4. Addition 5. Alteration 6. New Porch 7. Is existing building to be demolished? NO 8. Repair aker+he.fiFe. /2 0104 e Wt;Co U 11 t 6 4 F U't 'AI‘ w) r '4'i ''t Cp e G K s 9. Garage No. of cars Size 10. Method of heating 11. Distance to lot lines 12. Type of roof 13. Siding house 14. Estimated cost:- 3 C 4 d- 6 )) e'5 3 000.00 The undersigned certifies that the above statements are true to the best of his, her knowledge and belief. , AA't:/ / /4/1/1 Signature of responsible appicant Remarks f2 eP e wveD i , ✓ )1J' / ) / 2 c'4-5i414 t' » / 2 ' T ! ) t iJ H o rif c As ) v c x 5 . (9y - 1)/ — 31 J1. . _ 3 / 3 3 / 3 Z - 32_ # 9 '-` Cris Nor#ilamptun _* *+Ai% y4l4 m ;SPEtZtOt+S lassncltttsrtts F S Q � -= ° DEPARTMENT OF BUILDING INSPECTIONS , ___` 212 Main Street • Municipal Building �� Northampton, Mass. 01060 WORKER'S COMPENSATION INSURANCE AFFIDAVIT gi5 cooT Attic ins 5 eI.LIC 1-5 / NC (licensee/permittee) with a principal place of business/residence at: 010;3 7 `I / v "S I'}? ilLc P- ytrlY u-1Y £ F f HY IZ0N 114, (phone #) 5';3 7 _ Lj t/ I l) (street/city /stateMp) 53 y- Y 04 do hereby certify, under the pains and penalties of perjury, that: (f I am an employer providing the following worker's compensation coverage for my employees working an this job: T1 v et el .5 p / C /95/ //:- _u0` 0coR 1 - 9f y I)J ( Insurance Company) (Policy Number) wat 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: (Naive 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) (Name of Contractor) (Insurance Company/Policy Number) (Expiration Date) (attach additional sheet if necessary to include information per taiaing to all contractors) ( ) I am a sole proprietor and have no one working for me. ( ) I am a home owner performing all the work myself. NOTE: pl ease be aware that while homeowners who employ persons to do mafro,nanrx construction or repair work on a dwelling of not more than three units is which the homeowner resides or on the grounds appurtenant thereto are not generally considered to be employers under the worker's compensation Act (GL152.m 1(5)), application by a honteowaer for a Icea%e err permit may evideaoe the legal status of as employer under the Worker's Compensation Act. I understand that a copy of this r atemmi may be forwarded to the Depermscnt of Industrial Accidents' Office of Insurance for the coverage verification and that failure to secure coverage under section 25A of MOL 152 can lead to the imposition of criminal penalties consisting of a fine of up to S1,500.00 and/or imprisonment of up to one year and civil penalties in the form ofa Stop Work Order and a fine 0( 3100.00 a day against tee. For departmental use only Permit Number �.a✓ ' lilt 7Y hriap# hot # Si u' ..'!rof ' icensee/Permittee .tea r 10. Do any signs exist on the property? YES )< NO IF YES, describe size, type and location: x y 51b1- T e)- Yces Are there any proposed changes to or additions of signs intended for the property? YES NO X IF YES, describe size, type and location: 11. ALL INFORMATION MUST BE COMPLETED, or PERMIT CM BE DENIED DUE TO LACK OF INFORMATION. ;J 7)t)�& TO cti}NGe F12un c" $i .71 b t Building oBui �nrtffin in Required Existing Proposed By Zoning Lot size Frontage Setbacks - front - side L: R: L: R: - rear Building height Bldg Square footage %Open Space: (Lot area minus bldg &paved parking) # .p f 'Parking Spaces of Loading Docks Fill: J( vol -ume -& location) 13. Certification: I hereby certify that the information contained herein G is true and accurate to the best of my knowledge. DMITE: 3111- J 0 APPLICANT'S SIGNATURE _'' NOTE: 1 uano of a zoning permit does not relieve an app o rot' burden to oompty moth all zoning requirements and obtain all required permits from Board of Health, Conservation Commission, Department of Publio Works and other applioable permit granting authoritjes. FILE # 1 JUL 9 X96 ` File No.1 P 9 DEPT ©F 81 Fr ';1-";'' .,_ . ZONING PERMIT APPLICATION ( §10.2) PLEASE TYPE OR PRINT ALL INFORMATION 1. Name of Applicant: 74) cON5TiQucr /DN 5c-2/2U)c /NC Address: 9 /N/) U7T/21 � 1- L 95Ti9 H}T 5 7- 111-/ y / 3 - 76 W 2. Owner of Property: ll e �$ Ot4/' / 0 j` .OPTS Address: 13121 9 C.e J2 V No/an h P TO N Telephone: .5 ' 7 3 `f/ 3. Status of Applicant: X Owner Contract Purchaser Lessee Other (explain): 4. Job Location: 511 e D eck / t°Y1-I)S u N/T 'S y - 1/02 4 - ,3%/ 9 Li - 3V /A Parcel Id: Zoning Map# / 71:7 Parcel# ja District(s): _ (TO BE FILLED IN BY THE BUILDING DEPARTMENT) 5. Existing Use of Structure/Property /? H »J 'L - 4E1S. 6. Description of Proposed Use/Work/Project /Occupation: (Use additional sheets if necessary): • CND}//2 Of ,Nv (,,e'3 w nth/ N %>/Z rs we' e 7-12 J t /' Lw7 UN/ 61 y _3//01y - ,23/ ti'- x/ - 3a 12 ej3u ta, serr } F) 4, r )»(- 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 DON'T KNOW YES X IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained Obtained , date issued: POPP / /1 e T /f� ORM ON OTHER SIDE) F 9 Department: Reference No: BP -1999 -0039 Building, Electrical & Mechanical Permits Fee Type: Receipt No: Building - Renovation REC - 1999 - 000048 Paid By: Paid in Full On: Zaks Construction Fri Jul 10,1998 Received By: Check No: Linda Lapointe 3098 DEPARTMENT'S COPY Amount: 5280.00 DEPARTMENT ENT FILE COPY 491 BRIDGE RD CITY OF NORTHAMPTON BUILDING PERMIT Owner's pulling their own permits or dealing with unregistered contractors for applicable work do not have access to Guaranty Fund(MGL 142A) Issued: Permit No: Inspector: Tracking No.: Fee: BP- 1999 -0039 $280.00 GIS #: Map Block: Lot: Address: Zoning: Use Group: Lot Size: 8884 17D 012 001 491 BRIDGE RD URB 1169150.4 Contractor: License Type: Insurance: Zaks Construction CSL Workers Compensation Address: License No.: Insurance No.: 41 Avis Circle 054749 1E-4B-360c621 City: State: Zip Code: Phone: NORTHAMPTON MA 01062 (413) 584 -2118 Project No: Category of Work: Const. Class: Cost Estimate: JS -1999 -0052 alteration - addition $3,000.00 Description of Work: repair decks 24- 21,31,34,25- 23,32,33 GeoTMS® 1997 Des Lauriers & Associates, Inc. Signature: File # BP- 1999 -0039 I APPLICANT /CONTACT PERSON Zaks Construction ADDRESS /PHONE 41 Avis Circle (413) 584 -2118 PROPERTY LOCATION 491 BRIDGE RD MAP 17D PARCEL 012 ZONE URB THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out Fee Paid 0 ! _ Cry✓ • Type of Construction: - New Construction /��� -L'. , t- Non Structural interior renovations Addition to Existing ( ' , g C 1 / + 5/ 3 44 � J Accessory Structure Building Plans Included: — 3 j J -? Owner /Occupant Statement or License # 3 sets of Plans / Plot Plan THELLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION: 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 Board of Health Well Water Potability Board of Health Permit from Conservati Commission Signature of Buildi ' ° Official Date Note: Issuance of a Zoning permit does not relieve a applicant's burden to comply with all zoning requirements and obtain all required permits from Board of Health, Conservation Commission, Department of public works and other applicable permit granting authorities. 4 , l City of Northampton 3t`t `I`4 • 4u _ B uilding Department nimrling Department Office of the Building Inspector Permit No: BP- 1999 -0039 Date issued 14 -Jul -1998 Fee $280.00 Map 17D Block 012 Lot 001 Zone URB Section 116 C _ ' : Yes ❑ No . BUILDING PERMIT This certifies that Zaks Construction CSL054749 has permission to repair decks 24- 21,31,34,25- 23,32,33 Inspection on site - Foundations Over ❑ at 491 BRIDGE RD provided that the person accepting this permit shall in every respect Inspection of Plumbing - Rough Over ❑ conform to the terms of the application on file in this office, and to the provisions of the Statues and the Ordinances relating to the construction Inspection of Plumbing - Finish Over ❑ Maintenance and Inspection of Buildings in the City of Northampton. Any violation of any of the terms above noted is an immediate revocation Gas Inspection Over ❑ of this permit, Expires six months from date of issuance, if not started. Inspection of Wiring Service Over ❑ Inspection of Wiring - Rough Over ❑ Note: A certificate of occupancy will be issued by this office upon return of this card by the Plumbing, Wiring and Building Inspectors. Inspection of Wiring - Finish Over ❑ 1► i Building Inspection - Rough Over ❑ *Plumbing and Electrical Inspections required before Building Inspections Insulation Inspection Over ❑ ; , uilding Inspection - Finish e 8' / 7- g - - , Over ❑ u > ' . i> 1" , = - ' Smoke Detectors (Fire Department) s card must be so A r i d on s' • visible from I ublic way Certificate of Occupancy 1 Buildin• . commissioner