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Zoning
Miscellaneous Additions, Repairs, Alterations, etc. Tel. No. Alterations
C %r NORTHAMPTON, MASS. 1 9 Additions
APPLICATION FOR PERMIT TO ALTER Repair
_
Garage
1. Location I Lr& �� -S r C1,-►? \ Lot No.
2. Owner's name ` .rie C r -S cC._ Address
°1111114 Builder's name c e v r( i f+.....■ de.--- Address •67x- G' � � r'r , (4.-x C10t/' -(
Mass. Construction Supervisor's License No. ) (S `1 s Expiration Date \ l'1 2c >•
4. Addition 1411V -
5. Alteration Li -
Liz. • e '' iir i 4 ii i h. / // /ziu J _ ,�i' .iu ' NIir:1`L1
6. New Porch '
7. Is existing building to be demolished?
S. Repair after the fix %'Eta/`r►.1 NCiw Ae - 'oec -,' iv: r . ,eftCA
9. Garage 1) 1104 No. of cars Size
10. Method of heating 1.) ) fl-
11. Distance to lot lines VI A•
12. Type of roof ILefit
13. Siding house 1.) t Pi-
14. Estimated cost - fit I 000, '
The undersigned certifies that the above statements are we to the best of his, t
kneif . ledge and ke.1.‹.
S gnature of responsible appiicot
O
Remarks
Y
TO t5 lP U N
be. e )4 ` JUN , Crii� of Northampton 1 _—
. r 9 2000
!� 4p:�ti1►� � lcstRChncrlla —:
_ :
� ����� �'T t�l � � � � �� ; tti,ypE ARTI.TEIJT OP BUILDING INSPECTIONS � � ; --- -, Y.
— 2 Main Street • Municipal Building
Northampton, Mass. . 01060 WI s'. i
«'O RICER' S COMTENSATION INSURANCE AI FIJMArIT
v r--- L ,,..,\ tQzti s 7.c.--e.
(li ccusx/perrni ttec )
with a principal place of business/residence at:
Q 2p>c- C-, {1 . r-eV; iA - 0 IC (phone') [3 -Y
(srr t/city /staic/zip)
do hereby certify, under We pains and penalties of perjury, .hat
1 am an employer providing the following worker's cornocns non coverage for my
e uployces worming on this job.
(nsw no Comr_ (Policy Nu_ rr) (EA Date)
( ) 1 am a sole proprietor, general contractor or homeowner (cu cie one) and have hired
the contractors listed below who have the following worker's coaoens.aaon policies:
(Name of Contmcton (InR rant::. Coinoanyi?oiict Ntun: :;) (11 )irdUOfl Date)
(Name of Contractor) (lnsurancc Company /Police Nticlurr) (Expu uon Date)
(Name of Contractor) (Losurancc Company/Policy Numbzr) (Expiration Date)
(Name of Contractor) (1osuranC: Coro a ry /Policy Numtrrr) (Expiration Date)
(mach .d c'_kct ifnc ark to aocu& inform :ioo p.rtrunins to all c r-.-ro )
( ) I am a sole proprietor and have no one working for me
( ) I am .a home owner performing all the work myself.
NOTE: plc -, be ew-arc th w te J hoar_oµ e wbo cmplay p - sone to do rms u._ .:c_oo c rtp air µone on . d...ctl_ g of
not Wocc th_n Ltd tmi'u in wbieb the twmoowocr rcvdo oc oo the g ounc:3 zppurt<n_r i tbeceo c_--c nor b,.,crclly occri6. -- to be
c-r>loycs undo the wok crnp. tica Act (GL157,5a l(S)� ippticttioo by n homconncr for c Lc-mew: c p., rurt may cwid the
Icsal ma -me of en loyx under tho Worlcolc Comp<nsation Art_
I trod r tared that a. copy of thia crat.®mt may bo focw.vd.ed to tho Doponn ocre of Indus-rid ArodcortY °Moo of Imuanoe for tbo
oovmsc vcrifiemtion and that L•iltrc to socu c covettsc under section 25A of hMOL 152 can Iced to the 1n p0si ioa of criminal pcmllies
cooniszing of • rtnc of up to 5I }00.00 andlex aapri oomcn1 of up to one year todd oval pavfuo in 6C form of a Stop Work Order and a
fun o(S100.00 I by ifyinn me
r r-' 1� - " -) �,,e_., Fa- ckp �nv::�1 ur.c only
- - - -- - --- - -'"—'
f op Pc�mit Ntlmbcr F1 3 e i`4ap;; _ - Lot t: `
Sig.na un. of L • c rn uti cc
sins exist on the roe f. NO
10. Do any g property? � YES
IF YES, describe size, type and location:
7
ro osed changes to or additions of signs intended for the property? YES h0✓
Are there a n y p p 9
IF YES, describe size, type and location:
11. ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE DENIED DUE TO
LACK OF INFORMATION.
This coltmn to be filled in
by the Building Department
Required
Existing Proposed By Zoning
Lot size
Frontage
Setbacks - frnnt
- side L: R: L: R:
- rear
Building height
Bldg Square footage
%Open Space:
(Lot area minus bldg
&paved parking)
# of Parking Spaces
# 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 i le g _
DATE : DO APPLICANT 's SIGNATURE \j V C " `)
NOTE. 1 u noe of a zoning permit does not relieve an ap • lloanes • urden to - • mply with -all
zoning requirements and obtain all required permits from the _ - - of Health, Conservation
Commission, Department of Pubiio Works and other applioable permit granting authorities.
FILE
.JUN t 9 2000 e 11 File No. )5 1°,0 ///3
ADEP OF a r I G PERMIT APPLICATION (510.2)
• E TYPE OR PRINT ALL INFORMATION
1. Name of Applicant: Y— ��� —� JC
Address c1-L( ut cAr Telephone: Li / 2 i Z
2. Owner of Property: l 1,4r' A'C • _
Address: Telephone:
3. Status of Applicant: Owner Contract Purchaser Lessee
Other (explain):
4. Job Location: 1,lr't LF � - �
Parcel Id: Zoning Map# Parcel# District(s):
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
U 5. Existing Use of Structure/Property PL-L %0ai
6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary):
Ow C5)-04- 1
7. Attached Plans: Ivy 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 PermitNariance/Finding ever en 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 KNbV L___ 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)
File # BP- 2000 -1113
ro1/4 APPLICANT /CONTACT PERSON ROBERTS BUILDERS
ADDRESS/PHONE P 0 BOX 678 (413) 253 -7772
PROPERTY LOCATION FAIR ST - FAIRGROUNDS
MAP 25C PARCEL 251 ZONE URA
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out
Fee Paid Do
Tyneof Construction: REPAIR VIEWING BOOTH DAMAGED FROM STORM
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/ Statement or License 018385
3 sets of Plans / Plot Plan
THE FQLI.,OWING ACTION HAS BEEN TAKEN ON THIS APPLICATION:
pproved as presented/based on information presented.
Denied as presented:
Special Permit and/or Site Plan Required under: § /reSA /A5
PLANNING BOARD ZONING BOARD D�
Received & Recorded at Registry of Deeds Proof Enclosed 1
' 6
Finding Required under: § w /ZONING BOARD OF APPEALS _449 7 / ,, v
Received & Recorded at Registry of Deeds Proof Enclosed EXGqtostPONS
4'4.4 eAt3
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 Conservation Commi • Permit from CB Architecture Committee
• 4 Loos
Signature of Building 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.
I A
FAIR ST - FAIRGROUNDS BP-2000-1113
GIS #: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 25C - 251 CITY OF NORTHAMPTON
Lot: -001
Permit: Building
Category: Non structural interior renovations BUILDING PERMIT
Permit # BP-2000-1113
Project # JS- 2000 -1982
Est. Cost: $1000.00
Fee: $50.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: ROBERTS BUILDERS 018385
Lot Size(sq. ft.): 871 200.00 Owner: HAMPSHIRE FRANKLIN & HAMPDEN
Zoning: URA Applicant: ROBERTS BUILDERS
AT: FAIR ST - FAIRGROUNDS
Applicant Address: Phone: Insurance:
P 0 BOX 678 (413) 253 -7772
AMHERSTMA01004 ISSUED ON :6/9/00 0 :00 :00
TO PERFORM THE FOLLOWING WORK: REPAIR VIEWING BOOTH DAMAGED FROM
STORM
elk 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: Oil: Insulation:
Final: Smoke: Final:
THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF
ANY OF ITS RULES AND REGULATIONS.
Certificate of Occupancy Signature:
Fee Type: Receipt No: Date Paid: Check No: Amount:
Building 6/9/00 0:00:00 9024 $50.00
212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272
Building Commissioner - Anthony Patillo