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Zoning
Miscellaneous Additions, Repairs, Alterations, etc. Tel. No. Alterations
7 %r NORTHAMPTON, MASS. 1 9 Additions
r � ` A' APPLICATION FOR PERMIT TO ALTER Repair
` Garage
� c
1. Location ! tt,, F `l _ L e'. D EJt 44 ` i
k r Lot No.
.—
2. Owner's name — Z LA.e. i 4r1 i. /'4i /rtL,L1 ti L. 1 �. 1 4 k111/A
1111 Address i `t 4 re o e-A / 5 ) -
3. Builder's name $1140 fl h1 J-1 o;,) t y Address PP r-"r `ti Ii ? 4 . 1 A y » c ti i lie
Mass. Construction S rvisor's License No. v ` `l Q Cr t y Expiration Date / — V - C 9
4. Addition
5. Alteration /
6. New Porch ' ,V-- S C-g L „-..i., 7D, F'i M
7. Is existing building to be demolished? AG 0
8. Repair after the fire / J
9. Garage 41 No. of cars Size
10. Method of heating i/ //l
11. Distance to lot lines 9, -le l..A•N /1-1.1 A c - 1 - 1 CO
12. Type of roof A-se ivi ra -x-
13. Siding house ✓ -'" l
14. Estimated cost=s 0 i.> t," -
The undersigned certifies that the above statements are true to the best of his, her
knowled and belief Jr)
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ignature of responsible apps nt
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• wW �� " "' DEPARTMENT OP BUILDING INSPECTIONS • =L = t •
212 Main Street • Municipal Building
Northampton, Mass. 01060 or`''
WORT ER'S COMPENSATION INSURANCE AJi`IfI.11AVI'F
I,
1 friJAJ / 0 .V e:
Oi ipe
with a principal place of busness/resideoce at:
6 111 /-/ f ` I ? , `� l:✓�l t�� L /e hone,) 2 f5 - )„, 94 ),4
(s ryistairIzi p)
do hereby certify, under tie pens and penalties of perjury, til'_l
( ) I am an employer providing the following worker's compensation coverage for my
employees worming on this job:
•
(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 compeansation policies:
(Name of Contractor) (Insur Company/Policf Numbc (E)opiration Date)
(Name of Contractor) (Insun.nc Company /Policy Number) (Expiration Dale)
(Name of Contractor) (ltzsIlranc Company /Policy Ntur r (F�:piration Date)
(Name of Contractor) (In-nuance Compan Numb -_r) (Expiration Date)
(r n .r 4 r IAA iti 0Cs 1 c + _ if oco ,=.ry to oc.'i:tjc iafocmalioo per._:rsn4; to .11 « .,_don)
I am a sole proprietor and have no one worlring for me.
( I am a - home owner performing all the work myself.
NOTE: plca_sc be aware thr Vvhilo bomcovwcra wbo catplay pczsooa to do ¢a.mim>ncc c coa ructico or r air work on a dwctling of
not wort than thtco uniti in which the bomoowocr sides oc co the grounds appurtenant thcccco crc cot generally ooariderod to be
employer under tbo worker`s ccmpcmctioa Act (G L152_3=1 10)), application by a homeowner for a liccux cc permit may evidence the
legal rt./n. of an coployee uodcrtho Workcla Coasponvdioa Act.
I ' °1 this a copy of thin mtnvcat m.ay be forwuni<d to tbo Dcpartoacot of l.odutrricl //oc;dcntf Offsoo of L noon for tha
coverage vcnficitioo and that f luro to eaurc covcrabo under tcction 25A of MOL 152 can (cad to tbd io ositieo of erim,sl pcalries
comisting of a fine of ttp to S 1 X00.00 mdroc imprisoaaxat of up to one ycor and civz1 pen.hics in the form of a Stop W or c. Ocdcr and .
film oCS100.00 z day zgainl tnc
Sign... a .. day o I _ 1997 For dcpertmr_ct'i
A i 41 L; / Mt M P Number Lot # SA. or 1 . • c _ .u'..
...., .
MORTGAGE LOAN INSPECTION
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Locos Re PCREMLE Poem
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11.,or_ 3585 Per4e.16. 3149,
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- ._,_._. v -70
FEDERAL
I hereby report that the premises shown on this plan is not located within a
Flood Hazard Area as shown on the Federal Emergency Management Agency's Flood
Insurance Rate Map,
Community Number 250167 - 0002A
Effective Date April 3, 1978
By:
OWNER:
TO THE Springfield Institution for Saving Katherine M. Jenkins
AND THE Lawyers Title Insurance Co.
LOCATION; h
1-.9 Federal Street
I oleo report, to the beet of rey Northampton, Mass chuse t, Ls
knnwiefigfp, information And b,1trr,
I r A _1"i! A ' ilk-4-" i','
10. Do any signs exist on the property? YES NO X
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 column to be Filled in
by the Building Department
Required
Existing Proposed By Zoning
Lot size 1. ) c78 - b -f- /°c °
IS, 4 0U,uo T4' Mt) i.,A4//Z
Frontage g G
I cz , kl 0 rI Pc4/1 L
Setbacks - front 3 u c Ai ry I L (;) c)
-side L: (� R: L: R : c )
- rear∎ ZI'f c)-
Building height c
Bldg Square footage I `I 0 P A ! ►' -4- aep Co / o ttv r-- , 3 C0 4� o .
200 ft 3 ii *"
%Open Space:
Q
(Lot area minus bldg ( �
&paved parking) `%. , (.l J U, 1-
v
# pf - Parking Spaces
6 ikt 0 c f AN 't
#' f o f Loading Docks A _ J
Fill:
- vol- ume - -& location) ,fJ r —
13. Certification: I hereby certify that the inf•rmation con ained- herein
G is true and accurate to the best of my know
_1 p
f� = :)- - cl -) APPLICANT 's SIGNATURE
''' NOTE: Issuanoe of a zoning permit does not relieve a applioan s bu to oom - With - all
zoning requirements and obtain all required permits from the Board of Health, C - nservation
Commission, Department of Publio Works and other applioable permit granting - uthorities.
FILE I
AUG 25icy(
File No.g� >•
99
ZONING PERMIT APPLICATION ( §10.2)
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant: MART) I0 M 11 I-1 0 L'
Address: (o,1; i ht it y;a c it . I i 1 le Telephone: 01 3 ) (� 3 act (�
Owner of Property: a, et eCtl .r tc-%.+
Address: 14 Re_Ot ...—c..Q ' jl.c -.. Telephone: s$ G, - $' 3 9 7
3. Status of Applicant: Owner 1/ Contract Purchaser Lessee
Other (explain): ,!
4. Job Location: / I-C-'t & f4 L f .
Parcel Id: Zoning Map# Y `��arcel# 7` District(s):
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/Property R L l i p LA/ G L'- — FA NL J I
6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if ne essary): •
C �: .CT/Lc2 c '1' 1 1..%.“ t . GLt'h h{ "Pvwt; ln � s ' tAN , 2 v
•f 1a n f U 0 44 /hi c ,t.s r - , n.,A
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.
6 Has a Special Per,miWariance/Finding ever been issued for /on the site?
i -V
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 v rD 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)
FILE I 1 , J 9 9
6 ti
AUG 2 5
APPLICANT /CONTACT PERSON: ` ? -I' 9
ADDRESS/PHONE: ,:).- )0 -7 '4,_' :. / , e_ _!0 61 : 4_,'.f '. sue 0/0 - "' c-
PROPERTY LOCATION: _ /„, _ /_ , - �/ % _ .0, -�Zr ,71 h., A d�'- / /�f� - <
MAP j3 D PARCEL: 3 Z 6 NE ,/e/j 'j
,903 95
THIS SECTION FOROFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FTf .T,FT) OUT :/''
Fee Paid
Building Permit Filled not ,/''--
Fee Paid y.'�V,. ',— Z59 ti'
Type of Conctrurtinn•
New C'nnctriirtinn /G2 �-
•uss .• s • • ■.. Ge ,i_ fi/,.►,r 1 11t
�• -. dd itinn to Frict►n•
Arreccnry Structure
Riiilding Planc Tncluided- 0 /J �7
. . • a . • . _ . • se . s _• PI • L/ ✓ ce 0"._. lip
THEIF OLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION:
V 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
L fro •• onsey�at• o •� : ,
r , �1'"
r/4 _
Signature of Building rector Date
NOTE: issuenoe of a zoning permit does not relieve an applioant's burden to comply with all
zoning requirements end obtain all required permits from the Board of Health, Conservation
Commission, Department of Publio Works and other appiioable permit granting authorities.
2 5 199
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