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29-450 (10) co . tin 0* � � � �i � ti,bob � ..�. o I—, litIbi■`r: i 1 -;• o o c o . rn 0 o °, � ° CA, a 1. � 1C ° " o 0 o CD p- co � "' 70 E g. R �. ,, o 0 -• rt r _ CD" CD 2 x� � o °' � � E (1) = .. 3 CD tZ ►-- o cr.' Sp, Pwb d o E ril to � � oa�c o . 7. w c °' ro \ 1 Fsi g 0 n © 0 o ~ ilt rri o °, a CD 0�e o c�sA � c, n y � � C 5 z C4 cA mil 1::$ ,. 0 4o cn 5 s * > � = g .%11/ V) 0 � - �. � _ _ her l o CM 0 = ° ° ,- ll� ^ 5 0 o as N N = cn -n 0 Z a Ci7 w N ~ Cil a o o' 5 w c x • r0 � ` H IT y T 1 I v' 1 I = 03. o v' o i z ;� ❑ N g °0 .0 E ` 'CDC, 5. ' o' ac acv o' �' aoo 5 0 c CM d ., `. = = = = = = = CD CD o c� $$ \ 5 0 CO c CIL CA cra g. rri . o- CA o � (3) 5' z0 s c) CD .+° FILE I 9 r: ,-;18 /J127Z NOV 3 APPLICANT/CONTACT PERSON: ADDRESS/PHONE: .4/ PROPERTY LOCATION: Lve :tivt teez/`.---1 �" A ��- i < MAP ,27g PARCEL: il C ZONE THIS SECTION FOR-OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM F71 J.FT) OUT Fee Paid Building Permit Filled nut Fee Paid . ‘" .p902G— Type of Cnnctri,c•tinn• New C nnctrurtion Remodeling Tnterinr Addition to Rrieting Acreccnry Structure Building Plane Included! Owner/Occupant Statement n` nee O 74127 3 Sete of Plane /Pint Plan • THE O-LLOWING 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-Bd of Health Well Water Potability-Bd Health Permit from Conservatio ommission Zo/Aie Signature o .ui .g-I"aL tor Date NOTE: Issuanoe of a zoning permit does not relieve an applloant's burden to comply with all _ zoning requirements and obtain all required permits from the Board of Health, Conservation Commission, Department of Publio Works and other applicable permit granting authorities. NOV 13 4 File No. 9'6301 ZONING PERMIT APPLICATION (§10 . 2) PLEASE TYPE OR PRINT ALL INFORMATION 1. Name of Applicant: r COl°t° T'T� Address: 7' /f / S7 / � Telephone: ��/—�.S 7- 4..9 2. Owner of Property: 41. \/ ;S'A/ai Address: .2L/ CCeS Ve.c.i Telephone: 5L6-3 7) 3. Status of Applicant: Owner Contract Purchaser Lessee Other(explain): 4. Job Location: Parcel Id: Zoning Map# ,).0 Parcel# 45 District(s): �'/'vl l! (TO BE FILLED IN BY THE BUILDING DEPARTMEN ,11/17d41---AV) 5. Existing Use of Structure/Property ) 5t9.4 6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary): • °C C*?2 ocieW 1 ! d F 54-1/, Cn S 4e//�� 7// , LC4, CS 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 PermitNariance/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 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. This column 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: (vol-time--& location) 13 . Certification: I hereby certify that the information contained herein is true and accurate to the best of my knowledge. DATE: ft 22 c'7 APPLICANT's SIGNATURE _/ NOTE: Issuanoe of a zoning permit does not relieve an applioant's burden to oompty 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 # ,,,,,, , , e, �fi e ,G�, (set f N.tr±[[amptori i =* �'.i t f f lassxcllaactts -:` -- '"W. DEPARTMENT OP BUILDITjG INSPECTIONS , ___�f 212 Main Street • Municipal Building =r SSV Northampton, Mass. 01060 WORKER'S COMPENSATION INSURANCE AFFIDAVIT I, EZe / "T- ( /L' - �r (licensee/permittee) with a principal place of businesslresidence at: &/ Aka . Al ' ,./ sifry • ,/; ,d (phone#) ,..562 --- &S 2/ (street/city/state/zip) 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 Number) (Expiration Date) f ( ) 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) (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 ifnace:nary to include information pertaining to all contractors) (11 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 that while homeowners woo employ pczsam:to do r+t.team.nrr,construction or repair work on a dwelling of not more than three units in which the homeowner resides or on the grounrb appurtenant thereto arc not generally ooaiidcrcd to be employers under the worke?a compensation Act(GL152,ss l(5)),application by a homeowner for a license or permit may evidence the legal status of an employer under the Worker's Compauation Ad. I understand that a copy of this statement may be forwarded to the Department of Industrial Accidents'Omoe of Imw.oee for the coverage verification and that failure to secure coverage under section 25A of MOL 152 can lead to the imposition of criminal penalties oanisting of a fine of up to S1,500.00 and/or imprisonment of up to one year and civil penalties in the form of a Stop Work Order and a firm of 5100.00 a day against inc. Signed this /3j day of yJV , 1991 For dcputmratal woo only J <—'-'—,•., .-,,-- Permit Number Map# Lot# Signature of LiccnseefPertbittce 0 I ;.15-. < w .. it , , rr = -4 ° M 3 c o � f R `z = F T 7t7 n 5 -et ( Z r -i r -i Cr7 a Zoning Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations %r NORTHAMPTON, MASS. /MO V /3 19 > Additions kA' APPLICATION FOR PERMIT TO ALTER Repair Garage 1. Location ;x1 C/ s-f//2(/.�? /�1� Lot No. 2. Owner's name � .cA,-,IC di✓ Address S/370r1� , 3. Builder's name de ( Q/(t 7--i 3 12 Address 4. 1cC. d Ste" Mass.Construction Supervisor's License No. (7/SO Expiration Date 1/-36--20enei 4. Addition 5. Alteration 6. New Porch 7. Is existing building to be demolished? 8. Repair after the fire 9. Garage No.of cars Size 10. Method of heating 11. Dis��n►cie of lines / 12. Ti e o f (OU/eI e_)ue 8x,/,iii�✓y Alt- /.✓r�, �S k' f� A Cr S>ii,it� 4 S y � 13. Siding house 14. Estimated cost:- i‘co i The undersigned certifies that the above statements are true to the best of his, her knowledgef. Signature of responsible appitcant Remarks