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BATT INSULAT
1/2" SHEATHING VERIFY WITH
WHERE APPL14
WEATHER PROOF BARRIER
TYP. ALL GEOGRAPHICAL AREAS 1/2" GYP. BE
VAPOR BARRIER WHERE APPLICABLE BASE TRIM
BOTTOM PLATI
SLOPE GRADE AWAY FROM
FOUNDATION 6" IN FIRST 10'
(TYP)
MIN --�-- FOUNDATION (SEE FOUNt
FIN. GRADE O HOUSE WALL
FROM BOTTOM MOST ,
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SEE FRAMING PLAI
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MIN. LAP 48"
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B FASCIA OVER 1/2" GWB CEILIN
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O 24" O.C.
4' s O 24" O.C.
CORNER TRIM (TY
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;REENED METAL
:NTS O 48" O.C.
'2X CONT . j
WOOD STOOL do TR
ZIM RE: ELEVATIONS
INDOW RE: FLOOR PLAN / 2X4 STUDS O 16"
BATT INSULATIM
_OPT 1ONAL_CONSTI
(DING PER ELEVATION 2X6 STUDS O 16'
BATT INSULAT101
/2" SHEATHING VERIFY WITH EN
WHERE APPLICAE
FATHER PROOF BARRIER
YP. ALL GEOGRAPHICAL AREAS 1/2" GYP. BD.
'APOR BARRIER WHERE APPLICABLE BASE TRIM
BOTTOM PLATE
;LOPE GRADE AWAY FROM
"OUNDAT I ON 6 IN FIRST 10' 3 Tf G
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' MIN FOUNDATION (SEE FOUNDAI
FIN. GRADE O HOUSE WALL
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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. �y Alterations
NORTHAMPTON, MASS. 2 d 19 7 Additions
APPLICATION FOR PERMIT TO ALTER Repair
p �� /( � hp,�') Gara ge
1. Location 11 9-0g;d A k , �f� Lot No.
2. Owner's name ,7,roX1- MW AI I A�, IW I-. Address
3. Builder's name - � �� �5 r[YYZ /J Address
-
Mass.Construction Supervisor's License No. `s% y Expiration Date
4. Addition
5. Alteration
6. New Porch
7. Is existing building to be demolished? �p
8. Repair after the fire AJ 1-9
9. Garage _ No.of cars Size
10. Method of heating 6Q s f 6,#A4 AP f
11. Distance to lot lines
12. Type of roof ,!kPI A L
13. Siding house 'eX1I -10;' A S h W// �`�
14. Estimated cost:- ,
The undersigned certifies that the above statements are we to the best of his, her
knowledge and belief.
St ature of responsible app=icam
Remarks
o4Stt/W PT0
* OCT 2 2199( Crzt� of 'Nazt4alllvtatt z
9 6 M ass itch nsttis
m DEPARTMENT OF BUILDrNG INSPECTIONS
212 Main Street ' Municipal Building '
Northampton, Mass. 01060
WORKER'S COMPENSATION INSURANCE AFFIDAVIT
Yrt
(li permittee)
with a principal place of 6u ness/residence at:
r (phone#) �
(stzreUci ty/st ateJa p)
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 wort ng on this job:
fi
(Insurance Company) (Policy Number) (Expiration Date)
O I am a sole proprietor, general contractor or homeowner(circle one) and have hued
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 CompauyiPo(icy Number) (Expiraton Date)
(Name of Contractor) (Insurinc:; Comp-my/Policy Number) (Expiration Date)
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(attach additional shee!if neccz:iry to include jaformjLti on pr:tairung to all eortmdon)
( ) I am a sole proprietor and have no one working for me.
( ) I am a home owner performing all the work°myself.
NOTE:plmase be aware that vehilo homcowuer3 who employ persom to do ma i"f'm,n a wmututioa or repair work on a dwmlling of
not mac than three uniu in which the homeowner rc=dcs or on the Vv nds appurtenant,thereto are not g«xralty occ3iderod to be
employes under the wod(es ccxt�on Act(GL152-s 1(5)),application by a homeowner for a license or permit may evidence the
legal datum of an employer under the Worlcor'a Compomation AcL
I undaw-%nd that a copy of this ctatemeai may be forwurded to tho Department of Ind+utria,Accidea&Offioc of Inwrnnco for the
coverage va iGmdon and that failure to secure ooveraga undo section 25A of MGL 152 can lead to tba impaction of aitninal Pcnaal6ts
oomistirtg of a tine of up to S 1,500.00 and/or imprisotttvc d of up to one)ear and civil penalties in the form of a Stop Work Order and a
f=c(5100.00 a day agsitast me-
Signed `
this of d C/4V—day 1991 For dcpsrtmtntal use only
' Permit Number
lot#
Sigttah of Li crnuttt�
10. Do any signs exist on the property? YES NO V
IF YES, describe size,type and location:
Are there any proposed changes to or additions of signs intended for the property?YES NO y
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
- 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-ume--& location)
13 . Certification: I hereby certify that the information contained herein
is true and accurate to the best of my knowledge.
DATE: APPLICANT's SIGNATURE °` 1
NOTE: 1"uanoe o a zoning permit does not relieve an a wanf urden to comply wit44111
zoning requirements and obtain all required permits from the Board of Health, Conservtstion
Commission, Department of Publio Works and other mpplioable permit granting authorities.
FILE #
OGT 2 21997
Fi 1 e No
gall
ZONING PERMIT APPLICATION (§10 . 2)
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant: !,
Address: 2N f � Telephone: 7�/�3 ( 2
2. Owner of Property: ' -
Address: J�/ Telephone:
3. Status of Applicant: °�Owner Contract Purchaser Lessee
Other(explain): l ��
4. Job Location: l-/ I��'R� C�Q M 6R"i'/� *M�2"��7✓
Parcel Id: Zoning Map# Parcel# .J 0 District(s): _
(TO BE FILLED IN BY THE BUILDING DEPARTMENTT
5. Existing Use of Structure/Property S/nJ e- ,lm
6. Description of Proposed seMork/Project/Occupation: (Use additional sheets if necessa .
6� O(zI?,: 1 tvail 0()
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 Perm it/Va da nce/Finding ever been issued for/on the site?
NO DON'T KNOW- LZ 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)
FILE # 969025
�
CT 2 21997
APPLICANT/CG�NTACT PERSON: T'
ADDRESS/PHONE: ! - v
PROPERTY LOCATION: z/ � �L'` '� '�
MAP L"V PARCEL: / / ZONE
THIS SECTION FOR_OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM En JED OUT
Fef. Paid
Bufldin2 Permit Filled mit
�em,e
ou�--
T OLLOWING 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 Consery Comp!vpmn
Signature of Building ector Date
NOTE:Issuanoe of a zoning permit does not relieve an applionnt's burden to oompty with all
zoning requirements and obtain all required permits from the Board of Health, Conservation
Commission, Department of Public), Works and other applioable permit granting authorltles.
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