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FIN. GRI
COMPOSITIO
OVER 15# P
CDX PLYWOO
AIRSPACE CLEARANCE ABOVE I NSULAT I ON
2x O 16" t
SEE FRAMII
METAL DRIP EDGE
(2) 2x4 TO
MIN. LAP
GUTTER do DOWNSPOUT R-30 INSUI
1X8 FASCIA OVER 1/2" GM 1
2X6 SUBFASCIA 5/8" WHEN
O 24" 0.C
2x4' 9 O 24" O.C.
3/ EXT . YWOOQ CORNER TIt
SOFF W "X16" `t
SCREEN aXtwFTAL ►�
VEN O 4 O.C.
2X CONT . o
i
TRI REXEF
IONS — WOOD STOCK
WIND R PLAN 2X4 STUDS
BATT I NSU
SIDING ATION — OPTIONAL`
2X6 STUDS
1/2" SH BATT INSL
VERIFY Wl
WEATHER ARRI ER - -----• WHERE API
TYP. AL PHICAL AREAS
— 1/2" GYP'.
VAPO BARRIER WHERE APPLICABLE--
— BASE TR I k
BOTTOM PI
SLOPE GRADE AWAY FROM
FOUNDATION 6 IN FIRST 10'
(TYP)
MIN FOUNDAT ION (SEE FCI
FIN. GRADE ® HOUSE WALL
FROM BOTTOM MOST
WOOD TO GRADE
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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations
NORTHAMPTON, MASS. 19 Additions
APPLICATION FOR PERMIT TO ALTER Repair
,� Garage
1. Location �J'—/ ✓� Lot No.
2. Owner's name �� 7�1 IN P, Address o1 �� i �% A) �
3. Builder's name �/, i�'S/f1� [.lYi�'�� Address �Iy ,1 F
Mass.Construction Supervisor's License No. O-7- `' Expiration Date
4. Addition / /
5. Alteration 'UL 4/ /e; � ,4 /,d/,4 xcc 17�'l� C/z 4,.11%A,�
6. New Porch
7. Is existing building to be demolished? / � P�2 ' a es e—�X,4.)fp l i
8. Repair after the fire
9. Garage No.of cars Size
10. Method of heating
11. Distance to lot lines
12. Type of roof
13. Siding house �%/�.t.J �"�` tiu•-a .� % r a
14. Estimated cost:-
The undersigned certifies that the above statements are we to the best of his,
knowledge and belief.
1/�
Signature of responsible app,ican(
Remarks
i
�o oy
B �+csanrhnsctts
DEPARTMENT OF BUII,DMG INSPECTIONS
212 Main Street ' Municipal Building
$5 Northampton, Mass. 01060
�' -WORTCER'S CON PENSA'TION INSURANCE AFFMAVTT
(liccnscr/pclmittee)
with a principal place of business/residen e at:
('r
�a a�<7 (phone#)
(street/ci ty/sta&2i p)
do hereby certify, under the pains and penalties of perjury, that:
( ) I am an employer providing the folloNving worker's compensation coverage for my
employees worlang on this job:
(Insurance'Company) (Policy Number) (Expiration Daze)
( ) 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:
� 5
(Name of Contractor) (Insurance Company/Poticy Number) (Expimtioa Date)
(Name of Contractor) (In w-ancc CompanyiPohcy Number) (Expiration Date)
(Name of Contractor
(Insuranc CompanyiPolicy Number) (Expiration Date)
i
(Name of Contractor) (Insurance Company/Poky Number) (Expiration Date)
(atrarh additional sheer ifmccasary t4 ioducic infwmuioa Pertaining to ell cccrtracton)
j
( ) I am a sole proprietor and have no one worl;sng for me.
( ) I am a home owner performing all the work'myself.
NOTE:pteaae be aware that whilo hoacowncn who employ Pcnonz to do mx;M—w�wnsttudioa or repair work on a dwelling of
not more thin tbroo units in which the homoowncr rcaidca of oa the grroundl aVWrlenaat tbado arc not gmrrvlly comidard to be
cmploy—under tbo`0�1 ooct�c-Act(G L152�=1(5))�application by a hon=wna for a Gccnx cc Pamit may cvidcocc the
legal rta-bm of an emPioyer under the Workoet ComPeoaatioa Act_
I underhand the a oopy of this ctat®cni may bo f0rvrnni4d to the Dcportazcat of rndusO iel Aocideat>Ofroo of ltrau>nco for Liza
cov—gc Va'fiestioo and that failrrrc to acatre coverage undo section 25A of MOL 152 c=lad to tba impo oa of aimin4 penalties
0omisting of a Eme of up to S"500-00 and/or of UP to one year and avi�prnattia in the form of it Stop Work order and a
find of S 1000 1 day LPM51 me.
Signed this __ day Of— 199 FordcPr�aituaoaiy
Permit Number
� ���`�✓
Si f Li lPCr u ttcc Map# Lot#
I .
• I S
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 c01— to be filled in
by the Building IXpartment
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
f 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: /l�l'II �� ��! / APPLICANT's SIGNATURE �✓(/ i?il�.
NOTE: lasuanoe cN a zoning permit does not relieve an a -ant's den to oomply Wp4 .ipli
zoning requirements and obtain all required permits from the Boni Health, Conservtatior
Commission, Department of Publio Works and other applionble permit granting authorities.
FILE # -
a
NOV
t File No. L0// 3o/
p
ZONING PERMIT APPLICATION (§10. 2
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant:
Address: L Telephone:
2. Owner of Property:
Address: a 85 V- A)7 AJ Telephone: Y2.5`9
3. Status of Applicant: Owner Contract P chaser Lessee
Other(explain): el�O VOV
4. Job Location: ":�7 5 / / &410"V� �V
Parcel Id: Zoning Map# 3,9 (f _ Parcel# District(s): -�
(TO BE FILLED IN BY THE BUILDING DEPARTMEN
S. Existing Use of Structure/Property -HJ , +--�
6. Description of Proposed UseANork/Project/Occupation: (Use additional sheets if necessary):
NCI-0 VNy4 wJUJb-LVJ Amd Si4iI &
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 D cument#
9. Does the site contain a brook, body f water or wetlands? NO DON'T NOW YES
Y K
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 963014
ldql
AVnQ``!! I -d6
PLICM)CONTACT PERSON: D Zd2 A
ADD-RES.S/PHONE: M 411/_ 0
PROPERTY LOCATION:
MAP PARCEL: /,x'02 ZONE
THIS SECTION FOR-OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCL SED REQUIRED DATE
ZONING FORM M.I.E.-D OUT
]Rnildin2 Permit Filled nut
3Setr, nf 6;Q/pint
T�OLLOWING r ACTION HAS BEEN T ON THIS AP ICATIOM
Approved as presentedfbased 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 1
Other Permits Required:
Curb Cut from DPW Water Availability Sewer Availability
I�ealth Well Water Potability-Bd Health
Permit from Conservatio ommiss'og/
Signature of Building klogtor IDate
NOTE:laauanoo of a zoning permit does not relieve an applloant'n burden to oomply with all
zoning requirementa and obtain all required permits from the Board of Health, Conservation
Commisslon, Department of Publio Works and other applicable permit granting authorltles.
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