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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations
NORTHAMPTON, MASS. 19 Additions
a APPLICATION FOR PERMIT TO ALTER Repair
Garage
1. 1 S tf c3YlSk S`z . C 7 L �`�'`'°' S t , Lot No.
2. Owners name l DL'S' I Address � ` S"r
3. Builder's name 7<_) �-'SA, Address S�-nylc.- C j;-�6- La
Mass.Construction Supervisor's License No. �°-7 F-21 Expiration Date L U 2,ex,
4. Addition
5. Alteration
6. New Porch
7. Is existing building to be demolished? � S G . iu�(,tQ"l D�
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 .�
14. Estimated cost:- 2
t
The undersigned certifies that the above statements are we to the best of his,
knowledge and
Signature of responsible appicant
Remarks l O s f 2 ti ►�
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DEPARTMENT OF BUILDNG INSPECTIONS
212 Main Street ' Municipal Building '
Northampton, Mass. 01060 '
WORKER'S COMPENSATION INSURANCE AFFIDAVIT
cliper>�i«�e�
with a principal place of business/residence at:
Lz zJ
(strCcucity/stave;*
do hereby certify, under�he pains and penalties of pedury, that:
(tYl-am an employer providing the following worker's compensation coverage for my
employees working 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 compensation policies:
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(Name of Con=ctor) (Insurance Company/Poticy Number) '' (Expiration Date)
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(att c additioml shod if neccsssry to iacludc infocmarioa p=inning w all coat ncton)
( ) I am a sole proprietor and have no one workng for me.
( j I am a home owner performing alt the work myself
NOTE:please be aw=that whilo homeowaem who employ pazons to do mahAcnance,coazrnrcdoa'cr rcps it work on a d%w1ft of
not mu than throe voila is which the homeowner r c*ida or oa the grounds apne=a thasto ate not gc sally co=dcred to be
emploYcm undcr tba wockees compeam acs Ad(GL152,rs 1(5))�application by a homcoww fora Gcenw or pans d may evidcaoe the
legal status of as rmployw undwthe Workda Compaoaatiou AcL
I aaderstaad that a copy oftbia satema t may be fmwardad to tha Depwu cd ofln&ntrid Aod w&Office of lnsunooa fa the
covetzbe verificdim and that f l u+e to wore crimp i socdm 25A of GL 151 cm lad to tbd iaVG$itioa cfaimiaai pmaltia
000sWwS of a Em ofnp to S1�5W.00-Not kVc6oamat ofup to am year and eio pemuics in the foam of a Stop Wakovdw and a `
boo of5100 00 a say apices me.
For deputmacbItunodY
J (� Permit Number
� Lot
Ma
Signature License epermitice l
. ...
10. Do any signs ebst on the property? YES NO r
IF YES, describe size,type and location:
Are there any proposed changes to or additions of signs intended for the property?YES NO 4-�-
IF YES,describe size,type and location:
11. ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE DENIED DUE TO
LACK OF INFORMATION.
This Colt= to ba fillmd Ln
by tha Enilding 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)
10
# 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: (-Z �I°1 APPLICANT's SIGNATURE_
NOTE: Issuanoa of a zoning permit does not relieve an applioanYs burden to oom wit -
zoning requlraments and obtain all required p,lY all
q permits from the Board of Health, Conservation
Commission, Department of Publio Works and other appnoabla permit granting authorities.
FILE #
File No. Fa-O�C�?
ZONING PERMIT APPLICATION (§10 . 2)
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant: pA.1 � &
Address: 3 G SQ-JtVj" (Q Telephone:
2. Owner of Property: (�Yt t u _
Address: __- S" STS Telephoner
3. Status of Applicant: Owner Contract Purchaser Lessee
Other(explain): -�%�VL,��JA�
4. Job Location: k ST 2�Z L
Parcel Id: Zoning Map# V C-2 0- -parcel# District(s):
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/Property
6. Description of Proposed Use/Work/Pr o'e Occup lion: (Use additional sheets if necessary):
7. Attached Plans: �_Sketch Plan Site Plan Engineered/Surveyed pl--
Answers to the following 2 questions may be obtained by checking with the Buildino D-0 - `
8. Has a Special Permit/Vadance/Finding ever been issued for/(
NO DON'T KNOV%f YES
IF YES: Was the permit recorded at the Registry of Deeds?
NO DON'T KNOW YES
IF YES: enter Book Page ant
9. Does the site contain a brook, body of water or wetlands? NO i
IF YES,has a permit been or need to be obtained from the Conse
Needs to be obtained Obtained
(FORM CONTINUES ON OTHER
File#BP-2000-0527
APPLICANT/CONTACT PERSON Robert Walker
ADDRESS/PHONE 36 Service Center (413)584-1224
PROPERTY LOCATION 222 PLEASANT ST
MAP 32C PARCEL 168 ZONE CB
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Buildinp,Permit Filled out
Fee Paid '
Typeof Construction: DEMO GARAGE
New Construction
Non Structural interior renovations
Addition to Existing
Accessojy Structure
Building,Plans Included•
Owner/Statement or License 034783
3 sets of Plans/Plot Plan
THE F LOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION:
Approved as presentedibased 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 Board of Health Well Water Potability Board of Health
Permit from Conservation Co i on
Signature o uilding 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.
222 PLEASANT ST BP-2000-0527
GIs#: COMMONWEALTH OF MASSACHUSETTS
Map.Block: 32C- 168 CITY OF NORTHAMPTON
Lot: -001
Permit: Building
Category:demolition BUILDING PERMIT
Permit# BP-2000-0527
Project# JS-2000-0051
Est. Cost: $2500.00
Fee: $10.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: Robert Walker 034783
Lot Size(sq. ft.): 8015.04 Owner: HEROLD JORDI
Zoning: CB Applicant. Robert Walker
AT. 222 PLEASANT ST
Applicant Address: Phone: Insurance:
36 Service Center (413) 584-1224 Workers Compensation
NORTHAMPTON 01060 ISSUED ON.•11122199 0:00:00
TO PERFORM THE FOLLOWING WORK.DEMO GARAG E
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: c K 1:p-16-,?q
THIS PERMIT MAY BE REVOKED BY THE CITY F NORTHAMPTON UPON VIOLATION OF
ANY OF ITS RULES AND REGULATIONS.
Certificate of Occupancy.
Si g natu
Fee Type: Receipt No: Date Paid: Check No: Amount:
Building 11/22/99 0:00:00 $10.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Building Commissioner-Anthony Patillo