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23B-046 (137) i N.0 d i v _ 5 0 Z m lv> s -, �, Z > - _ yo Ic Z ., 0 --i 0 O b �I r Zoning Miscellaneous Additions,Repairs,Alterations,etc. Tel.N ( Alterations NORTHAMPTON, MASS. 19"'1 Additions ' APPLICATION FOR PERMIT TO ALTER Repair Garage 1. Location 4� 1 n1 SGT �C P f Tim- �� (�C7- cRT Lot No. 2. Owners name .20-L L.-Li i C K i Address 3. Builders name ` k:r F— PE 12�t, )- �, CVL ,�} Address J PEN i1�l1 E Mass.Construction Supervisor's License No. �' X105 �5��-�- Expiration Date l 5 4. Addition 5. Alteration� � �,l) S i t 9 i ry �t R--�l �--L CCU 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. Distance to lot lines 12. Type of roof 13. Siding house 14. Estimated cost- The undersigned certifies that the above statements are true to the best of his, her �js kno belt f. "710 . Signature of responsible app.icant Remarks s °i MAR 2 4 Gif of 'Wart4ttnlptall $ l ass itch Itsetts cfl 4 3li DEPARTMENT OF BUILDrNG INSPECTIONS _.. 212 Main Street ' Municipal Building ' Northampton, Mass. 01060 ' WORKER'S COMPENSATION INSURANCE Arl t AVTT (li ceuserJptrmi ttee} with a principal place of business/residence at: r �)R, (phone#) (strC_-Ucity/ rip) 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: &5-jyz� G:SL,.P,"t (Insurance Company) (Policy Number) (Expiration Date) I am a sole proprietor,Ceri:eral n r homeowner circle one) and have hired P ( the contractors listed below who ve o wing worke r's compensation policies: i o—c 1 c try} (Name of Contractor) (Insurance Company/Poticy Number) (Exp tion Date) ran ir„c 5$a(' FEE 1 � ,gym E Pct e A F►00il-ry I Su t`'R to l (Name of Contractor) Gnsu lance Company/PoGcy Number) (Expiration Date) (Name of Contmctor) Gas-u=c_- Compauy/PoEcy Number) (Expir-abon Date) (Name of Contractor) (Insurance Company/Policy Number) (Expiration Date) (attach additioml sheet ifneccusry to inchsdc information pertaining to all oo�za-don) ( ) I am a sole proprietor and have no one working for me. ( ) I am a home owner performing all the work myself. NOTE:please be aware that wbilo homcoKVm who employ parent to do mxbatc,•ee,C=st lion or repair worts on a dwelling of not morn than tbroo uad%m which the homoownrr r=dcn or oa the grva56 appurtenant thereto ue not gencratty ooc=dcrcd to be employ,=under the wockcz~s oompanudion Act(GL152,ss 1(5)),application by a homeowner for a licrnse or perMa may evideme the legal ru ua of an employer under the Wodccea Compomatioa Act I understand that x oopy of this ztal®mi may be focwruded to the Dtpertmccd of Inrluatrial Ace& a&Otboo of Imuranoe for tla ooverage verificatioa and that failure to sauce ooverago under section 25A of MOL 152 can lead to tbd imposition of criminal penalties 000satmg of a fine of up to S1,500.00 sadlor im priso® of up to one yew and civil pennies is the form of a Step W orlc Order and a firm of 5100.00 a day against tnc For dcparb=n l uao oaty Permit Number Mai# Lot# of Li�lPermittce T 4 DEPARTMENT' OF BUILDNG INSp'EGTiONS Wtpt:CT _ �, 21 12 Main. Street ` Municipal BuRding `hI OF 811i' ra'°�"-A 1 Northautpton, Muse. alOBp CONSTRUCTION CONTROL DOCUMENT (^I) Project Title$ T,A)1 pp.1 _ Q���"hate : � - `7 Project Location: C LC--Y �cKIt1�4,1t�P1".YVAiMap : Parcel : Zone:_ Scope of Project: In accordance with SECTION 116.0-116.4.2 of the sixth edition of the Massachusetts State Building Code: I, :V78 Mass.Registration Number *416 °C) being a registered professional Engineer chitect hereby certify that I have prepared or directly supervised the preparation of all design plans,computations and specifications concerning: N Entire Project ( ] Architectural [ ] Structural [ ]Mechanical [ ] Fire Protection [ ]Electrical [ J Other(specify) for the above named project and that to the best of my knowledge, such plans, computations and specifications meet the applicable provisions of the Massachusetts State Building Code,all acceptable engineering practices and all applicable laws for the proposed project. Furthermore, I understand and AGREE that I shall perform the necessary professional services and be present on the construction site on a regular and periodic basis to determine that the work is proceeding in accordance with the documents approved by the building permit and shall be responsible for the following as specified in section 116.2.2: 1. Review of shop drawings, samples and other submittals of the contractor as required by the construction contract documents as submitted for the building permit, and approval for the conformance to the design concept. 2. Review and approval of the quality control procedures for all code-required controlled materials. 3. Be present at intervals appropriate to the stage of construction to become generally familiar with the progress and quality of the work and to determine, in general, if the work is being performed in a manner consistent with the construction documents. I shall submit periodically,in a form acceptable to the building official ,a progress report with the pertinent comments.Upon completion of the ,I shall submit to the building official a final report as to the satisfactory completion and readiness roject fo u May. Signature of registered professional SqbscriW and sworn fore me thi X 3AV—da 'f 1999 y commission expires on_Turd D. Etheredne Notary Public Notary Public My Commission Expires 4/15/05 Building Department 413-587-1240-----fax 413-587-1272 10. Do any signs ebst 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 MAST BE COMPLETED, or PERMIT CAN BE DENIED DOE TO LACK OF INFORMATION. This aolmm 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 paz-ki.ng) # of -Parking Spaces f of Loading Docks Fill: -(vol-ume--& location) 13 . Certification: I hereby certify that the .informati-6 ntained herein is L e a d accurate to the best of my e q DATE: �I APPLICANT's SIGN ATUR NO han anoe of a zoning permit does not relieve an at Iicanre burden to oomply wide all Czoning requirements and obtain all required permits fro the Board of Health. Conservation ommission. Department of Publio Works and other app cable permit granting authorities. FILE # MAR 2 419% File No. r k � ✓✓✓ Ns WING PERMIT APPLICATION (§'10 . 2) 9 PLEASE TYPE OR PRINT ALL INFORMATION 1. Name of Applicant: + `- V V Ac f� �C Address: t 011-1 I vu �Y.DF4►A�,Q elephone: � 2. Owner of Property:C�;LL'te--L�)_I c:K-jk-.L �QSP FFAL o Address: S, O Telephone: 3. Status of Applicant: Owner -Contract Purchaser Lessee VOther(explain): (� 1 4. Job Location: _t�c} ���5��"(i'. LI�EST (3)1NG PICT" Lct) - Parcel Id: Zoning Map# J ? Parcel# District(s): (TO BE FILLED IN BY THE BUILDING DEPARTMENT) 5. Existing Use of Structure/Property rv �-- 6. Descn ti of Propose se/Work/Project/Occupabon: (Use additional sheets if necessary} _ Eti 6 V✓ T-F— G t2_`rt e L-l �cF A TGI Q1 90AC W rna MINL P- A I..l._ 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. 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 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#BP-1999-0783 APPLICANT/CONTACT PERSON Kurt Peterson ADDRESS/PHONE 4 SOUTH MAIN ST (413)268-7251 PROPERTY LOCATION 30 LOCUST ST MAP 23B PARCEL 046 ZONE M THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Fille o Fee Paid _:Jy 3 77` Typeof Construction: REHABILITATION DEPT RENOVATIONS-HVAC,WALL,PLUMBING& ELECTRICAL New Construction Non Structural interior renovations Addition to Existiniz Accessory Structure Building Plans Included: Owner/Statement or License 065822 3 sets of Plans/Plot Plan 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 Board of Health Well Water Potability Board of Health Permit from Conservation C ion Signature lding 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. �«, a� �. s � �,f� _� r <° ,, � �;'�� �' �` ,� ti; .,,7� >;; � � �- �_, g 30 LOCUST ST BP-1999-0783 GIs#: f COMMONWEALTH OF MASSACHUSETTS 1VIap:Block:23B-046 CITY OF NORTHAMPTON Lot-001 Permit: Building Category:renovation BUILDING PERMIT Permit# BP-1 R99-0783 Project# Js-1999-0129 Est.Cost.$180000.00 Fee $680.00 PE"ISSIONIS HEREBY GRANTED TO: Const.Class; - Contractor.- License: Use OroW: Kurt Peterson 065822 Lot Stie(sq ft.): 667077.84 r: OOL Y QjQQjSON HOSPITAL INC Zoning:M lic t: Kurt Paterlion -401 CUST ST AnnlicantAdr ress�, Phone Insurance. 4 SQUTH MAN ST (413)268-7251 Workers Compensation HAYDENVILLE 01039 ISSUED Q1V:3124/1999 0:04:04 TO PERFORM THE FOLLOWING WORK.-REHABILITATION DEPT RENOVATIONS - HVAC, WALL, PLUMBING & ELECTRICAL POST THIS CARD$O IT IS VISIBLE FROM THE STREET Inspector of ftwbing Inspector ofWhing D.P.W. Inspector of Buildings Underground `{ Service: Meter: •A f!L L S` Footings: Roughs Rough:Cr^p COL G171f House# Foundation: Final: � r al: �`f f �9 Rough Frame: ©k .. q'+'—{/f'7 Gas Fire Deuartment Fu.place/Chimney: Rough: n: Insulation: Final: Smoke: Final: ©k THIS PERNIIT`MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOL TION OF ANY OF ITS RULES AND REGULATIONS. 1 attire: ipr- Fee Type: Receipt No: Date Paid: Check No. Amount: Building 3/24/1999 0:00:00 $680.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Building Commissioner-Anthony Patillo