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35-037 (3) z � T r► cDn r u —3 — C .Z n 1 > �j Zoning Miscellaneous Additions,Repairs,Alterations,etc. Tel.No.-5� / Alterations NORTHAMPTON, MASS. 19 Additions ' APPLICATION FOR PERMIT TO ALTER Repair Garage 1. Location J y 1 ` Lot No. 2. Owner's name J W J Address / 9 F 3. Builder's name <,— IL Address 4X0 &+*AA-1111 s e Mass.Construction Supervisor's License No.J V 0 - e4 Expiration Date 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. Distance to lot lines p 0 Q _ 12. Type of roof S E }-- I _ SM+ 13. Siding house 14. Estimated cosL- i The undersigned certifies that the above statements are true to the best of his, her knowledge and belief. `1 Signature of r sibte app,icant Remarks �o Gip oyfl t g !,J a g '9� .� �t�,��hRr�►t, 3 JL 4ARTMENT OP BUII DWG INSPECTIONS (#„ --212, Main Street ' Municipal Building Northampton, Macs. 01060 WORKER'S COMTENSAXTON MSURAANCE t t AVTT (li c::ns�/perav ltc:) with a principal place of busincss/resideoue at: h=/St2j-fjZ]P) do hereby ecruO,, under the pz�ins and pe,a2 hes of perjury, thai. ( ) I am an employer providing the follo%vurg compensation cove age for nw employees worLng on this job. (Insurance Compaay) (POLicy Number) ( o❑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) l Qnsuf-aBc-- Compauy/Poucy Number) (Expim6o❑ Datc) (Namc of COntr2C oc) (l nlr r Co alp a-IlyfPolicf t:umocr) (Expiraoon Dz1e) (NZrnc of Contractor) (Ins-ur c-- Coapaay/Pot y Numb--r) (Eipira000 Datc) (Name of Contractor) -(IDsuFa-au,Compaay/Poticy Numb�-r) (Expiration Datt;) (caic?��Cditioml r�-1 ifoc�.ry to o;..Uck iarecmi�ea pa'..,imng to.11 o�ctr�on) O I am a sole proprietor zn l have no one wor4ing for me. ( ) I am a-home owner perforru( all the work myself NOTE'pl—� be aware the w{;y]o Euxr.+v n«bo carp!cy pcsors w rcpir work oo.d..<1tinz CC not meet th r,threo units in wfrie'the or oa Lb-rS�--�•r,�-�tcaud 12rscto uz oe(Sc� UY c-aj; d cd to be csploym U-icr tM veorc cz s,«�--aim A,c1(G LI52 1(5)�npplic Eon try,Le o:rncr fer.d L oe ce pm=t may evil!c tEe 1c�rtzai.of an oa (oyec un dct t'.io Comp I_ica�lct [uo k—tr d d t a CC?y of tbiu cr icmfat—y b.,fog war i-1 to tbo Aputc—ot of ln off—o{[cur—ror t_`- mvcr>,�vcrifi—ion and that fulurc to t�-,c coves,under scctioo 25A d MOL 152 can tc d to tbd irrapositiCA of crL=1 pcac 16CS ooasisting of A-fmc bf up to S 1'5oo.00 9aJct cnprnocmxnt oCup to one yu rnl Civil pc 16l in the f«m CCn Sto9 W cr',Oc�',ct n;d i ffrmoCS100.00 z<�ay igaiuA.mc. Signcd this day of 1997 F«dcPnu:C—W "wry Pc_rmit Number 1vfap4 Lot 9 Signatum of LiccnsccJPc—!tt- G' . r 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 MAST BE COMPLETED, or PERMIT CAN BE DENIED DUE TO LACK OF INFORMATION. This coim= to bs >`i1Zed is by the Bailding 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) # .�"f -Parking spaces # %f Loading Docks Fill: :(volume--& location) 13 . Certification: I hereby certify that the information contained herein is true and accurate to the best of my knowledge. ,l DATE: APPLICANT's SIGNATURE (� NOTE: Issuanoe of &a zoning permit does not relieve an appljd2nVa bu 0on to oompty with all zoning requirements and obtain all required permits from the Board of Health, Conservation Commission, Department of Pubiio Works and other applioable permit granting authorities. FILE # 96% }gyp' File No. DFPT ZONING PERMIT APPLICATION (§10 . 2) PLEASE TYPE OR PRINT ALL INFORMATION 1. Name of Applicant: in �n r r ! f' U-- Address:�a �o-i-� ii,u� s �cx-b�' ka,X��c,L,Telephone: _J Z 4v 3 2. Owner of Property: J t�V fir,-vt �c Address: oz,,u i 9J--Telephone: 3. Status of Applicant: Owner ontract Purchaser Lessee Other(explain): c� 4. Job Location: A,,�/y`vi Parcel Id: Zoning Map# Parcel# District(s): (TO BE FILLED IN BY THE BUILDING DEPARTMENT) 5. Existing Use of Structure/Property 6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary): 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) 4t h Department: Reference No- BP-1999-0035 ................................. Building,Electrical & Mechanical Permits ... .................•----•-------•--......................--•....---................---- Fee Type: Receipt No: Roofing REC-1999-000043 .......................................................................•---•-•----.----- Paid By: Paid in Full On: Larry Paquette Thu Jul 09,1998 ............. ------------------•-•---•-----.............-•-••-.._...........--•---...... .................. ................... Received By: Check No: Linda Lapointe 2114 •.........................................•----......----•-.......------------........... ...................................... DEPARTMENT'S COPY Amount: $20.00 ........................... DEPARTMENT FILE COPY 198 WEST FARMS RD CITY OF NORTHAMPTON BUILDING PERMIT Owner's pulling their own permits or dealing with unregistered contractors for applicable work do not have access to Guaranty Fund(MGL 142A) Issued: Permit No: Inspector: Tracking No.: Fee: 09 Jul, 1998 BP-1999-0035 $20.00 GIS #: Map Block: Lot: Address: Zoniniv Use Group: Lot Size: 6854 35 037 001 198 WEST FARMS RD SR 118918.8 Contractor: License Type: Insurance: Larry Paquette HIC Address: License No.: Insurance No.: 40 East Green Street 100679 City: State: Zip Code: Phone: EASTHAMPTON MA 01027 (413) 527-6375 Project No: Category of Work: Const. Class: Cost Estimate: JS-1999-0048 roofing $4,500.00 Description of Work: strip & shingle roof GeoTMSO 1997 Des Lauriers&Associates.Inc. Ci.m�fi.rn•