35-098 (3) > o.9 'a
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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations
NORTHAMPTON, MASS. 1 q Additions
! Repair
• ' APPLICATION FOR PERMIT TO ALTER
Garage
1. Location 13 t)r n S D K) 0 r Lot No.
2. Owner's name)(i t.) y jeia, c r 4 1 k,ou Aa prs.c--4�e&A s Address ��� t7�-e.A;S e" I)r
3. Builder's name C1 1%+ J. C Ar r, i e r Jr- Address -64. S o-A�,s.M n�e n.
Mass.Construction Supervisor's License No. O l ss`l Expiration Date
4. Addition
5. Alteration Aj A 9 Lai De-A. 4, c�Lxt SAi")-1 W o U L-Qa &1- PoO
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-
T The undersigned certifies that the above statements are we to the best of his, her
knowledge and belief.A�\
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Signature of resp nsible app icant II
Remarks
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m J DEPARTMENT OF BUILDING INSPECTIONS
w w, 212 Main Street ' Municipal Building
Northampton, Mass. 01060 '
WORKER'S CO?YITENSA`I`ION INSURANCE AF i A.VTT
with a principal place of business/resideuce at:
(phone#) S� 7 — b33 3
(strc�i/ci ty/statrJ�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 working on this job:
(Insurance Comppanny)) (Policy Number) (Expiration Date)
I am a sole proprieto genera] contractor or homeowner (circle one) and have hired
the contractors s elow who have the following worker's compensation policies:
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(Name of Contractor) (Insurance Compaay/Pohcy Number) (Expiration Date)
(Name of Contractor) (Insurance Compauy/Policy Number) (Expiration Dale)
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(attach additioail Acct ifnocc=s ry to iociu&irSofmatioo pcxtaiaing to all ooatrn r3)
( I am a sole proprietor and have no one working for me.
( ) I am a home owner performing aH the work myself.
NOTE:please be awzm that whilo hom:oKUm"ba auplay pcsxom w do m.:..icau,n o=s ruction or repair work on a dymlflng of
not moco than thre-o units is which the homeowner reridca of oo the grounds appurtenint the cw uc DO(gearnlly coaridacd to be
employexa under the wod cc's ocaTcm4ca Act appLirabon by a homcowi r for a bccase oe permit may evidence the
Legal o-f" of an amp loyoc undertho Workoes Compmzatioa Act_
I undcrstxad that a copy of this�xfc nut may bo fo%wIudod to tbo Dcpa�of Indar in!A«idmtf Ofui of Ifzsufwoe for dh
coverage vaificatioi aid that failure to acaue covcrn undo socdoa 25A of MoL 152 an Lad to tbo imposition of aiminal pcnaltia
ooaustiug of a fine'of up to S 1,500.00=idtof of tip i4 oie year and civil penalties is the form of a Stop Work Order and a
fmo of 5100.00 Idly against me
For dCP=taJWW tl'o only
permit Number
(Dc> Lot#
Signature of Liccnsec/Permittce
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10 Do any signs exist on the property? YES NO x
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.
Thin cclu= to be fill d in
by the Buil.dj Ikpnrtm t:
I Required I
Existing Proposed By Zoning
I Lot size
C7� U 0 S a wt ��071
Frontage q a t s a w /C15_
Setbacks
- side L:3y' R: aS L: .30' R: ,.2 3 o?O
- rear
Building height
Bldg Square footage 0110
%Open Space:
(Lot area minus bldg f; Q Q! 7 20
&paved parking! ( V
# of -Parking spaces t
#
of 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.
DATE: Y--+- APPLICANT's SIGNATURE
NOTE: lusuanoe of a zoning permit does not relieve an mplanoanit burden to m with
zoning requirements and obtain all required PIY hall
q Permits from the Board of Health. Conservation
Commission, Department of Publio works and other appiioabla permit granting authorities.
FILE #
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"7ZONING PERMIT APPLICATION (§10 . 2
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant: 1C e„� Ll • c•v v v° �r-
Address: I G 0-4 „1 k ,,A,,,v Telephone: 5.'t V?
2. Owner of Property: ( G w y-e ru C—re- + u w I C% R 0 Lew�f
Address: tt'?3 U re w .5Q•'s Dr. Telephone: S gy 7 JL
3. Status of Applicant: Owner _Contract Purchaser Lessee
Other(explain):
4. Job Location: / i 5 c Wv D
Parcel Id: Zoning Map# �3j Parcel#_za District(s):
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/Property V'4
6. Description of Proposed U /Work/P(roject/Occu ton: (Use additional sheets if necessary): [
AA Q 0"X IX �ee-k T-o �Xkc'V >c kovS-91/21 ch %y �e �i `�o � lxt7c�ve Geg4.
X"I '(S-11W 70;i S (,`` G•t, CJCsll-r e—k S 00—,Q j v�a.5 � ` �Da Ue t K ur K (t
4 Ft-V i 5 L-s-
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 ly 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)
f
File#BP-2000-0842
APPLICANT/CONTACT PERSON Robert Carrier Jr
ADDRESS/PHONE 16 David St (413)527-0333
PROPERTY LOCATION 83 DREWSEN DR
MAP 35 PARCEL 098 ZONE SR
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: CONSTRUCT 8 X 12 DECK
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building,Plans Included•
Owner/Statement or License 059154
3 sets of Plans/Plot Plan
THE 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 ission Permit from CB Architecture Committee
ZB LoO 0
Signature of Building icial Dat
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.
83 DREWSEN DR BP-2000-0842
GIS#: COMMONWEALTH OF MASSACHUSETTS
' ``Map:Block: 35-098 CITY OF NORTHAMPTON
Lot:-001
Permit: Building
Category:ADDITION BUILDING PERMIT
Permit# BP-2000-0842
Project# JS-2000-1584
Est.Cost: $2900.00
Fee:$50.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Groin: Robert Carrier Jr 059154
Lot Size(sq. ft.): 901 6.92 Owner: ROBERTS LAWRENCE P
Zoning: SR Applicant. Robert Carrier Jr
AT. 83 DREWSEN DR
Applicant Address: Phone: Insurance:
16 David St (413) 527-0333
SOUTHAMPTONMA01073 ISSUED ON:4121100 0:00:00
TO PERFORM THE FOLLOWING WORK.-CONSTRUCT 8 X 12 DECK
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:
THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF
ANY OF ITS RULES AND REGULATIONS.
Certificate of Occupancy Signature:
Fee Type: Receipt No: Date Paid: Check No: Amount:
Building 4/21/00 0:00:00 1178 $50.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Building Commissioner-Anthony Patillo
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833 DREWSEN DR a City of Northampton BP-2000-0842
cIS#: BUILDJNC�I SPECTION LABEL ASSACHUSETTS
MaP Blok:35-098 APP V E E) MffON
���LA-001 1
luild n; Inspector `J
Date� DR
PIT
Permit#
BP-2400-ug4z __-
Pt�t1 JS-2044-15 -4
Cost $2900:00
Fee:$50.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
use Groan: Robert Carrier Jr 459154
lgt Si r&Ug.ft.! 9016-92 Owner: RQD=LAY9MCE P
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ATr $3 DREWSEN DR
ticant Address,;_ Pls one. Insurance:
16 David St (413)527:-0333
SOUTHAMPTONMA01073 I„ ►LIEU f1N:4lZl�00¢«00:OD
TO PERFORM THE FOLLOWING WORK.-CONSTRUCT 8 X 12 DECK
POS MQRD§Q IT 0 3=1&FROM THE§LMET
Inspector of Plumbing Inspector of Wiring D.P.W. Inspector of Buildings
Underground: Services Meter:
Footings:
Rough: Rough: House# Foundation:
Final: Final:
Rough Frame:
Gas Fireplace/Chimney;
Rough: Insulation;
Final: m e• Final: 0 K Gam'-3.,10 'All
THIS PERMIT MAX BE REVOKED BY THE CIT F NORTHAIVJ[P'TON UPON VIOLATIO OF
ANY OF r1 S RULES AND REGULATIONS.
Co-ttit,010 of
ee Resit 1. Date Paid: Check No: Amount:
Building 4/21/00 0:00:00 1178 $50.00
212 Main Street,Phone(413)587-1240,Fax:(413)587-1272
Building Commissioner-Anthony Patillo