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18D-058 (16) a 2 70 'v < n- v b c• � � � m 3 Zm C � z yo z �, o m _a Zoning Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. / Alterations NORTHAMPTON, MASS. 19_ 7 Additions APPLICATION �OR PERMIT TO ALTER Repair Garage 1. Location y Z� ���� � ,� � � Lot No. 2. Owner's name qkW UU! N f; Sk-e Address ] -C,,!U " Sr, : 6AWi`AM. M 1\, 3. Builder's name K� o co Address 2S w ► W�uttxx- Mass.Construction Supervisor's License No. C� �� - Expiration Date 120 o 4. Addition Q�MC.E mb 31 ok3 5. Alteration 6. New Porch NU 7. Is existing building to be demolished? hl(A 8. Repair after the fire 9. Garage No.of cars Size 10. Method of heating 1 11. Distance to lot lines 50 liz-1 LEFT� 1 "T 12. Type of roof 13. Siding house 14. Estimated cost:- -7)00<e. to The u 7k*rsii c ies that the above statemen F t of his, her knowledge and belt EDWARD q�yG J. m ° RY FC X1.61 S& nat re of respo able 11336� of FGISTER�" ��, FSS ONAL ENG� Remarks 4-(ri/J•I PT O O Ffi �fl (rZf 7 If 'Warf11aillpfon . B 6 �+cssachn's�Us m DEPARTMENT OF BUILDING INSPECTIONS 212 Main Street e Municipal Building Northampton, Mass. 01060 WORZCER'S COMPENSATION INSURA-NCE AT,MAVTr (Li c,msc^J pe rmi t tf^.) with a principal place of business/resideoce at: Ls Lt��klegc,met, Aye-- MV-&—J,P'W4 0&*0 (phooC' 413-53;? 1.97e- city/ Zt Zip) do hereby ceraf),, under the pains and penalties of perjury, ( gym an employer providing the follo%,,1ing Nvor�er's compensation covcc-age for my employees worldog on this job: a S 66QK 4L44))-1118 d4l -- i q/(?g (Insurance Comp2my) (Policy Nttniber) iraa Date) ( ) I am a sole proprietor 6 eral contra for homeowner (circle one) and have hired the contractors listed below who have the following worker's compensation policies: (Name of Contractor) QI_ surancz- Company/Policy Number) (Expiration Date) (Name of Contactor) (Lantra-nom CompanyrPo!icy Number) (Ea-pirabon Date) (Name of Contractor) Rn urancz— CompaM,/Policy Numbzs) (Expitaaoo Date) (Name of Contractor) (Inniranc-- Company/Poky Number) (Expiration Date) (aIIic�a6c!itioml cboci if noc�.iry to ocUdc iafocalaa oo pert_imng to all ccds-.won) ( ) 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 acrsrc tb,t whilo bomcowocrs vrbo csnplvy pcczom w&MXjnj�coa5:ructi00-cr rcpas work on a d--Uiag Of oo(moc c tlLa thsmo units is which the bomoocvncr r=ides oc oa the p ouads Tpurica�tbacto um oo(gmavlly oomidcrcd to be cmPlayrrs under tbo-V&--'s.0=oP Silica Act(G1,152,ss 1(5)�appd=Ldoa by a boowow=far a Gccme or perma may cvidmec the legsl ct�nu of as employee uodeetbo Worpo�a Componsalioa lid. I uedcrstand tbct x copy of thin mtcmcct may bo foew.0 tied to tho Dcpnrmxct of j.&Le ricl k dd.C&ofs.of law.00e for the oovccag va ificatioa nad that failure to so=m oov=Va trader section 23A of MOL 152 can toad to tbd impo —of-kam l P-16- 000sistiag or a fiat of ts�to S 1 300.00 md/or imprttio oCup t o ooc year and an7 PSG=is the form of n Stop W tick Otdcr anti a fincoCSl00.00 achy cgainst.mc. ' i zthis � day of Q11.�°I 199 7 For dry:rtma�al—only Pcrm.it Number(j�:Z Mapf Lot 9 • Signalzu�c o iccnscrJPcrmitl.cc 10. Do any signs exist on the property? YES V NO IF YES,describe size,type and location:_ SNL l�l. 1© tiQ�I�I� E�f� l�1 i Are there any proposed changes to or additions of signs intended for the property?YES NO IF YES,describe size,type and location: k l3.-���A"P�L VJ� S`LG� OF ENTRANCE U (Q)-b \c 2.-CD 11. ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE DENIED DUE TO LACK OF INFORMATION. This colamn to be fillad in by the Banding Department Required Existing Proposed By Zoning Lot size 161 cdo 'it-7 s5 �,_ %; 1 re . 1 Frontage Setbacks frnnt 2 - side L: 50 RA-60 L: S3 R:-1-60 - rear 3rat\(+ Building height Z4 Bldg Square footage 24 A-12 ActkTL0'vAA. i t 2 %Open Space: (Lot area minus bldg i 5 azjz�,SK &paved parking) � # of Parking Spaces f of Loading Docks Fill: 'Avol-rime--& location) `3°� Gy ekANVE 13 . Certification: I eby certify that the information_ contained 4erpin is true and acc ate the st of my knowled— D '1"E: /no AP LIC SIGNATURE NOTE: Iss o a zontn ` g permit d es not relieve a applioae u en to 0o ply wltt�,alp Czoning ulrements and obtain all required permits from the of Health, Consei�votio ommission, Department of Publio Works and other appiioable ermit granting authorities. FILE # Fi 1 e No. pLIP i ZONING PERMIT APPLICATION (§10. 2) PIMA E TYPE OR PRINT ALL INFORMATION 1. Name of Applicant: -Zi1�P� lt� Address: (o? StLUiEk S7't NQAVJW. f� Telephone: 4-1 C j E)!b 2. Owner of Property: P -`�f--'f " L� Address: {$64WNAa Mk Telephone: 44 3 0 7 85�c 3 720 3. Status of Applicant: V Owner Contract Purchaser Lessee Other(explain): 4. Job Location: V ©RA Ve 6 bu3mi Imo,., t4-RKI Parcel Id: Zoning Map# Parcel# J District(s): (TO BE FILLED IN BY THE BUILDING DEPARTMENT) 5. Existing Use of Structure/Property kJdRI-ok wARpszi vet Q(y. ejN.il L 6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary): 7. Attached Plans: IS 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/Vadance/Finding ever been issued for/on the site? NO DON'T KNOV%' YES IF YES,date issued: IF YES: Was the ermit recorded at the Registry of Deeds? NO DON'T KNOW YES IF YES: enter Book Page and./or Do ument# 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 # 9P � J5 AUG 24A�/� ONTACT PERSON: It 2l f Gl`2 t ADDRESS/PHONE: / ='�t,�e�� ! "=z� .``-t•c. ` P, C � PROPERTY' CATION: / "�'� <��..�� - < << � MAP PARCEL: I' ZONE =/ THIS SECTION FOR-OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FH.T,FD OUT c Z Fee Pnid 11Tvilding Permit Filled pilt t .,. THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS AP ICATION: Approved as presentedfbased on information presented V Denied as presented: Special P rmit andk4 Site Pia equired under: § /0, 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-Bd of Health Well Water Potability-Bd Health _Permit froin Conservati C mmissi Signature of Building Inspector Date NOTE:Issuanoe of a zoning permit does not relieve an appiioant's burden to oompty with all zoning requirements and obtain all required permits from the Board of Health, Conservation Commission, Department of Publio Works and other npplioable permit granting authorities. FILE # iJ� SEP 1 8 19�l > APPLICANT/CONTACT PERSON:_& 12 !r C,_ ADDRESS/PHONE: PROPERTY LOCATION: ZZ MAP f�/' PARCEL: �ij ZONE— THIS SECTION FOR-OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FH,T,FI) OUT Fee Pnirl Building Permit Filled nut -- Fee PAid Type of Constniction- �./ THE�OLLOWING ACTION HAS BEEN TAKEN ON THIS AP ICATIW 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 Appro -Bd of Health 4ell Water Potability-Bd Health !Permit from Consseer/vation mmissio �` Signature of Bui ding InspecpCOr Date v • NOTE: lnsuanoe of a zoning permit does not relieve an applioant's burden to oompty with all zoning requirements and obtain all required permits from the Board of Health, Conservation Commission, Department of Publio Works and other npplioable permit granting authorltles. 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