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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No Alterations
NORTHAMPTON, MASS. 007- 19 Additions
APPLICATION FOR PERMIT TO ALTER Repair
a
Garage
1. Location L/ Lot No.
2. Owner's nameA/UAr),,J�, Address 5r1y-,,a-e-
3. Builder's name r V (Di2g-c� Address / C .5J- _
Mass.Construction Supervisor's License No. Expiration Date Z1`3e1)-Z;Lr"- d
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
12. Type of roof 5M to
13. Siding house
14. Estimated cost-/Soc✓ _
The undersigned certifies that the above statements are true to the best of his,
knowledge and bel' ..
Signature of responsible app,icant
Remarks
1
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Of X=f4amptan
4 'j 1 Massachusetts
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m ---� pEPAR NT OF BUILDEgG INSPECTIONS
APT OF gUltDit w ,
TFi`,Ft'� --- ain Street Municipal Building '
Northampton, Mass.' 01060 `
WORKER'S COMPENSATION INSURANCE AFFIDAVIT
e- r
with a principal place of business/residence at:
S /v '�il✓ 1W hone#) S�71
(sit/city/statclriP)
do hereby certify, under the pains and penalties of penury, that:
( ) I 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) (In5dmn(-- Company/Poucy Number) (Expiration Date)
(Name of Contractor) (Insurance Company/Poke Number) (Expiration Due)
(Name of Contractor) (Insur--ac-- Company/Policy Numb--x) (E-,piration Date)
(Name of Contractor) (Insurance Company/Policy Numbs) (Expiration Date)
0f—h additional xhoct ifmocaary to in� fcrta,5oa Pcrtaizing to all oo tro r3)
( I
and 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 v;Wo bomco-.+vcn Hbro a=ploy pasom to do tai¢rte--+,—wasrt c oa-or mpau worst on a dwelling or
not mo v thaw throe U=U is which the bomoowvcr r macs or oa tho grounds appurtma tbcctu arc not Ecoaally 000=&-cd to be
employ—under the worker•%ecmp=s4on Act(GL152ss t(5)),appliealion by a bomcowoxr for a Gccax or Permit mar evidc Om the
lcgsl%talus of as employer under the Workces C.ompaoaXkoa Act-
I uadc A%nd dm&a oopy of this ratcmmi may be ro werd+d te,the Dcpertmmt of In&. .l A BOO of Lx%M-oo'for tb.
o>vcrxge va ificatioo and that failure to secure covaaba uadcs socdoa 25A of MOL 152 eta Ind to tbe'unpin—of aimiml pcaaltin
oomisana of a tine bf up to S 1,500.00 anNor of tip to one year aid civil Pcmltia is the form of a Stop Work Qdtz aid a l
find OCS100.00 a day ajdast Me.
For tiae only
PczmitNumbar
signattuz taf L:iocascdPcisaitLce
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 MUST BE COMPLETED, or PERMIT CAN BE DENIED DUE TO
LACK OF INFORMATION.
27US C0,1== to be filled in
by the Banding 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 parkingi
# 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: Ab -el 'CK APPLICANT's SIGNATURE
NOTE: Issuance of a zoning permit does not relieve an applioanYs burden to oompty wlttp all
zoning requirements and obtain all required permits from the Board of Health. Conservation
Commission. Department of Publio Works and other applionble permit granting authorities.
FILE #
{ r u-
OCT a
DEPT SU1L0lNG R`°� �(�:' File No. '
ORTHAMITON Mi 01060
ZONING PERMIT APPLICATION (§10 . 2)
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant: ee"
Address:L( W-k-e'/ 5,4- Telephone: .S6y-65W
2. Owner of Property: AiJA&Vtl ziy4e'o t+r'
Address: �7 O`a*V'-V--t P/Z Telephone: .�aV-2,5 .2—
3. Status of Applicant: Owner Contract Purchaser Lessee
Other(explain):
4. Job Location: :5 -
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 UseA'Vork/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)
47 O'DONNELL DR BP-2000-0373
G1S#: COMMONWEALTH OF MASSACHUSETTS
Map:Block:35- 128 CITY OF NORTHAMPTON
Lot:-001
Permit: Building
Cateeorv:roofing BUILDING PERMIT
Permit# BP-2000-0373
Proiect# JS-2000-0599
Est.Cost: $1800.00
Fee: $25.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: Ed Corbett Jr 116069
Lot Sizes .ft. : 11717.6 4 Owner: ENGERMAN ANTHONY F&CHARLOTTE
Zoning: SR Applicant: Ed Corbett Jr
AT. 47 O'DONNELL DR
Applicant Address: Phone: Insurance:
4 Reed Street (413) 586-5192
NORTHAMPTON 01060 ISSUED ON.'1010411999 0:00:00
TO PERFORM THE FOLLOWING WORK.-STRIP & SHINGLE ROOF
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 Sitnature:
Fee Type: Receipt No: Date Paid: Check No: Amount:
Building 10/04/1999 0:00:00 $25.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Building Commissioner-Anthony Patillo