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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations
NORTHAMPTON, MASS. �� 19 10 Additions
' APPLICATION FOR PERMIT TO ALTER Repair
�
Garage
1. Location � F� /O/�'�►�<1 f�'I•� Lot No.
2. Owner s name Address .2�' �gccl v/� $ ///r/c) e Ep6e nr�' w
3. Builder's name 712 w 0' Address 7,Q"
Mass.Construction Supervisor's License No. 0,24!9V4 Expiration Date a6��$r fl a U
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
13. Siding house V) % 6r `I -
14. Estimated cost:-//hZ/v4 b.
The undersigned certifies that the above statements are true to the best of his, her
knowledge and belief.
Signatur ojresponsible app icant
Remarks
pT -
a a )l1N 17 1998
g _ 8ic�axcansctta
m DEPARTMENT OF BUILDrNG INSPECTIONS
212 Main Street ' Municipal Building
Northampton, Mass. 01060
WORIU-IR'S COMPENSATION INSU RA-NCE A FMAVITp
�/ (liccnscrJ�rtxlitzr�,}
with a principal plac,yof bUSLnesSJrCSidence at.
A-P
.. -- �`- ----�-- -----( o city/stalrJzip)
do hereby certil", under the pains and penalties of per- I y, that
((/l am an : nployer providing the iollowin; "vortce!'s coh}pel,sat!on coverage or my
emoloyecs wor4:i1}o on 1111s lob
(Ln ulanc� Cc an��} (Po!ic-f?Ia:n °r) (F�DL2 On Dam)
O I am a sole proprietor general coda actor or homeo�rner (circle one) and hve hired
ti e contractors listed below who have fa(- follo�r�ng worker's compensation poLcies:
CLVaIllC Oi
cNamc, 01 couii-'cle[) CoulDao)'[Polio' Nuj-kCr) (E-,ptfaGOn Da(c)
(N2me of Connector) (LaalranC'� Comp2n)'/Po6cy Nut-'!L-T) (F_Ypiraoo Date)
(Name of Contr ctcr) (Lnsurrm� Conm )any[Mcy Numlr�r) on Dair)
(r_ttadt��ticci!i�-ct ilnca�l:y t�:n�}ud-ui(cr;n�tioc:F.,::t,__vr_F to>Il ac3:.-GOn)
( ) I asri a sole proprietor and have no one worL-i-ng for me.
( ) I am a home owner performing all the work myself.
NOTT~please be awr,-r flit v Ui bOQ CXJ YDCi]tvbo employ peros w do utico:cc rcpaa work on x d�vclling oC
not mono tban tbr—tmib in wbjc�L oonzkkd d to be
botxsoowncr redo or oa tho�oundi appurtcnsn!tbcrdo uc got ecncrallY
c—ploycrz ixnda lba woticcr s oo z ym Aa(GL15�n 1(5)).aWdcztioo by a homeowner for a liccax a permit tray cvidcvoc the
1cV1 axt.of an employw under tho Wockoe'Comps "L-i A-(-
I undersixnd thrt a°"pY a thu y bo fatwnrdod to tbo Doparfieni of In�rie Aoeid�D�oo of Inxarsoou for tbn
govern&'-vcrMcztioo and tbitt f%du=to scauc coven undcr sociion 25A of MOL 152 C-A l-d to tbo im�oa of crriminil pca&Wcs
°O ACx fine oCup lo:S1'500.00 and/or imprit ® of up to.00c year end avil pavltia is the form of Stop WoikOtdcr.ind a
fins of 5100.00'}dey igpttiii toe "
tsio
dcP rt>rr�c�1 Poly. . -
-
Siglat�?rc ofLjscc7Pc
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.
This cols 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:
(Lotarea minus bldg
&paved parking%
# ., f -Parking spaces
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.
.l
D?II"E: /6 t1' APPLICANT's SIGNATU,�
NOTE: Is anoe of a zoning permit does not relieve an a lioanta burde to oom wtt
PP PIY ...+All
zoning uirements and obtain all required permits from the Board of, ealth, Conservation
Commission, Department of Publio Works and other applioable permit granting authorities.
FILE #
File No. ✓ i
ZONING PERMIT APPLICATION (§10 . 2)
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant: R�d Z? S/C�h1 .�u� d?N1>•v �= �•d'�}t.
Address: ?7S-1 c / Al lf?//A^► P 7"aL I L4Telephone:
2. Owner of Property: ^7-4 Ell fi9v�a»�F�
Address: 00'F ?Q.9n1 �� ��0�?�n>c� I'�?/��' Telephone:
3. Status of Applicant: Owner Contract Purchaser Lessee
Other(explain):
4. Job Location:
Parcel Id: Zoning Map# �� Parcel# �� District(s):
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/Property 's f
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)
N - FILE # qG 3GS 1
JUN 1 7 '1998 t _
APPLICANT/CONTACT PERSON:
ADDRESS/PHONE:
i
PROPERTY LOCATION:
MAP PARCEL: �i ZONE .�
THIS SECTION FOR-OFFICIAL USE ONLY:
PERMIT APPLICATION_CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM EHLET) OUT
Fee PAid
Rnilding Permit Filled nut
FePpflid In o c_) d _�
Arceggn v �trn�tnrP
131A .. Tnclylded-
3 !Rpk of Plans /Plot Plan
THE LLOWING ACTION HAS BEEN TAKEN ON THIS AP ICATION'
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:
r rC utty from DPW Water Availability Sewer Availability
Mi
SeP, Approval�I3c�of Health Well Water Potability-Bd Health
fro onservatio wmission
f
Signature of Building ln66ector Da Fe
NOTE:Issuance of m zoning permit does not relieve an applicant's burden to comply with all
zoning requirements and obtain all required permits from the Board of Health, Conservation
Commission, Department of Public Works and other applicable permit granting authorltles.
r
Department: Reference No: BP-1998-0066
----------------------------------
Building, Electrical & Mechanical Permits
.........................................................................................
Fee Type: Receipt No:
Vinyl siding& replacement windows REC-1998-000071
.........................................................................................
....................................
Paid By: Paid in Full On:
B & R Siding Wed Jun 17,1998
.........................................................................................
....................................
Received By: Check No:
Linda Lapointe 16070
.........................................................................................
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DEPARTMENT'S COPY Amount: $20.00
...........................
DEPARTMENT FILE COPY 808 RYAN 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:
17 Jun, 1998 BP-1998-0066 963683 $20.00
GIS #: Map Block: Lot: Address: Zoning Use Group: Lot Size:
6972 35 156 001 808 RYAN RD SR 20734.56
Contractor: License Type: Insurance:
B&R Siding HIC Workers Compensation
Address: License No.: Insurance No.:
781 Bridge Rd. 100465 10000280A
City: State: Zip Code: Phone:
NORTHAMPTON MA 01062 (413) 586-4167
Project No: Category of Work: Const. Class: Cost Estimate:
JS-1998-0066 $2,400.00
Description of Work:
install vinyl siding& replacement windows
GeoTMSOD 1997 Des Lauriers&Associates_Inc. Cidsnwharo-