35-138 (2) O
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Zoning
Miscellaneous Additions,Repairs,Alterations.etc. Tel.No. Alterations
NORTHAMPTON, MASS. 19 Additions
• Repair
' APPLICATION FOR PERMIT TO ALTER
Garage
1. Location Lot No.
2. Owner's name Address W15
3. Builder's name Address 15
Mass.Construction Supervisor's License No. 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
12. Type of roof �Ph r O�: rL
13. Siding house
14. Estimated cosL-
J The undersigned certifies that the above statcmcnts are true to the best of his.
knowledge and I
Signature of responsible appdicant
Remarks t-4 'J � ) A0 t-j S k,,E) 15
NY
#f Obif 4amptan
t� ? AUG """' pt*TMENP OF BUIMING INSPECTIONS
t Main Street a Municipal $uitding
r Northampton, Mass. 01060
WOP=R'S COMPENSATION INSURANCE AF EDAVTT
• (licevsa'Ipermitice) .
with a principal place of business/residence at:
1 za)N (phonett) �' -
( cityistalr/ap)
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 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) (Insutranoc Company/Policy Numbcr) (E�imtion Datc)
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(Name of Coulraetor) (aawancc Compary/Policy Number) (Expiration Dale)
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(attach sddi6ocal:boot irnooezaary to iaohsda iafncmatioa pert icing to all ccd,a on)
( I and a sole proprietor and have no one working forme.
( ) I am a home owner performing all the work myself
NOTE:plc=ae be aw2xc thsl WWo bomoowncn wbo c=ploy per%*=w do m•i• N+ ooe%7u ocror troth work as a dwelling of
cot moan than throe units is which the bocnoowncr ruidn or oo the preuads ap xkauA tbacto tic Dot ycoa..ldy oo¢sidaed to be
employcn under tbo wockce.%coc paaatim Act(GL152,=1(5))6 appliraCoa by a homoowncr for a liccaae or permd tmy evidence the
Itpl st su of as employer undertbe Workoes CompeosWou Ad.
I oodentaisd that a oopy ofth6 suf4meal may be f*nr did to rbe Dep ft...0 ofled.aatrial Aocidmt>•Ofr—of Inxaraow fa rte
oovaagev+aificatipn wd that faiba�e to t:octsre oovcrr=n uadee soetiou 21Aof K4L 152 can ind b tba impoaitim oCaimiazlpmdtict .
oomistiatg of a Sac taCup to S I�SCO 00 wd/ot isapci soomea[of tip to ooe Tar and an7 pcoa tics is the focm OCR Stop Wodc Or4w and a 'y'
find of 3100.00 t dxy tpinst wa .
FordcpwftnwWvu000ly
Permit Ntttnbcr
MAP4 Lot I
S . c�itttoc I ;
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.
Thi.= col— to be filled in
by the Bnildi.nq Department
Required
Existing Proposed By Zoning
Lot size
Frontage
Setbacks
- side L• R: L: R:
- rear
Building height
Bldg Square footage
%Open Space:
(Lot area minus bldg
&paved parking)
# 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
DME: �&-a3 -�� APPLICANT's SIGNATURE
NOTE: issuanoe of a zoning permit does not relieve an applioa V urden to oomply Witt)-.ali
zoning requirements and obtain all required permits from the Board of Health, Conservation
Commission, Department of Publio Works and other applicable permit granting authorities.
FILE #
Fi1e No.
ZONING PERMIT APPLICATION (§10 . 2)
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant: W Py D VC V L
Address: 15S C-J�,-tL- Sk � h�» Telephone: ��g2'.3 -a
2. Owner of Property: ECc DD-'41
Address: c i i,,- Telephone:
3. Status of Applicant: Owner Contract Purchaser Lessee
Other(explain):
4. Job Location: LI0 J "I �-
Parcel Id: Zoning Map# Parcel# District(s):
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
S. Existing Use of Structure/Property 7 ( � �ph-��
6. Description of Proposed seMork/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)
.► t
40 WESTWOOD TERR BP-2000-0190
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map:Block:35- 138 CITY OF NORTHAMPTON
Lot:-001
Permit: Building
Category:roofing BUILDING PERMIT
Permit# BP-2000-0190
Project# JS-2000-0310
Est.Cost: $3200.00
Fee:$25.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: Wayne Ducharme 118101
Lot Size(sq.ft.): 10454.40 Owner: DOYLE JEFFREY L&SUSAN B
Zoning: SR Applicant: Wayne Ducharme
AT• 40 WESTWOOD TERR
Applicant Address: Phone: Insurance:
15 Gaugh St (413) 527-8940
EASTHAMPTON 01027 ISSUED ON:812311999 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 Signature:
Fee Type: Receipt No: Date Paid: Check No: Amount:
Building 8/23/1999 0:00:00 $25.00
212 Main Street,Phone(413)587-1240,Fax:(413)587-1272
Building Commissioner-Anthony Patillo