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36-033 > z v -� '• D L(1 ao 7t7 p' '1 Z -� Fri o a Zoning Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations NORTHAMPTON, MASS. 19 Additions APPLICa ATION FOR PERMIT TO ALTER Repair Garage 1. Location L� 1 ��" p/�` c �2l Lot No. 2. Owners name ! r»�t �G i( 1 Address Lf uldlk/ 3. Builder's name ' OA-, Address 16 �A 1C Ce'z" F Mass.Construction Supervisor's License No. C j I r Expiration Dat e+� „ 1?l T 191) 4. Addition_ / C ''I G A/ A G C<` Gd"A f}e- 5. Alteration 6. New Porch 7. Is existing building to be demolished? X c 0-19A Y'C` 8. Repair after the fire 9. Garage l ( /� r,1 6� No.of cars l Size L/ 10. Method of heating l{G f �— A 11. Distance to lot lines Foe .vt 0 9 I V FT 12. Type of roof 5 19 4 S h i oU & /'e- 13. Siding house Q rk) 14. Estimated cost:- d The undersigned certifies that the above state is are we to the best of his, her know ge ,�rtd bel Signature of res nsible app icant Remarks ' � `2YA ,2 -tt.V(pTO -I a Cr i af Narillanzpfari . _t Q A:sinchnsrtI% } DEPARTMENT OF BUILDING INSPECTIONS 212 Main Street ' Municipal Building Northampton, Mass. 01060 W O M=,R'S C O N T EN S ATIO N INS'URA_N CE 1 , A V-IT t (li�nsr.Jperuv ttc;.) with a principal place of business residence at: ck (su�lc;h,/saic/zi p do hereby c(,-rYci ,, under the pins uld peaalues of perjtuy, L112 O I `m an employer provictin1- the follo%� )g \','orker s cotnoensauou cove: for m� employees working on this job". (Lnsuiance Copy) (PoLicy Number) (Expiration Date) Cam a sole propriet encral coouactor or homeowner (circle one) and have hired the contractors listed below who have the following workers compensation polici(-Is: (Name of Contractor) Comp-�),/Pobcf Number) CExpim6on Datc) (Name of Coonctor) On-s11nnc- CoIIpznyiPo��cy Nulnocr) (E�oiradon Dec) (Name of Coarmcior) (Lnsuranc Compan),fPolicy Numtxr) (jE- pLm6c)o Datc) (i,Iamc of Contractor) (loa=cc CompauylPoticy Numks) (Expiration Datc) (cnit3�Gditioml t+>cct if❑ccarry to o:..�dc iaformrj ca PC,�anr�to.0 ocdr-�.on) ( am a sole proprietor and have no one worEng for me. O I am a home owner performing all the work myself. NOTE,plc be atruc ch"d w♦ j.ACA 4v_n.4Uo cloy perzo-i w do work oo a .<ll nz or not mocc the throb uniu is wtmh the Eccrowo r c dl cn LS-07C iO 3 zpp tttaunt t2>,to u c oct&Cocr2l2y o� -a°d t°F� cmptoym uodcr tho wockce ,ccmpc ca Act(G appttaboo by a hoa owocr far a Gccnx oc permid rosy c C x x IcS l rt3naa of an cup loy c under tho woke,Compoa•.lioa A t" [und=rtx d that a oogy o(thii m r-r s.y bo f,­d«3 d.«1 to tbo DcV°,at of ln.'.i�i cl hcadmt�OLfi oo of[ �<-mow for tib cove-1&,verifictioa aad this Giilurc to recut cover by under soe oa 25A dI -(OL 152 cw ler_d to tl>d imposiEca ormmi3A pea-iltiet coasisting or•Fmc of up to 11,500,60 an'Jor�prno®cat orup to o�yr t a�nvd p altio n the form bra Stop Work Order and a 5tm of 5100.00 x cby LVinA.tnc Sign this day of S`F' T 1997 �� Permit Number Tviallf Lot 4 sigaabxrc 0f Li Pcrmi tics { r 1 Qt G s' ` Ilk x- C` o Aj cy t-H, C C- Ae" U Lot Do(t,4 I'V Pf c 7�,41,11 I rlo qQ 7s Q'I- i 11 Vp, , k `Al 6� C a� I� L-` L' C' r i i i i i rl Ilk t-H, 7—/ov TC Per� S 12,9;vpt ��� ... erC) d co (c C) Aj I �Ll i VA i Ij I _ t I o ICI 17, IT 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 aolma to be filled in by the Building Department Required Existing Proposed By Zoning Lot size v' 5-J Frontage ( o 10-e, Ja-V Setbacks -frnnt ` - side L: �,O R:,-76 L:36 R: /9 - rear Building height Bldg Square footage C) l l o� So %Open Space: (Lot area minas bldg '� //� �(f ' &paved parking) C # _0f _Parking Spaces G rOf Loading Docks Fill: 4voi-11me--& location) 13 . Certification: I hereby certify that the information contained erein is true and accurate to the best of my know dge. D�"E: �,j �_ APPLICANT's SIGNATURE !,/C NOTE: lasuanoe of a zoning permit does not relieve an a lioant's burden to oo PP PAY wit t11,ok11 zoning requirements and obtain all required permits from the Board of Healt Conservation Commisslon. Department of Publio Works and other applioabla permit granting authorities, FILE # s .Mv p 5 File No. ZONING PERMIT APPLICATION (§10 . 2) PLEASE TYPE OR P-)RINT ALL INFORMATION 1. Name of Applicant:_ 0#)U/�— P l 6/�- L 'e. '/%'- Address:, 2 /' e'0,0 C'P S �/�C��/ Telephone:l-P/'� Cl d C? 2. Owner of Property: II"" / Address: Oil /A,'(2 Cl(t'2[ G` )C, Telephone: 3. Status of Applicant: Owner Contract Purchaser Lessee Other(explain):_ C6)'<A XAC110 2.- 4. Job Location: 171C glly e rlf� /1—/ 6W-Lef61 Parcel Id: Zoning Map# 136 Parcel# District(s): G7( (TO BE FILLED IN BY THE BUILDING DEPARTMENT) S. Existing Use of Structure/Property 45�a) (c l//{fit L 6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary): 7. Attached Plans: L/ Sketch Plan r/� 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 KNOVV YES IF YES,date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO_ I 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) FILE # 4 , APLICANT/CONTACT PERSON: A.DDRESS/PHONE: PROPERTY LOCATION: MAP_ PARCEL: ZONE�Z /2 . THIS SECTION FOR-OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE Fee Paid Bnilding Permit Filled niit Fee Pgid 0, 91— Type of Constnirtion- 5��) f SHE FOLLOWING ACTION HAS BEEN TAKEN ON THIS AP ICATION: Approved as presentedfbased 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-Bd of Health Well Water Potability-Bd Health !Permit from Conservatio ommissio❑ Signa e or ate NOTE:lssuanoe a 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 Commisslon, 13,epartment of Publio Works and other applicable permit granting authorltles. � w p= ° z 21 'd y w o 001)) ~off 0 o 0 0 0 x rn cn 0 k ° a, cr Lo ID 0 QA �s c� o � � y oaCD � a gam' (. . o c. o aq w Di 65 D eD PL y CD o p n 21 t ell, o oo o' Q - P 9 x 0 N• r a o cn o Q out o �j o O Z3 z � 5 C� �- � � ::I o p O 0 tz- cy 5 5 o ' o o y . � � o yv° 0 0 0 0, 0 5 0 o a � o y G L 1 O' C Q' 0 ZS 0 j' n �J Q 0 a fj (Tq dq e4 c� b 5 � 5 i o �. o g o S O F O p R A m ❑ N '� n O �..I C O S "� N aq v/ (� O M O vs (Q 0 O cn UQ o' 5 y � CrJ o co ro °z �,. ;� �. ��.` ; _si 4a ��_ n b Bowe Ln Lo `� S. �• o � bd 5' g ed g. n r a a � O rr t N• LQ ✓� pp n y E o Q F,. i..h OrQ oj co 0 CL m z y Q y < rto mss d got. _ goo v Ci. 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