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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. q7 7702- Alterations
NORTHAMPTON, MASS.- 19-X7 Additions
APPLICATION FOR PERMIT TO ALTER Repair
a
Garage _
1. Location 'R3 QUel�n� / (�Pil�>� Lot No.
2. Owner's name &-9 ��l��Qo�f n Address
3. Builder's name O'PP &A(-01 /� �- 5� � Address_—._ "� s?� U✓ _
M No:._.,, �� � Expiration Date da �
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 ��oalel
13. Siding house
14. Estimated cost:-
The undersigned certifies that the above statcmcnts are we to the best of
knowledge and beli f.
Signature of responsible app.icanf
Remarks
O O
� t' : � - �lassachusctte
F ,II IPJ 2
DEPARTMENT OF BUILDITjG INSPECTIONS
INSPECTOR X12 Tvlain Street • Municipal Building
Northampton,MA 01060
Applicant Information l
Name--!°p� ;,„70�------------------ —
Location ------------
city— CT'�'rc ---�t71--------------
1 am a homeowner performing all work myself
I am a sole proprietor and have no one working in any capacity
❑ I am an employer providing workers' compensation for my employees working on this job.
Company Name---------------------------
Address --------------- -------------
C i t y---- Phone #
Insurance Co._------------_—Policy#------ --_
Company Name
Address
City Phone#
Insurance Co. Policy#
Failure to secure coverage as required under Section 25 A of MGL 152 can lead to the imposition of criminal
penalties of a fine up to$1500.00andfor one years'imprisonment as well as civil penalties in the form of a STOP
WORK ORDER and a fine of$100.00 a day against me. I understand that a copy of this statement may be
forwarded to the Office of Investigations of the DIAfor coverage verification.
I do hereby certify u er t pairs and penalt of perjury that the information prroovid a ve is true and correct.
Signature Date D X7
Print Name 0 Q3c J/o� Phone# �� 7,a5?
Official Use Only Do not write in this area to be completed by city or town official
City or Town Permit/License# ❑ BuMungDept
E]Lrensuig Bond
Check if immediate response is required
❑Selectn='Dept.
Contact Person Phone#
❑ Health Dept.
r
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 v
IF YES,describe size,type and location:
11 . ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE DENIED DUE TO
LACK OF INFORMATION.
This columm to be fi2led in
by the Building Aepartment
I Required I
Existing Proposed By Zoning
I Lot size
Frontage
Setbacks - frnnt
- side L: R: L: R:
- rear
Building height
Bldg Square footage
%Open Space:
(Lot area minus bldg
&paved parking!
# c)f Parking spaces
# 'of Loading Docks
Fill:
-(volume--& location)
13 . Certification: I hereby certify that the information contained herein
�r is true nd accurate to the best of my knowledge.
DATE: a APPLICANT's SIGNATURE
NOTE: Issuanoe of as zoning permit does not relieve an app ioanYs burden to comply pty with alt
g requirements and obtain all required permits from the Board of Health. Conservation
Commission. Department of Publio Works and other applioabie permit granting authorities.
FILE #
T
vY
11 IN 2 1999
File No. f 7
w 90kING PERMIT APPLICATION (§10 . 2)
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant: fo &419
Address: jf 5"24- _57— Telephone:
2. Owner of Property: Ad V-04&1
Address: 0R3 OU'e iiokl F2�or6lic-t_'_ Telephone: Vl:�P
3. Status of Applicant: Owner Contractt Purchaser Lessee
✓ Other(explain):
4. Job Location: 033 oyPrlcb1(
Parcel Id: Zoning Map# } Parcel#
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/Property ��,,�� )O
6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary):
� 8-W- ove/ ore- &. eZ
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 PermitA/ariance/Finding ever been issued for/on the site?
NO ON'T KNO t 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 Conserva ommission?
Needs to be obtained Obtained ,date issued:
(FORM CONTINUES ON OTHER SIDE)
23 OVERLOOK DR BP-1999-1037
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map:Block:36-121 CITY OF NORTHAMPTON
Lot:-001
Permit: Building
Category:roofing BUILDING PERMIT
Permit# BP-1999-1037 Y
Project# JS-1999-1753
Est.Cost: $2700.00
Fee:$20.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: TODD BOYNTON 126807
Lot Size(sq ft.): 24742.08 Owner: VADNAIS ROBERT L&WANDA L
Zoning:URA Applicant: TODD BOYNTON
AL. 23 OVERLOOK DR
Applicant Address: Phone: Insurance:
83 SILVER ST (413) 772-8829
GREENFIELD 01301 ISSUED ON.61411999 0:00:00
TO PERFORM THE FOLLOWING WORK.-SHINGLE ROOF OVER EXISTING L LAYER
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 6/4/1999 0:00:00 $20.00
212 Main Street,Phone(413)587-1240,Fax:(413)587-1272
Building Commissioner-Anthony Patillo