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36-179 (2) a 70 'fl v v o• 4 v a N 3 C O cn .� Z m c. C. C': co in Z 70 _ > �• O Z m r � Q ° a A Zoning Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. - � �7'� Alterations NORTHAMPTON, MASS. �( �I? 19 Additions APPLICa ATION FOR PERMIT TO ALTER Repair Garage 1. Location ` -� / �' ' '/ Lot No. 2. Owner's name �� 1`�� Address q5— 3. Builder's name ,Aa2 4 -I/Iyet Ir Address Mass.Construction Supervisor's License No. Q Expiration Date 4. Addition 5. Alteration _ 6. New Porch ff1f(ftA 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 14. Estimated cost:- The undersigned certifies that the above statements are we to the best of his, her knowledge and belief. S awre of responsible a icon, Remarks i GR 3 { { �- VJ "f-„ , s r {k � r 4: A f R'. y t i4j a�► i ' s e e i a °ti R ffffff I " I y � 1 I { f' _ j k i? f i y a AY oil Ow w�, }��- .` ' � ) �� �� __,_ .� _ t __._... . ,_._. �_..__. �--�--__�M. � 6 F t 1 � �+,..+ rs.. 3 � � � f Y r -,...'m 77� � ` y�. 1 ' { �j `oi�c '�` �, � j �•,X 1 t � � � 1 qi t i�F � ` I � \_ -0 � e ! ; �� �� �_.. : � �, � � � a .� � 1 �, t �. � � : . � _ _ �__ t :. ...�,.., � _._ , k � � r �`�e ' ��� ? s � 3 �: ,� a ...,. .,. __,�..A __ ....,: a e.�.._�. 1 yya hh r-ssr..«� 5 l t �� �# Y I,( � ti� Y ff , 1� � ���e� e tr Y � .� ______ I �.__ ___ _ _ . ._ __�__.____._.__,_______ ¢ ,. , _,. _..�. .� a._. ._._1.__.n�. ��..� a .I f �+ i"� �a� Y � ` � �a s �: -..k..,.. j � � "' .. � Mtn` ''*, �twrrTao- o �zlJa � ?1 ( Q Al 1 2 ® 691 :ssncErrtsillr i 3 m DEPARTMENT OP BUILDING INSPECTIONS Z12;x Maiu Street ' Municipal BuRcLing Northampton, Macs. 01060 woRICcR's CONMENSA"zION INSURANCE < < AVrr with a principal place of bu-Smesslresideoce at: (sue Uci t)'/aatrJzi p) do hereby cerij under the puns and penalties o,perjury, tl>> ( ) I am an employer- providlil" Ule followu)g %vol"_cr`s compensation cove agc For my employees wor�aag on this)& (Insurance Cody) (Potic7 Numtxr) (Expiration Date) ( I aIn 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 Contactor) Qmsu.ranc:� Corop-amp/Pouc/Numbcr) (Fxpira600 Datc) (Name of Contactor) (i--ipiraaon Date) (N2me of Contractor) (tnntnncz CorJpamy/Poticf Numbu) (F_cpira000 Dal c) (Name of Contractor) (Lasuranc-- Cornpauy/Poky Numkr) (L;piratioo Date) (att—h-ddiEoml bOCz facet_.pry to �dc nfo mica per t--u�to ll oodr on) (C-K. a sole proprietor and have no one wor.Li ig for me. O I am a home owner perfor i-130 all the VlOrk, myself. NOTE_pte be owra th t wt,iJo Lb�om��eo��v�DC�rs wt� employ pcscr w cio c uez oo a rc{x r work on i dwelling of n.ot mock a-J3 thrco traits in tEica t.bc t�.n:i:xnrUCl rrndv, ,,th-F,t h zptxutc H tbcr uc roc gcocrztn'oc uidcrcd to be cmployrrs undo tbo v+ockcs`x.ccalpcc:nicn let(G L152--�1(5)�:pplinL on try&bo—owner far a liCrQ-oc per a l may cvK c�UC the Itvi rtab-or an cnployec und<rtbs WoriC t Compo l;t a A� I undcntrnd t+u.rt a Dopy of thin cT, c ©..y bo kC d'I 'Off—of I for t1- eovcr>,ae verification and thzt Giltrcc to cccurc co"n under sCui a a5A ormoL 151 un tcssi to t' is panties orcrim ail P—' cs coasL-ting or x-fine orup to S 1-500.00'nNc<imprao®cat orup to a�y¢r and can?p�cs in d-x focm oCa Step W of a Order and find ors 100.00&day a&inzt.me s Sign this ! da of V 19 9 7 FCC dp-t=-eJ—ca y / Pcrm.it Numtxr r�i ,K f �' . / m2 P-4 . Lot 4 Sig)aabam of Li ccmiuu 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 colvm 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: (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 tru a d accurate to the best of my know dgre. _1 DATE; ! � APPLICANT's SIGNATURE 12 NOTE: Issuanoa of a zoning permit does not relieve an applioanre urden to comply w[W.—olt- zoning requiramants and obtain all required permits from the 13oard of Health. Conser nation Commisslon, Department of Publio Works and other applioabla permit granting authorities. FILE # R ' AUG 2 01997 Q d 1 Fi 1 e No. ! ,� ZONING PERMIT APPLICATION (§10 . 2) PLEASE TYPE OR PRINT ALL I fN�FORMATION 1. Name of Applicant: llche-e�p i'7 1'n lJ /- �— G� Address: �/ j ��� /1 Telephone:__ 2. Owner of Property: C (, -� /'/ r /1 Address: Cl j�U�� � �� Telephone: Cf �' 3. Status of Applicant: Owner ontract Purchaser Lessee Other(explain): y 4. Job Location: ®U' / 11-2x Parcel ld: Zoning Map# 'P Parcel# 129 District(s): (TO BE FILLED IN BY THE BUILDING DEPARTMENT) 5. Existing Use of Structure/Property z�/1 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/orr Doocument# 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 # JV�5 AUG LQ?PWANT/CONTACT PERSO : -O 1 .7' r� ADDRESS/PHONE: PROPERTY LOCATION: �� 9� MAP PARCEL: 17 ZONE . THIS SECTION FOR_OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM Vff T.F-D OUT Fee Paid Ryffldin2 Permit Filled nut Fee Paid ryT2 1 THE LLOWING ACTION HAS BEEN TAKEN ON THIS AP ICATIOM 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: Curb Cut from DPW Water Availability Sewer Availability r7 ' Septic Approval-Bd of Health Well Water Potability-Bd Health Permit from Conse on o ssion Signature of Building "r Date NOTE: lasuanoe of a zoning permit does not relieve an appiioant's burden to oomply wRh ail zoning requirements and obtain ail required permits from the Board of Health, Conservation Commisalon, Department of Publio Works and other applionbie permit granting authorities. ,�y.�• co 21 z 0 0 o x Ln a o' o' �. a' n ° 0 b o. 0 E,3 o g o •a.�•� f7 p-y D 0 (b 9 o tD Uri �• � o n b CD ,...3 �� °� CCD - b C ct � cr �, m n =$ w 0 (1 1 vo ~ as ° yo ~ m n r c n cra �s o- in n p q O y• N Wft O (IQ Q O Cal r) 0 N 50 � 000 �' � a at attic n y � 0 ? � (D In CrQ o rl CD to 5 ►d d �. 0 14. 08 go. C•X O O Cc, j s j o b gono o o o o 5 CD o r � ' d o , _ 58 " 0 CD ® N O Fri Ln O• O co �' O c�