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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No.`/12-13k'L ySyy y Alterations
a NORTHAMPTON, MASS. 3- 19�1L Additions
Repair
APPLICATION FOR PERMIT TO ALTER
R
Garage
1. Location 2 Lot No.
of
2. Owner's name V Address—S-
3. Builder's name Address
Mass.Construction Supervisor's License No. O h'r' c 7 9 Exp n 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
13. Siding house
14. Estimated cost R go, C¢D
The undersigned certifies that the above statements are true to the best of I
knowledge and belief.
n of responsible app icant
Remarks
4tlt/WP�.
O O
� �a3ENCll tTS[tl5
2 A DEPARTMENT OF BUILDING INSPECTIONS
L 212 Main Street ' Municipal Building '
a Northampton, Mass. 01060 '
�'�PT Of St! , ��'�iG iNSPECTlOd'"
COMPENSATION INSURANCE AF t AVIT
(licensecJpermittee}
with a principal place of business/residence ax:
ZJ
f (phone#) .7 �!
(stre;'tucity/ zip)
do hereby certify, under the pains and penalties f perjury, dial:
( ) I am an employer providing the following workerjs compensation coverage for my
employees working on this job:
(Lnsurance Company) (Policy Number) (Expiration Dace)
( ) 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) (Lasurancc Compalry/Policy Number) (Fxpimtion Date)
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(Name of Contractor) (In_nlrance Compauy/Policy Number) (Expirntion Dale)
(Name of Contractor) (Insurance Compauy/Policy Number) (Expiration Date)
(atlach additiooal lhec i if noceuiry to iochsde information pataiuing to all oce't' d rs)
I am a sole proprietor and have no one worming for me.
I am a home owner performing all the work myself.
NOTE:please be aw2rc tlut whtro homcownm wbo cu ploy personr to do mAiau=a mns Auction or rcpair worst on a dwclling of
not morn than Limo units is which the hamoowocr raids oc oa tb e groins appurtta th=w arc oot& xna-z y oDwidcrcd to be
employers ttndef the worktt .ccmpcataiioa Ad(GL152-"1(5)},application by a homcowDrr for a Uccase or P—:d may evidcaoe the
ItS11 etairu of an omployor under tho Woticoda Compensation Aei
I undcrstand that z copy of this ctatcmcsst may bo forwarded to tho Dcpartarod of Industrial Acri&Q&Offioo of Iuwnnoo for the
coverage verificalioo and that failtu c to scarce covcrago undcr scctioa 25A of MGL 152 can Iced to tho'imposition of criminal penaltics
oomisiiag of a-fine of up to S 1.500.00 andlor of tip to one ytar and civt7 penalti a in the form of a Sbp Work Or&x and a
find o(5100.00 a day against tvc
t For dcputaxtal trio only
Permit Number
Map# Lot#
ignahuG '
� 4
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.
This columm to be filled in
by the Building Department
Required
Existing Proposed By Zoning
I Lot size
Frontage
Setbacks
- side L: R: L: R:
- rear --
Building height
Bldg Square footage
%Open Space:
(Lot area minus bldg
&pax•ed parking;
# of Parking Spaces
# '6f Loading Docks
Fill:
-(volume-& location)
13 . Certification: I hereby certify that the information contained herein
G is true and accurate to the best of my knowledge.
DATE: 3` vZ - 4j'C APPLICANT's SIGNATURE--l`
NOTE: Issuanoe of at`zoning permit does not relieve mi applioa r to mp with ,a�U
zoning requirements and obtain ail required permits from the Board alth. Conservation
Commission. Department of Publio works and other applicable permit granting authorities.
FILE #
[T I4t f
I MAR22W9 I
File
`TPT OF BUS "C'INSPECTI`
- ZONING PERMIT APPLICATION (§10 . 2)
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant:
i
Address: KJ Telephone:L// 3''C:5�9,0"'
2. Owner of Prop
Address: 6�A4
, C -+ Telephone:
3. Status of Applicant: Owner> _Contract Purchaser Lessee
_Other(explain):
4. Job Location:
_n �
Parcel Id: Zoning Map# 04 /7 Parcel#� District(s):
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/Property —'I �^ �
6. De DtLon of P posed Use/Wof roject/Occup 4on: (Use additional heets if ecessary):
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.
S. 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_,K_ 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)
4 �
File#BP-1999-0777
APPLICANT/CONTACT PERSON Tom Boyle
ADDRESS/PHONE 43 Damon Pond Road (413)296-4544
PROPERTY LOCATION 59 COOLIDGE AVE
MAP 25A PARCEL 075 ZONE URB
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out
Fee Paid o� ;677Z777---
Ty_peof Construction: REPLACE BROKEN STEPS ON PORCH
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/Statement or License 040979
3 sets of Plans/Plot Plan
THE &LOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION:
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
Approval Board of Health Well Water Potability Board of Health
Permit from Conservation Commission
h
Signature of Building Of ' Date
Note:Issuance of a Zoning permit does not relieve a applicant's burden to comply with all zoning
requirements and obtain all required permits from Board of Health,Conservation Commission,Department
of public works and other applicable permit granting authorities.
IL
59 COOLIDGE AVE BP-1999-0777
GIs#: COMMONWEALTH OF MASSACHUSETTS
Map-Block:25A-075 CITY OF NORTHAMPTON
Lot:-001
Permit: Building
Category:Non structural interior renovations BUILDING PERMIT
Permit# BP-1999-0777
Project# JS-1999-1272
Est.Cost: $350.00
Fee: $20.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: Tom Boyle 040979
Lot Size(sa.ft.): 5314.32 Owner: BRESNITZ VIVIAN
Zoning_URB App
licant: T B I
AT: 59 COOL IDGE AVE
Applicant Address: Phone: Insurance:
43 Damon Pond Road (413) 296-4544
CHESTERFIELD 01012 ISSUED ON.3/23/I999 om:oo
TO PERFORM THE FOLLOWING WORK.-REPLACE BROKEN STEPS ON PORCH
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 3/23/1999 0:00:00 $20.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Building Commissioner-Anthony Patillo