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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No.*-h ` = � Alterations
NORTHAMPTON, MASS. 19 Additions
APPLICATION FOR PERMIT TO ALTER Repair
Garage
1. Location (-4 zl 0-- Lot No.
2. Owner's name a'- "Y VI 0--16 Uj Address
3. Builder's name �Z i �-4 c= Address �f ," f r. � i�'►��
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
13. Siding house c ic' k a--c._. (i(r '- UrC`,,,;r
14. Estimated cost:- ;3, 600
The undersigned certifies that the above statements are we to the best of his, her
knowledge and belief.
ignazure of responsible app icon!
i
Remarks
fi 1 Crxi lafoxlJalitfan .
e
AIJG 1 4 1998Izs,acl,R��llr -
a -
m f3PiRRTMENT OF BUILDWO INSPECTIONS
DEPT Of Rt s tl a.'s kit A PfOR.0 r ^—" Main Strect Municipal. Buildint;
Northampton, Mass. 01060
WORYCER'S COM ENSAUON INSURANCE A F AVUr
(liCMSc /peruUttCC)
with a principal place of busiocss/resideoce ac
�2./ r
o JE/ 0 IAQ 7 (pb0oe ?.9
� �t,•is��p>
do hereoy ccfu-f,, under Lbe p,,-Ins and peaJhes of perjury, tai:
( ) I cm an employer proviL-)g the following %vor-�cr's compensator coverage for My
employees WOr�=g oo this job:
(Ln�ran(X- Compz y) (POUCY Number) piraaon Daft)
O I am a sole proprietor, general contractor or homeowner (circle one) and have hired
the contractors listed below who have the following workees compensation policies:
(Name of Contractor) QnsuraoC-- Coru}pam,/Poky Number) (Exp rm6on Datc)
(Name of Conrctor) 0xLSI C-- CoMPLOy/Pokey Number) (Exp moon Da1c)
(Name of Contractor) (iasura= Compao),/Poky Numbs) (Expim600 Date)
(Name of Contractor) (Laauanc: Coropaay/Poky Numb-.r) (Expira000 Date)
(ctii c3�Cditioml c_�,-C it ncoci..ry to o:..Udc iafcYmi�ca pc',._i�nb w mil near-won)
O I am a sole proprietor and have no one working for me.
( ) I am a-home owner performi_og all the work myself.
NOTE_plcns._be as arc tbri walo boaowncra wbo employ pcsons w So c..Z vctioo'or rcpaa work on i ell nZ or
not mecc tb-.0 Ibroo traits in which the xrvocr r--ed a m Lh-U"ncis:pp_c�tbcdo uc roe gcn a-I y non.-iducd to be
employ—t dcr tbn vrockcr z. nicn/,ct(G 1.152-s 1(5)}, by i bomcowDcr for a l ctIIx cc pcs'mis may cvidcrx tLc
legal rwu* of nn e—ploy.<uodor ibo W.odr 1,Coo�a A,(-
I uadcntrnd tort a oopy oIL4do rat<>vcai c y bo focwarded to ibo Dcp�allnduilirJ�cod<ofl OtSoo oltusucz.ow for ts.
covcrxgc Yaific doa and tb�t[inure to scauc oovcrnbo tiuydct sxtioa 23A o[MaL 152 can Id to tba imposition of aimin,l P—Incs "
00=-,Tz of&:13:0C bf up to S 1,5oo.00 md/cc improocmcnl orup to o�_ycr umd ayd pcarhio in db form of a Stop Work Or,r-and i
S340f5100.00 idly agxiust.mc-
' Signed this day of 1997 Fordx��l�onty
Permit rlumbcr
Lot ft
. Sigia�of I:iccvsccyPcrm_iticc
10. Do any signs ebst 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 cclu= to be filled in
by the Banding Diapartmeat
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
&pared 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.
DATE: APPLICANT's SIGNATURE (X'=
NOTE: lasuanoo of a zoning permit does not relieve an appllo nt's bu en to oomply witl)-"pll
zoning requirements and obtain all required permits from the Board of Health, Conservation
Commission, Department of Publio Works and other applionbla permit granting authorities.
FILE #
Li
4 l�9� � __ c`, 1
A►16 ► 1
File N 1
PERMIT APPLICATION (§10 . 2)
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant:
Address: ,� t Telephone: K/
n
2. Owner of Property: _ --ciri ;a..' <�c'E Vn 4-111- y L-L*-ti.-C,
Address: 6-1'` -- Telephone:
3. Status of Applicant: Owner i-contract Purchaser Lessee
Other(explain):
4. Job Location: �� -r n
Parcel Id: Zoning Map# Parcel# District(s):
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/Property
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/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)
Department: Reference No: BP-1999-0189
...................................
Building, Electrical & Mechanical Permits
Fee Receipt No:
Vinyl siding REC-1999-000382
Paid.6y: Paid in Full 0 n
Larry Paquette Fri Aug 14,1998
...... ...... .... .. . ...... ......
Received By Check No:
Linda Lapointe 21.33
......................................................................................... .................•..........•.........
DEPARTMENT'S COPY Amount: $20.00
................. .........
DEPARTMENT FILE COPY 18 COOLIDGE AVE
CITY OF NORTHAMPTON
BUILDING PERMIT
Owner's pulling their own permits or dealing with unregistered contractors for applicable work do
not have access to Guaranty Fund(MGL 142A)
Issued: Permit No: Inspector: Tracking No.: Fee:
14 Aug, 1998 BP-1999-0189 $20.00
GIS #: Map Block: Lot: Address: Zoning: Use Group: Lot Size:
4311 25A 094 001 18 COOLIDGE AVE URB 8407.08
Contractor: License Type: Insurance:
Larry Paquette HIC
Address: License No.: Insurance No.:
40 East Green Street 100679
LitE State: Zip Code: Phone:
EASTHAMPTON MA 01027 (413) 527-6375
Proiect No: Category of Work: Const. Class: Cost Estimate:
JS-1999-0181 $3,000.00
Description of Work:
SIDE REAR OF HOUSE
GeoTIVISO 1997 Des Lauders&Associates,Inc. Signature: