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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No.�`'1 _ 0 Alterations
NORTHAMPTON, MASS. `` 19� Additions
APPLICa ATION FOR PERMIT TO ALTER Repair
Garage
1. Location I//i f/ Lot No.
2. Owner's name S �°" ° '"L-t �` Address l -p � �
•�Vt
3. Builder's name A .r�- c .� Address tfdi_ + QVGe �a �/t�� ✓u'� C�v�
Mass.Construction Supervisor's License No._/�-� b Expiration Date a .-
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 v'-✓t el� i e;i_ !ZtrL —y�ctP e► -�Q?Vie.
13. Siding house
14. Estimated cost:-
The undersigned certifies that the above statements are we to the best of his, her
knowledge and belief.
Sig azure of responsible app icani
Remarks
Ciz. �� ���il ant fri�T
c SEP l
8 �laS5 AC11R5C(16
DEPAAT?dENT OF bUILDITjC INSPL'CTIONS
212 Main Street Municipal Building
Nrorthalnpton, Mass. 01060
'WOR E, R'S COMI'ENI SATZON l-NSUIZANCh. ATh_IDAV FY
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COi1CId�uOi')--- TI'.� '.CC COI:1'�1i: '�l Oi1C, �':LLihr.�I', "— 1h0i? Date)
1ne of COI1Ii3GcOr) (Zrsu.._nc C.orn��ar.,iPoilc, til��nt-�r! (E .Vliat on Da.e
a2 amt of Conmactor) Date)
(Nallic Of COIlCIaCt01� — jf,SInmcC2 CoInDany/Pollcr Nlur? --;) D2!C)
{°RU?1:.dui�cril z_:cd ifnax�ziry:c i:r_!iuyc�,__.n�:c:i;t�}°;ai:ii:s to rill cc�i::��on)
O 1 am a Sole proprietor atld have no one ;vor�ima for nle-
O .[ am a borne ovrt_ler performing a1_I t-he work myself.
NOTE:pleas:be aware th-la"+.rile hcmcoµu_ts ab c�!oy to do w rcpas vote on a d«cllirg of
cwt mcto th=n th co units m wfiiclt or ou the appurtcn.iri the ct a C no(gcr,—Uy OJC.IllcfLd to be
cmp!oycs under the work s:oompcnsatioa Act(GLI52 ss 1(5)�Apg ication by a homwu c fcr a lic i:D-oc P-Inii mcy cvidcacc L-'c
legal autLu of an—Ployor under tho Wori(c t Com .tiou Act
I un&rv-ad that a copy of thu r2itcmcn2 miy bo fora-nrd.od to tho Dopartn—t Ofljoo of Insucwco for the
coverage vc i&catioa and that failurr to acc=covccmEo trader stc ion 25A of?AGL 152 can lrsd to tbo'in`xzsifiou of criminal Penalties
coaust mg of a Prne ofup to S1,500.00 extd/or impriso�ofup to ow year And civil pcniltio in the form of m Stop Work Order and a
fine
of S 100.00 a day against t
For d puti> a1 ut+o colt'
J y Permit Number
Map# Lot#
Signatirr�of I,iccnscclPcrmi
MUF
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 colm n to ba filled in
by the Banding Department
Required
Existing Proposed By Zoning
Lot size
Frontage
Setbacks - frnnt
- side L: R: L: R:
- rear
Building height
Bldg Square footage
%Open Space:
Lotarea minus bldg
' &paved parking)
�f. Parking Spaces
f fof Loading Docks
Fill:
-=(volume--& location)
13 . Certification: I hereby certify that the information contained herein
r,4 . is true and accurate to the best of my knowledge.
DATE: APPLICANT's SIGNATURE
NOTE: I�ssuanoe of a zoning permit does not relieve an applfdanru b den to oompty with all
zoning requlrementn and obtain all required permits from the Boar of Health, Conservatlon
Commission, Department of Pubno works and other appiloable permit granting authorities.
FILE
SEP I 1 i9 '8
File No. �
........ ..: ... . .
ZONING PERMIT APPLICATION (§10 . 2)
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant: 1,�' A Y
Address: Telephone:_ ,7Z
2. Owner of Property: /a-� S /`— �sz--
Address: /.� Telephone:_
3. Status of Applicant: Owner _Contract Purchaser Lessee
Other(explain):
4. Job Location:
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):
--�
Lj
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-1999-0296
......................•............
Building,Electrical & Mechanical Permits
Fee Receipt No:
Roofing REC-1999-000720
'P�W6�:.......................................................................... ...........-•---••aid i n FuI'l...0...n':...*.......
Larry Paquette Fri Sep 11,1998
........... ..•. .. . ...I.. ......
iReceived..By.: .C.h.e c.k.No:...................
Linda Lapointe 21.59
......................................................................................... .........................•.•..••......
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:
11 Sep, 1998 BP-1999-0296 $20.00
GIS#: Man 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
Liy-i State: Zip Code: Phone:
EASTHAMPTON MA 01027 (413) 527-6375
Proiect No: Category of Work: Const. Class: Cost Estimate:
JS-1999-0181 roofing $5,600.00
Description of Work:
STRIP & SHINGLE ROOF INCL PORCHES
GeoTMSOD 1997 Des Lauriers&Associates,Inc. Signature: