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25C-078 (3) < n � � m 3 ' Z C: co _ in z _a A Zoning Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. S�C-"f` Alterations NORTHAMPTON, MASS. iq Additions � APPLICAa TION FOR PERMIT TO ALTER Repair V Garage 1. Location =1111`_--�, c,v Lot No. 2. Owner's name S �,-v `�� ti1 ,^�r'� Address 3. Builder's name 3 Address Mass.Construction Supervisor's License No- 4. Expiration Date C�c 4. Addition 5. Alteration P,�_ tl_� ��7C�T�Sc�t, \ �ct� ( 1�y 6. New Porch 7. Is existing building to be demolished? t1"� 8. Repair after the fire w—, 9. Garage V1 p No.of cars Size 10. Method of heating 11. Distance to lot lines 12. Type of roof `�`�� e_ 13. Siding house z 14. Estimated cost:- The undersigned certifies that the above statements are we to the best of his, her knowledge and belief. Signature of responsible app,icant Remarks _ _ 4 r �1`Cl NNW g�ttAMP� O O 1 11991 Ctlit r of 'Nort4a tptnn $ 6 �lassacflnsetfa m DEPARTMENT OF BUILDING INSPECTIONS 212 Main Street ' Municipal Building Northampton, Mass. 01060 WORKER'S COMPENSATION INSURANCE AFFIDAVIT L Scott Harlow DBA Harlow Builders (licensee/petmittee) with a principal place of business/residence at: 350 Coles Meadow Road Northampton Ma (phone#) 586-0465 (streeUcity/stately p) do hereby certify, under the pains and penalties of penury, that: ( ) I am an employer providing the following worker's compensation coverage for my employees working on this job: Eastern Casualty Ins WCP0029365 8/24/97 ansuiance Company) (Policy Number) (Expiration Daze) ( ) 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) (insurance Company/Policy Number) (Expiration Date) (Name of Contractor) (Insurance Compaay/Policy Number) (Expiration Date) (Name of Contractor) (Insurance Company/PoLicy Number) (Expiration Date) (Name of Contractor) (Insurance Company/Policy Number) (Expiration Date) (attach additioml sheet ifneo=uy to include information pertaining to alt caatr=ton) O I am a sole proprietor and have no one working for me. ( ) I am a home owner performing all the work myself. NOTE:please be aware that whilo homeowacra who employ persons to do m&,1enmee caaouction or repair work on a dwelling of not mote tban three units is which the homeowner residrs or oa the grooads appurtenant thereto arc not generally considered to be employers under the woricees oompemsation Ad(GL152.p 1(5)),application by a homeowner for a 6=3e of permit may evidence tho legal statue of an employer under the Workers Compematio ,Ad. I understand that a copy of this statement may be forwarded to the Departmoo2 of Industrial Ac6Ac rts'Office of Iasruancc for the oovera verification and that failure to aeaire coverago under section 25A of MGL 152 can lead to tba imposition of criminal penalties oomisting of a fine of up to SU00.00 andfor imprison of up to one year and civil penalties is the form of a Stop Work Order and a fma of 3100.00 a day against me. Signed this day of 1995 i:ordepatm=tdUsconly Permit Number Mal# Lot# Signature of Liccnsee/Permittee I 127 - 27 ' 36 641 j W1830 B18R W1 830L V 270612 W1 830R J R ,_ II 6) 3 _1 B18L SB27 ;% , R18R 36 r W3015 O 104 W2130 BD21 7/31/97 I 4 GLENWOOD 2ND FLOOR 33 L REFF l MERILLAT CABINETRY G DOORSTYLE: SHETLAND ARCH MAPLE W/ NATURAL �— Dwg no. glenwod4 Scale : 1/2 " = 1' Design : 07/19/97 All dimensions &size designations This is an original design and must Date 07/31/97 given are subject to verification on not be released or copied unless scott harlow job site and adjustment to fit job applicable fee has been paid or job --- copditions. order placed. Designer Glenwood 2nd 'Icon' Kitdh n outlet on porch R 2F_ 11 2/"6x6/4 5 -911 I 2nd Floor Bath New Floor Tub surround kit °_� f2111 New ceiling + Moulding New ceiling Ceiling Fan vented Mirror + strip lighting + �l New cabinets kitchen 28F142FF 8'-8 1/241 New counter-tops 31-311 I Electric � F a If 41 F8 Plumbing -- ---- � i Neat 28 1ix 41 3/4" IAN Replacement windows 1 j 4 ° o �s V, r, f Lsx �� Ls 4 Glenwood Ave 'Ist. Floor ,t ° _ r F ^I VIII` . TO I r i . � . ST 1 1 I -.�..,� ...... i i m cJ 3 t .. .v: a . , New i f s ' ! 3c: t S "a E t rt' 4( a ,rf-i i tl k 2 .. _18 Patch wks, K t"` 'e° Fix J4 4,..a f.:3 a P i r S .t1 old` R Lf 3 S.. tf la.I "4 ...v/ ,74 Vl~,. VMS XT rY -- - 102 - -- - -- F 0 W3015 W3630 WC2430L -- - -------- j BT�gL DISH. 24" - BC36R TL W12 30 B27114 BD18 R 1830 0 3 REFR W3315 I — -- _ Dwg no. [glenwodrl Scale:l/2"=1' Design: 07/19/97 All dimensions&size designations This is an original design and must Date : 07/30/97 given are subject to verification on not be released or copied unless coff halow ---�----- __ job site and adjustment to fit job applicable fee has been paid or job Designer --- conditions. order placed. --- -- 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 colw= to be filled in by the Building Department l 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 e_ &paved par king) c?=v J� # of -Parking spaces fl # '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. j DATE: fi ,� APPLICANT's SIGNATURE ' /: " NOTE: Isau'anoe of a zoning permit does not relieve an a` lioanta burden to oom PP Ply.with,,+pll zoning requirements and obtain all required permits from the Board of Health, Con$ervtation Commission, Department of Publio Works and other applloable permit granting authorltlea. FILE # ti �5 Fi 1 e No. .� ZONING PERMIT APPLICATION (§10 . 2) PLEASE TYPE OR PRINT ALL INFORMATION 1. Name of Applicant: :,:__ � ,��1 ' �� - c y Address: Telephone: 2. Owner of Property: Address: L4 Telephone: 3. Status of Applicant: Owner N Contract Purchaser Lessee Other(explain): 4. Job Location: '7 � ;!7i Parcel Id: Zoning Map# dQ52:2� Parcel#74-- District(s):,./)-A0— (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/PermitA/adance/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 `N 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) FILE J F1 1 199 1 APPLICANT/CONTACT PERSON: ADDRESS/PHONE: < U ' PROPERTY LOCATION: - ' 2Zc," o� PARCEL: ZONE �-- MAP THIS SECTION FOR-OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM MLED OUT Fee Paid Ruilding Permit Filled mit New Cnnstrnrtinn Addition to Existing C — a 1 -t �; -- THEY61,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 Septic Approval-Bd of Health Well Water Potability-Bd Health Pe fro ons a ' C _ on q ellx / Signature of Building for Date NOTE:Issuanoe of at zoning permit does not relieve an applicant's burden to oompty with all zoning requirements and obtain all required permits from the Board of Health. Conservation Commisslon, Department of Pubiio Works and other applicable permit granting authoritles. City of Northampton REQUIRED INSPECTIONS 1. Footings and Walls BUILDING DEPARTMENT 2. Structural Components in Place* 3. Complete Building* No. 767 Office of the Building Inspector Zoning Form No. 962654 Date 8/14/97 Fee$40.00 Check# 2073 Page, 25C Parcel 78 ,Zone URB Section 127 ❑ Yes 0 No BUI]LDINGPERMIT * Plumbing and Electrical Inspections required THIS CERTIFIES THAT Scott Harlow before Building Inspections has permission to remodel 1st & 2nd fl kitchens & 1st fl bath Inspection on Site—Foundations situated on 4 Glenwood Avenue - Steve Robinson Inspection of Plumbing—Rough provided that the person accepting this pen-nit shall in every respect Inspection of Plumbing—Finish conform to the terms of the application on file in this office, and to the Gas Inspection provisions of the Statutes and the Ordinances relating to the Construction, Inspection of Wiring—Rough Maintenance and Inspection of Buildings in the City of Northampton. Any violation of any of the terms above noted is an immediate revocation Inspection of Wiring—Finish of this pen-nit.Expires six months from date of issuance,if not started. Building Inspection—Rough Note:A certificate of occupancy will be issued by this office upon return Insulation Inspection of this card signed by the Plumbing,Wiring and Building Inspectors. Building Inspection—Finish Smoke Detectors(Fire Department) Other THIS CARD MUST BE DISPLAYED IN A CONSPICUOUS PLACE ON T�T PRE ISES Certificate of Occupancy _ �" Building Inspector