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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations
NORTHAMPTON, MASS. lg Additions
APPLICATION FOR PERMIT TO ALTER Repair
Garage
, C�Cp .
1. Location 1�, Lot No.�
2. Owners name Address L
3. Builder's name Address S `
Mass.Construction Supervisor's License No. (a;1-;z Expiration Date
4. Addition
5. Alteration
6. New Porch 1 ► ;s 1
7. Is existing building to be demolished? �� V
8. Repair after the fire
9. Garage ------ No.of cars Size
10. Method of heating AJ
11. Distance to lot lines t 1 i '3o '
12. Type of roof
r
13. Siding house
14. Estimated cost:- ,C,,.�
�a L
The undersign certifies that the above statements are true to the best of his, her
knowledge d 1'
Signature of responsible app,icant
Remarks
0��tiAMp�0 FEB 251,998
s $ Crit� Of Nart4amption L
� � ` �tasaacflttsftta
m DEPARTMENT OF BUIL)FNG INSPECTIONS
212 Main Street ' Municipal Building '
Northampton, Mass. 01060
WORKER'S COMPENM SATION INSSURANCE AFFIDAVIT
o, V �I�,Q�t-�
(li censeelpermi flee)
with a principal place of business/residence at:
P-7 Cr Pootne- (phone#) ecl `3 3 S
(street/city/staf 2:ip)
do hereby certify, under the pains and penalties of pequry, that:
O I am an employer providing the following worker's compensation coverage for my
employees working on this job:
(Insurance Company) (Policy Number) (Expiration Date)
( ) I am a sole proprietor, general contractor or homeowner (circle one) and have hired
the contractors listed below who have the following workers compensation policies:
(Name of Contractor) (Insurance Comparry/Policy Number) (Expiration Date)
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(Name of Contractor) (Insurance Comparry/PoLicy Number) (Expiration Date)
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(amen additional shod ifneccnary to inc}tide infncm,rioa pertaiaing to all ooutn a )
Q 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 while hoa=wm n who employ pasons to do maadcnance,construction or repair work on a dwelling of
not morn thaw throe u-b in which the lwatoowncr raider of m the grounds applexa A thecdo art not ecoaaily coandued to be
emPloyera undcr the w%ket's comp=s4ca Act(GL152,ss 1(5))application by a homeowner fora license of pcm'rt may cvida=the
legal statue of an employee under the Worker's Compensation Act
I understand that a copy of this ctatemcat may be forwarded to the Depnrtmcaa of In u3ftid AjDc-idca&Offioo of 1nnu2nco for the
-v—go verification and that failure to secure coverage under section 25A of MGL 152 can lead to the imposition of criminal peaaltics
oocnisting of a fine of up to S1,500.00 and/or imprisonma#of up to one year and civil pcnaltia is the form of a Stop Work order and a
find of 5100.00 a day against mc.
v Foe dep atwomw use only
Permit Number
io zj?qj,7(7
Iviap# _Lot# --
Signature of Liomsee/Pernut tee
FEB 2 5 11998
McCutcheon Construction
Full Service General Contractors
87 Chestnut Street _ .. — p - •w:wm - , 'y.__ "`._ ' "° .--'°°
Florence,Mx 010
(413)584 3352
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1& 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 NOA
IF YES,describe size,type and location:
11 . ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE DENIED DUE TO
LACK OF INFORMATION.
Thin columm to be fi2led in
by the Building Department
(Required
Existing Proposed By Zoning
Lot size C�
Frontage —7Z,
Setbacks
- side L: Z�2 R:-Lq— L:J R: _
- rear
Building height
Bldg Square footage -
%Open Space:
(Lot area minus bldg t icC
&Paved parking; -1 l
# .,of Parking spaces Lj
# of Loading Docks �T
Fill:
-(volume -& location)
13 . Certification: I hereby certify that the information contained herein
G is true and accurate to the best of my know
DATE: APPLICANT'S SIGNATURE
NOTE: lasuan e 46f n zoning permit does not relieve an a plioant's burden to oompty with oil
zoning requirements and obtain all required permits from the Board of Health. Conservation
Commission. Department of Publio works and other applicable permit granting authorities.
FILE #
t
FEB 2 51,998
g
File No.
ZONING PERMIT APPLICATION (§10 . 2)
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant: "c-,�.'� 'tri£eC I
Address: 'i Tele p hone: ' 33
2. Owner of Property: % 1�c)jv IE?� _
Address:_ a OCI-1 f�t,"� Telephone: 52,LA CA 9 z-
3. Status of Applicant: Owner -Contract Purchaser Lessee
Other(explain):
4. Job Location: �r`,� �' ,(o�` ,,�pCL'
Parcel Id: Zoning Map# o?�-5e Parcel# District (s):
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
S. Existing Use of Structure/Property
6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary):
Der-- —it A 2'�-'Ac
UT11 No
7. Attached tans: Sketch Plan Site Plan Engineered/Survey d PI ns
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 K DON'T KNOW YES
IF YES: enter Book Page and/or Document#
9. Does the site contain a brook, body of water or wetlands? NO3�_ 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 # 963242v
1313
9
FHB 2 51998 v /,, r _
APPLICANT/CONVICT PERSON: Pat� ��/C�Cpl �'l� S ` J
'�ADDRESS/PHONE: F 2�
PROPERTY LOCATION: iy ., K cwt
MAP PARCEL: "179
THIS SECTION FOR-OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FULEM OITT
Fee Paid
-Bnilfjin2 Permit Filled nnt
E Paid
t�
X(a `� Z
Rerrindeling Interior
Addition t
AcressaryStructure
cl
�y
THI �LLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION-
Po' 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
Permit from Conservation mmiss'ion
Signature of Building h or Date
NOTE:issuanoe of a zoning permit does not relieve an applioant's burden to oompty with all
zoning requirements and obtain all required permits from the Board of Health, Conservation
Commission, Department of Public War" 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. 1313 Office of the Building Inspector
Zoning Form No. 963242 Date 3/2/98 Fee$40.00 Check# 3720
Page, 25C Parcel 77 ,Zone URB Section 127 ❑ Yes ® No
BUI]LDINGPERMTI
* Plumbing and Electrical Inspections required
THIS CERTIFIES THAT Paul Mccutcheon before Building Inspections
has permission to replace existing 4' X 6' north entry porch Inspection on Site—Foundations
situated on 300 Bridge Street - Joe Squires Inspection of Plumbing—Rough
provided that the person accepting this permit shall in every respect Inspection of Plumbing—Finish
conform to the terms of the application on file in this office, and to the Gas Inspection
provisions of the Statutes and the Ordinances relating to the Construction, Inspection of Wiring—Rough
Maintenance and Inspection of Buildings in the City of Northampton.
Any violation of any of the terms above noted is an immediate revocation Inspection of Wiring—Finish
of this permit.Expires six months from date of issuance,if not started. Building Inspection—Rough
Note:A certificate of occupancy will be issued by this office upon return Insulation Inspection
of this card signed by the Plumbing,Wiring and Building Inspectors.
Building Inspection—Finish
Smoke Detectors(Fire Department)
Other
THIS CARD MUST BE DISPLAYED IN A CONSPICUOUS PLACE ON PREMISES
Certificate of Occupancy
Building Inspector
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Ciotvof Northampton ,$SQUIRED INSPECTIONS
BU%
DING DEPARTMENT 2 Band Walls is in Plane*
3. Complete Building*
No. 1313 Office of the Building Inspector
Zoning Form No.
963242 Date 3/2193 x$40.00 Beck# 3720
Page, 25C Parcel 77 ,Zone URB Section 127 ❑Yes No
BUI]LDING
*Plumbing and Electrical Inspections required
THIS CERTIFIES THAT Paul McCutcheon beffi a Building Inspections
has pernussion to replace existing 4! X'61 north entry porch Inspection on Site--Foundations
situated on 300 Bridge Street Joe squires Inspection of Plumbing—Rough
provided that the person accepting this`,permit shall in every respect Inspection of Plumtnnng -Fuush
conform to the term 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 Nmthampton„
Any violation of any of the terms above noted is an inu ediate revocation Inspection of Wiring--Finish
ofthis permit.Erin essix monthsfromdateofiovance,ifnotdarted.
Binding Inspection—Rough
Note;A certificate of occupancy will be issued by this office upon return , Insertion Inspection
of this card signed by the Plumbing,Wiring and Building
Building Inspection--finish ri k, `Y ra cP-110
Smoke Detectors(Fire Department)
O
THIS CARD MUST BE IDISPLA I A CONSPICUOUS PLACE ON TT JE PREMISE
Certificate of Occupancy ,�+"'`►
Building Inspector