25C-097 Y > 2
"V ,� o
� 'L7
A
v v o• �
00 3 m
f z
° v
Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations
NORTHAMPTON, MASS. `7 l� 19 Additions
Repair
APPLICATION FOR PERMIT TO ALTER
Garage
1. Location 3 ' `Q 5-7— Lot No.
2. Owner's name CU C— Address / 3 — /c s
3. Builder's name T Address lam ��c�� F T ��s'7t�cx�-�+mf
Mass.Construction Supervisor's License No.�,.�z L 4/ Expiration Date -7"
4. 7
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 Sj!;�'42 11C
13. Siding house
14. Estimated cost:-
The undersigned certifies that the above state en are we to the best of his, her
knowledge and bell
Signature ojresponsible app,icant
Remarks
�tA}f p�.
Q �cssncfansitlf -
DEPARTMENT OP BUILDDIC INSPECTIONS
212 Main Strect ' Municipal Building
Northampton, Mass. 01060
W0M== R'S CoiyeENSA`I'ION MSURA-NCB x AVIT
r C cy �ato
(l c J�rullttc
,:nth a principal place of busincss/residence at:
(p h o o e",)
(srrcc--:j-Unt�•/ irJzip)
do hereby cer-d-f,, u-oder Lbc pzms aiid pc,-12l6es of penury, L11?i
( ) I am an employer provicing the follo%�* )g �,,�or`_&S cotnpensaLOn cover2oe for My
employees woriing o❑ this job.
(InRtranC,-- CO MP211y) (Policy Number) (Expiratio❑Date)
( ) I am a sole proprietor, ge-opral contractor or homeowner (circle one) and have hired
the contractors listed below who have the following worker's compensation policies:
(Name of Concmcwr) Corup--G),fPolicf Numtxr) (Expim6o❑Datc)
(Name of Conractor) (lnsur�cr Co mpznyfFoGc�Nt mgr) (E�p n�oo Datc)
(Name of Contractor) (Insurance CompaD)'/Policf Nuu t r) (Expiration Datc)
01,lame of Contractor) (Insttrancz Cocupasry/Pohq Numt--r) (E)cpl 2 6 o D D,,L0
(cn�c3>1,rliticml choci Y—c--y to p--...iag to to mc:r-won)
( I am a sole proprietor and have no one worEng for me.
( ) I am a home owner perfor-ruing all the work myself.
NOTE pta be aware thst wbhJo 6ccxm4-_n�tw employ pcz to Sa • t -, pct oo r c;xur work oo •c link of
not mat th-n t.brt Units in w1mch the hero w r L do n co tb.:acucx! zpruttccuat lk cio ut oct gcac.-ally oom ie o be
cmptoyrn unc'.cr rho wo<kct`z.copes.Act(G L152,rs 1(5)�apptluDon by I 6cmca vn t far a L crux cc pad m.,Y c f 5c
1cga.!riv'ara oCna c�ployoC undo tho Woriccl�Condom-1wa A� .
I undc ztxnd thsi a ooyy oI lhi. t cuy b f«vwrd<d In bo D 4°ax°t°t i i, �l/c4dmtf 0L6oa cc IzL-v<=nc nor t 4
covcczsc vc:cificstioo and that L+.Urc to cccurc combo uadcr section 25A of h1oL 152 can lcul to tloy impasitiw olmcv�il pen-i![ics
ooaiisiing oC x�fine bCtzQ to S1,5o0.Oo xnsor i[ uocmc::•t Ocup to o�.yc-.t and avd p�.shio in the form or.Stop Work Onicr and i
find oCsIoo.00•day tgsimt.mc-
' Signcd 11tp day f 1997
Perumit Number
Mai/ Lot i!
Sigaabxm of)✓iccnscclPctmiucc
x .
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 coluw= to be filled in
by the Building Department
I Required
Existing Proposed By Zoning
Lot size
Frontage
Setbacks -frnnt
- side L: R: L: R:
- rear
Building height
Bldg Square footage
%Open Space:
(Lot area minus bldg
&paged parking]
# of Parking Spaces
f (of Loading Docks
Fill:
_(vol-ume--& location)
13 . Certification: I hereby certify that the info ation contai e herein
is true and accurate to the best of my know ed
.1
DATE: 7 APPLICANT's SIGNATURE
NOTE: Issua e f a zoning permit does not relieve an appiioant'a burden to oomply wlt4 all
zoning requirements and obtain all required permits from the Board of Health. Conservation
Commission, Department of Publio Works and other appiloable permit granting authorities.
FILE # .
A
i
File No.
ZONING PERMIT APPLICATION (§10 . 2)
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant: ��^�A45�rze-e'fl c j
Address: 5E 5 /,-T &,i7 Telephone: Cad 5" 2 Z 7
2. Owner of Propery: -re", Cc, -e Y
Address: `q` � 4' Telephone: rR'q-9 17�O
3. Status of Applicant: Owner Contract Purchaser Lessee
Other(explain):
4. Job Location:
Parcel Id: Zoning Map#-sue✓r� Parcel# District(s):
(TO BE FILLED IN BY THE BUIL ING DEPARTMENT)/
5. Existing Use of Structure/Property_ 6 y ( 1
6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary):
S /' 11 L/r),J
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)
9'{ FILE # s i�
§WPLA� T/CONTACT PERSON:
ADDRESS/PHONE: � a�7
PROPERTY LOCATION: ,5— ` 1
MAP �J� PARCEL: ZONE
THIS SECTION FOR_OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FULED OITT
Fee Pnid
jBijildin2 Permit Filled ntit
Fee Paid 1793
0 -
ArressaryStruchire
THE LLOWING ACTION HAS BEEN TAKEN ON THIS AP ICATION:
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 Cq from DPW Water Availability Sewer Availability
—Septic A pp royal-Bd of Health >*lell Water Potability-Bd Health
!Permit from Conservatio mmissi4o
9�/z 2
Signature of Building for Date
NOTE: Issuanoe of as zoning permit does not relieve an applioant'a burden to oompty with all
zoning requirements and obtain all required permits from the Board of Health, Conservation
Commission, Department of Publio Works and other applioable permit granting authorttles.
F�°��'�. City of Northampton REQUIRED
INSPECTIONS
BUILDING P 1. Footings and Walls
DEPARTMENT 2. structural Components in Place*
3. Complete Building*
No. 894 Office of the Building Inspector
Zoning Form No. 962794 Date 9/23/97 Fee $20.00 Check# 1793
Page, 25C parcel 97 ,Zone URB Section 127 ❑ Yes ❑ No
BUI]LDINGPERMIT
* Plumbing and Electrical Inspections required
THIS CERTIFIES THAT western Mass Siding & Roofing before Building Inspections
has permission to strip,install 1/2" ply & shingle roof Inspection on Site—Foundations
situated on 193-195 Northst - Tom McCurry Inspection of Plumbing—Rough
provided that the person accepting this pemlit 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,
Maintenance and Inspection of Buildings in the City of Northampton. Inspection of Wiring—Rough
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.
** Install per Manufacturer's information: windows,vinyl siding,roofs Building Inspection—Finish
and woodstoves Smoke Detectors(Fine Department)
Other
THIS CARD MUST BE DISPLAYED IN A CONSPICUOUS PLAg. ON THE M ES
Certificate of Occupancy - '
wilding inspector