Loading...
25C-132 (3) F n cDn r Z m � uL� cn Z R _ Y O -� m t2l c z a rfl Zoning Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. .515" 7 Alterations NORTHAMPTON, MASS. � S 19 Additions APPLICATION FOR PERMIT TO ALTER Repair a f/ O Garage //� 1. Location `70'7� t/1/7- q ir - `Lot No. B 2. Owner's name_1 ,`1�}r0PZ SI A - -��/n/Aj Address Pig S)". 5'`i` X195 d1ge�J AJ ; 3. Builder's name Ll• G�Pf4 1�D�- /fit e76i:,e S Address 1417 IU o Mass.Construction Supervisor's License No. 04 'VO / //5 S//� Expiration Date 9 Q5 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 lrt OCR J 14L /1✓ 13. Siding house 1///y y 14. Estimated cost:- /D/ OOa p O The undersigned certifies that the above statements are we to the best of his, t knowledge and belief. Signature of responsible app:icani Remarks 1V d ' /1U' 3QGi ?-- 0 /g� ZA ,J/0 X 9/0 D s JAN 611998 "� Cr f >af Narf4aillpfan :. a �asascE?nsctta 3 B . DEPARTMENT OF BUILDING INSPECTIONS 212 Main Street ' Municipal Building ' Northampton, Mass. 01060 WORTCER'S COMPENSATION INSURA-NCE AI+FIDAVIT with a principal place of business/residence at-. /V7 /V mu U/ate (phoney) S 1Cz 7 (stmr_Ucity/sta dzip) do hereby certify, under the pains and penalties of perjury, 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 Daze) ( ) I am a e ro , 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 Compauy/Policy Number) (Expiration Date) (Name of Contractor) (Insurance Company/Policy Number) (Expiration Date) (Name of Contractor) Gmairanc_— Compaoy/PoLcy Number) (Expiration Date) (Name of Contractor) (Insurance Company/Policy Number) (Expiration Date) (aHach additico it sbcc(if noo=Lxry to inchu&infrxmstioa patnimng In rill ooatrndon) (Vyl 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 tbzt wixilo hoaacowocn who crnplay perrom to do mxadcaanec�cowhvdioo'or repair work on a dwelling of not mote than thcoo units in wi- ieh the homeowner rraidcs or on the Vouad3 appucteaant tba-do am Dot gcoa-I ly cociidcred to be employers under tha worker's.coaipcas4cn Ad(GL152,m 1(5))�application by a homeowner for a license or permit may evidence tbo legal ctshrs of an employer under tho Workers Comparution AcL 1 undcnsaad thst a copy of this c>ascmms may be forwarded to tbo Dopertmmt of lodisst d A,dd,a&OtEoo of ln5ucwee for the coverage vcnficdLoo and that fadtmc to soave coverage undcc section 25A of MOL 152 can Icad to tba'imP s-of aimin4 penalties comi.stiag of a-fnc bf up to 11,500.00 no-Nor inrprisoomcat of up to one year sad civil pcmlGa in the form of a Stop Wodc Oidcr and a firm oe5100.00 a day agaiaA'tne Signed this `day of� � 199 For dgnrtmal W- Signed Permit Number lvfap Lot.# �- _ Si of ermitfcc --NOTE- THIS PLAT IS COMPILED FROM DEEDS, PLANS AND OTHER AND IS NOT TO BE CONSTRUED AS AN ACCURATE SURVEY AND IS NOT TO BE RECORDED. 4 . w 6 :998 rj 4 I _i �o•coo '3 ' ^c ♦�nn Ul �N< EASTHAMPTON S*VINGS BANK & LAWYERS TTTLE '"INSURANCE CORPORATION I ,HEREBY REPORT TH T I HAVE EXAMINED THE PREMISES AND BASED ON EXISTING M" NU'MENTATION ALL ASEMENTS, ENCROACHMENTS AND BUILDINGS ARE LOCATED ON T GROUND AS SH9,*N AND THAT THE BUILDINGS ARE ENTIRELY WITHIN THE LOT LINES, EXCEPT AS NOTED. I 'FURTHER REPORT THAT THE PROPERTY IS NOT LOCATED WITHIN A FLOOD PRONE AREA AS SHOWN ON FEDERAL FLOOD INSURANCE MAPS FOR COMMUNITY # 2 s LL1 6 SURVEYOR: �' -1- � NOTE— THIS PLAT FOR MORTGAGEE LOAN PURPOSES ONLY F2 AND DOES NOT CONSTITUTE A PROPERTY SURVEY —MORTGAGE LOAN INSPECTION PLAT- " DALL NORTHAMPTON, MASSACHUSETTS PREPARED FOR 40 `3 fM32 THEODORE J. WILLIAMS, ET ALS SCALE: 1 "=20 ' SEPTEMBER 26 , 1995 su HAROLD L. EATON AND ASSOCIATES, INC. REGISTERED PROFESSIONAL LAND SURVEYORS �• �" 235 RUSSELL STREET — HADLEY — MASSACHUSETTS 10. Do any signs exist on the property? YES NO V IF YES,describe size,type and location: Are there any proposed changes to or additions of signs intended for the property?YES __ NO L/ 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 Building Diepar tment Required Existing Proposed By Zoning Lot size / �'em f J Frontage � y� Setbacks - frnnt 71 - side L: / R: L: R: 5� - rear a X/ 0? Building height Bldg Square footage �S—�Z S ! G °°Open Space: (Lot area minus bldg /V1© C) &p=eed parking; # of Parking Spaces # 'of Loading Docks `J Fill: -(volume--& location) 13 . Certification: I hereby certify that the information contained herein G is true an accurate to the best of my knowledge. .1 DATE: % - 1 APPLICANT'S SIGNATURE NOTE: luayA ano of a zoning permit does not relieve an ap li ant's burden to comply Wit4'aii zoning uire ents and obtain all required permits from he Board of Health. Conservation Commission, Department of Publio Works and other applionble permit granting authorities. FILE # � 1 JAN 611998 � File No. ZONING PERMIT APPLICATION (§10 . 2) PLEASE TYPE OR PRINT ALL INFORMATION 1. Name of Applicant: Address: `'� ✓ f IV Telephone: - Z�zc�7 7 2. Owner of Property: tAL A <' 0 1-4- Address: LrA S)j SY V ff/ Telephone: 7 3. Status of Applicant: Owner t' Contract Purchaser Lessee Other(explain): 4. Job Location ,y- / /r-�" �_/ / : ',7"2-- ,`r" Z1 z-4 zt Parcel Id: Zoning Map# Parcel# District(s): (TO BE FILLED IN BY THE BUILDING DEPARTMENT) 5, Existing Use of Structure/Property In ��t/ 6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary): i�cxe ao 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/Vadance/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�ON'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) D� L5 G Lr, U l5 �1 FILE # 9 C JAN 6 M �} APPLICANT/C NTACT ERSON: �/� �//-L � �� lid 7 DEPT Of 8 c ARONE: /✓�_ � � .� PROPERTY LOCATION: ZONE_ MAY �� PARCEL: /� THIS SECTION FOR_OFFICIA.L USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM MLET) OITT Fee Pniri Z t, Building Permit Eilled wit Type of Constniction- 'RemnrielinZ Interior THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS AP ICATION: < Approved as presented based on information presented XDenied as presented: x Special Permit and/or Site Plan Required under: § 512- I G� `0� �d C 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 SeFYer Availability Septic Approval-Bd of Health Well Water Potability-Bd Health Permit from Couservati ommission Signature of Building for Date NOTE:Issuanoe of at zoning permit does not relieve an applioant's burden to oomply with all zoning requirements and obtain evil required permits from the Board of Health. Conservation Commission, Department of Publio Works and other applioable permit granting authoritles.