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25C-128 ` a z v -o o• � rn m vDi 3 o Z En Z t� > 1 O •r. i i Zoning Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations NORTHAMPTON, MASS. 19 Additions APPLICa ATION FOR PERMIT TO ALTER Repair Garage I. Location t241 X41 zy-�—e—Yh �7c Lot No. 2. Owner's name 0, Ay/So w/`C Z Addresso?5� CFkZ.g G e A 5-2: 1Vef 1,4A,W b N 'P/Y-4 091-c,091-c,3. Builder's name W/441 fin'i ,41E�C Mass.Construction Supervisor's License No. C)/7 a 41y Expiration Date 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 13. Siding house 14. Estimated cost- The undersigned certifies that the above statements are we to the best of his, her knowledge and belief. 'j Signature of responsible app,Ant Remarks 1-p, i 1 O���MpTO x `f ofoZ'#l�ttllt�t#nit W AUGyridSfttCt(tiSttts � ZOO EPARTMENT OF BUILDING INSPECTIONS INSPECTOR 212 Main Street • Municipal Building >o H Northampton, MA 01060 Applicant Information Name — Location City--- ---- ------- ---------- 0 1 am a homeowner performing all work myself ❑ I am a sole proprietor and have no one working in any capacity I am an employer providing workers' compensation for my employees working on thisjob. Company Name—_1jiA� % t�/Y/— 0/0 A tot---_------- Address�Vd — A /,ss (2),k—I']1"–_---- City--- e-V Phone# L e Insurance Co.–�qGl/ 1 —j1 CQ 649 Policy Company Name Address City Phone# Insurance Co. Policy# Failure to secure coverage as required under Section 25 A of MGL 152 can lead to the imposition of criminal penalties of a fine up to$1500.00andlor one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of$100.00 a day againstme. I understand that a copy ofthis statement may be forwarded to the Office of Investigations of the DIA for coverage verification. I do hereby certify under the pairs and penalties perjury that the information provided above is true and correct. Signature Date ( /C Print Name L.L 14 Lod � �'Nlf Phone Official Use Only Do not write in this area to be completed by city or town official City or Town Permit/License p Building Dept ❑Lrewing Board Check if immediate response is required ❑selecttten'Dept. Contact Person Phone _ ❑ 13eakh Dept. 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 cola to ba filled in by the Building Dapa —at 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) # 0f Parking Spaces # �of Loading Docks Fill: location) 13 . Certification: I hereby certify that the information contained herein is true and accurate to the best of my knowledge. DA'Z'E: - 5' �' F' APPLICANT's SIGNATURE / NOTE: lasuanoe of an zoning permit does not relieve a pplioant's burden to comply with all zoning requlrements and obtain all required permits from the Board of Health. Conservation Commission. Department of Publio Works and other applicable permit granting authorities. FILE I At j 2 Q ) N File No. 6 lo ZONING PERMIT APPLICATION (§10 . 2) PLEASE TYPE OR PRINT ALL INFORMATION 1. Name of Applicant: U)"/'x Atet Address:c�L,o 2V,, -ye4.4 Sl; �1h��L�°�- Telephoners/3J 2. Owner Owner of Property: 1y1S oUJI`e Z Address:cAV &/2.62�A�A 54 r),eX&4 ,�Telephoner/1) 3. Status of Applicant: Owner k--Contract Purchaser Lessee Other (explain): , 4. Job Location: �/ 12 x� SEX/ 7 Parcel Id: Zoning Map# Parcel#� District(s): (TO BE FILLED IN BY THE BUILDING DEPARTMENT) 5. Existing Use of Structure/Property M,,'& IFLO Sib FZ2 cep- 6. Description of Proposed UseANork/Project/Occupation: (Use additional sheets if necessary): 1` ���/y Ccl a e ,CDC ��y7 © 1�kD rt 1` /2,-7d 2P.f?'c 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 r"� 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 b`� 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) a 24 ELIZABETH ST BP-2000-0187 GIS#: COMMONWEALTH OF MASSACHUSETTS MV Block:25C- 128 CITY OF NORTHAMPTON Lot:-001 Permit: Buildifi Category:roofm BUILDING PERMIT Permit# BP-2000-0187 Project# JS-2000-0301 Est.Cost:$8000.00 Fee:$25.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: William Gnatek 017240 Lot Size(sa.ft.): 4791.60 Owner: ANISOWICZ CHRISTINE A&BEVERL Zoning:URB Applicant: William Gnatek AT: 24 ELIZABETH ST Applicant Address: Phone: Insurance: P O Box 204 (413) 584-5682 HADLEY 01035 ISSUED ON.•812011999 0:00:00 TO PERFORM THE FOLLOWING WORK:STRIP,PLY & SHINGLE FRONT & REAR OF HOUSE ROOF POST THIS CARD SO IT IS VISIBLE FROM THE STREET Inspector of Plumbing Inspector of Wiring D.P.W. Inspector of Buildings Underground: Service: Meter: Footings: Rough: Rough: House# Foundation: Final: Final: Rough Frame: Gas Fire Department Fireplace/Chimney: Rough: Oil: Insulation: Final: Smoke: Final: THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Certificate of Occupancy _ Signature: Fee Type: Receipt No: Date Paid: Check No: Amount: Building 8/20/1999 0:00:00 $25.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo