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Zoning 1L
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. 3 I(Of Alterations ;i<W11,(t/.t--"U'+'�/i
NORTHAMPTON, MASS. —k%R' - 19 -t Additions /1/c
APPLICATION FOR PERMIT TO ALTER Repair
Garage /1/J
1. Location 't��/`� /�a,t+)6 r �=�a/1,L-Yvc.: Lot No. 7 C3
2. Owner's name Address �-I . r- AA& c r'
3. Builder's name Address c_56 a-j �j � 461- loy fri.�
Mass.Construction Supervisor's License No o W 71 Y Expiration Date jCa by Zzi
4. Addition A)
5. Alterations�'a T"E' C J 77�_ ! •�J �7. `f'�.
6. New Porch 1416
7. Is existing building to be demolished? /1/1)
8. Repair after the fire
9. Garage A6 No.of cars Size
10. Method of heating (5 r A-1"1
11. Distance to lot lines //
12. Type of roof A<A oaall
13. Siding house
14. Estimated cost:- +Y� ,Q p G
The undersig a certifie t the tatcments are we to the best of his, her
knowledge d lief
Signature of responsible app�icant
Remarks ej [Z c'-,r
- 7J
2 .
1W
Kitchen
hen
ti 5 LA+v17
tt�
2
Li4ng
a-LAS.
39 25 14! 2'
Al '�e•tL� y .
14? Both
n l.Oft
8ecf-oarn Open to EWoow
20' Bad Oc rn 14'
Be -cx n i 2`
I F
AREA CALCULATIONS SUMMARY LwIP
Area l"ma nf ,•�� -
i
,>
-;
�,;
2
°Goht� Flow- 1-do
/0,75)= Sl2 IbT
1-lna�s Is a W
7.415
X8.35 15.�
X233 2.5
4,f
-7 -205--r 8'8'10 1�
c ,��� x,855 z' -- �RL=0
X75 _2/ A3 86x7(7.4r5 +l233�2a3)=� ,83,p
_3 o2J 4472 q-q 7Z = Rk
8''6ca7(-7 �F�s�t 2�.��203j=1�83L
_R
PL
Poe+ I�L= ys/o
PJ:. 14 7 a
4 33 k J l7b`f
/2 (43 3,F')(7,475)
�2 =-Z2
- -i 30 +i4
�3 ' 2 (2,5)( 21 `172
xjA OF 4*4s,,,.
mv►1GX= )02.13 ` �� ��� FREDERICK
J. °n
y wl L �f-7 2 o.1765
= � No.17657 �
.090 9FOVERti�
3 7 Fsa�ONAI
USC 2- 1 q X 11 ye --
Am a x: 2 (9'7ko) 5"60 -1f� --7-. � x,6
U
r
,_ �
�.
Floor T is7
L
I2,6 9,/5` /
�o
Z �Ra=� 8D(12.6;►� _ �'-1,831e1
68.35 W�
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cv=80 ��1
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263
OF yAa�gc9
c FREDERICK ON
DZIALO ca
NO.17657
•O90 9Fli�S'1131��'4�'�
��ONAL4
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/ � F
F. J. Dzialo & Associates
Consulting
Structural
Engineers
C%ZG�'YL
Li2 V GL Registration
/,L �fyU Q Connecticut
Massachusetts
�Jel n j New York
LVl S Vermont
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19 Pleasant View Drive,Hatfield,MA 01038 Tel/Fax 413.247.5740
gK 11AN P�.
0
a e JUN i '998
' jxaaxc(tnsitta
` I3EPARTMElTr OF BUILDING INSPECTIONS
212 Main Street ' Municipal Building
Northampton, Mass. 01060
WORKER'S COMUENSA'I'ION INSURA-NCE Ali , AVIT
censcclpermi U ce)
with a principal place of buainesslresidence at:
Z-� `C? Ct��i-�1�0 �(.� ., • l7Vi���� —�Pnone#} J Z7- �`��o'�
do hereby certify, under the pains and penalties of pcuw-y, that.
(^'�l am an employer providing the follo"vi-og worker's compensation coverage for my
employees worling on this job:
(Ln�uau�Cpmpaay) (Policy Number) (Expirah Date)
( ) 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:
(IvIame of Contractor) (Ins i�_:cc Company/Policf Number) (Expiration Datc)
(Name of Contractor) (Instmance Company/PoUcy number) (Expiration Date)
(Name of Contractor) (Lrulnance Compam}'/Policy Number) (Expiration Date)
(Name of Contractor) (La_surance Compaoy/Policy Numbes) (Expiration Date)
(atLlch additicml nc�ct if nocrniry to inch�dc infocmrti a�prtzining w rill ooattndon)
O I am a sole proprietor and have no one wor4-rig for me.
( ) I am a home owner performing all the work myself.
NOTE_plc-ac be aw�rc thzt whilo homcowocr�Fvbo cmploY p,,,=w do n coffin ctioa ar rcpa r work on a dwelling of
not-00 than thr--arts to which the honxowncr a tbo grounds apputtcnan116 nin a c oo(gcocrarly o—idcrcd to bt
employ—under tba worker's-mpcas4ca Act(GL152,s t(5)),apptialion by a homeowner far a bcco3 cc permit may cvit c the
Itp-1"-b-of an omployx undertho Wo,i .Compcmat�oa AcL
I Lux&rvt nd that a oopy of thu cht®csst may bo forw.v to Lb.Dtpa.rtnxos of of insur.nco for tbo
coverage verification and tbat failure to statre covcm3a tmd.-r soU oa 25A of MG 152 c A lead to tbd imposition of criminal Peaalbes
cooiistatg orx•fine of uP to S 100.00 and/or imprisoor=cat of lip to ow-year Lod civil Pemltics in the form of n Stop Wodc Order and a
fim of 5100.00 a dry lgiinA tna
Foe dcpatm-r W u'°only
Permit Nul bcr
�:, Sigii?hlrc Liomsecfpermnittce
1
2&
1 4 �1 f
'
I t c�" en
K;tC�'1e '1
2 ®at.h Er 12
EkKkoom
39 2-9 14` 2'
Bath Lift
8Kt-oom
Open to 8rei aw
20 8ectooM 14'
Ekickoom 1 2'
M VLi --- 1 . . F
AREA CALCULATIONS SUMMARY LIVII
Ar+ me of Area SEZEA ToWis
YES NO
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 coltm to be filled in
by the Building Department
Required
Existing Proposed By Zoning
Lot size +
WS
Frontage
Setbacks - front
- side L: A10 R:c,?O L: R:
- rear IWO i ---
Building height SIU
2r z�S
Bldg Square footage
37,E `7
%Open Space:
(Lot area minus bldg 7
&paved parkingj
# of Parking spaces
# 'of Loading Docks N
Fill:
-(volume -& location) fV10I✓e
n ,,
13 . Certification: I hereby certify that the information c ntai d ere-in
G is true and accurate to the best of my knowledge.
DATE: APPLICANT's SIGNATURE
NOTE: Issuanoe f a zoning permit does not relieve an p s burs t oom ty Wittr off Y/z
zoning requlrements and obtain all required permits fro a oard of Health. Conservation
Commission. Department of Publio Works and other applioable permit granting authorities.
FILE #
File No.
ZONING PERMIT APPLICATION (§10 . 2)
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant: Z
Address: 1-1 oc Telephone:
2. Owner of Property:
Address: Telephone:
3. Status of Applicant: ✓— Owner __Contract Purchaser Lessee
Other(explain):
4. Job Location: � R,-, ,di T=an Q
Parcel Id: Zoning Map# Parcel## c3 District(s):
(TO B5 FILLED IN BY THE BUILDING DEPARTMENT)
5, Existing Use of Structure/Property -V"Ct
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 Permit/Variance/Finding ever been issued for/on the site?
NO_ DON'T KNOW YES_ U—' IF YES,date issued:/6 7-7�c`►�
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 f/" 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
JUN I i`
APPLICANT/CONTACT PERSON: '
AT S IONE•
PROPERTY LOCATION: -
MAP` PARCEL: ,
THIS SECTION FOR_OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FTf LED [MITT �
Fee Pahl
Fee Pqid z/
.2c,;767 t/
Addition , 't"Zj
Arrevgnry Strnctnre
BiLM
3 Sets noinnS)/Pint Plan
Qa ✓
tom-'
THE FPtLOWING 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 Cut from DPW Water Availability Sewer Availability
ptic Approval-Bd of Health Well Water Potability-Bd Health
lPerm't from Conservation mission
Signature of Building for Date
NOTE:Issuanoe of a zoning permit does not relieve em applioant's burden to oomply with all
zoning requirements and obtain all required permits from the Board of Health. Conservation
Commission, Department of Publio Works and other appiioable permit granting authorities.
Department: Reference No: BP-1998-0053
...................................
Building, Electrical & Mechanical Permits
................................................•---.....................•-•-----........
Fee Type: Receipt No:
Building- Renovation REC-1998-000057
..................................•---•--.................---............•---............
..............................••......
Paid By: Paid in Full On:
Sackrey Construction Mon Jun 15,1998
..........................•-•-•-----.....--------................I........--........
Received By: Check No:
Linda Lapointe 2267
--------------•-------......------.....---•-----........................---........•-----
......................................
DEPARTMENT'S COPY Amount: $64.00
DEPARTMENT FILE COPY 444 BRIDGE RD
CITY OF NORTHAMPTON
BUILDING PERMIT
Owner's pulling their own permits or dealing with unregistered contractors for applicable work do
not have access to Guaranty Fund(MGL 142A)
Issued: Permit No: Inspector: Tracking No.: Fee:
15 Jun, 1998 BP-1998-0053 963606 $64.00
GIS #: Map Block: Lot: Address: Zoning: Use Group: Lot Size:
1619 17B 008 001 444 BRIDGE RD RR 135036
Contractor: License Type: Insurance:
Sackrey Construction CSL Workers Compensation
Address: License No.: Insurance No.:
288 Chesterfield Rd. 040714 na
City State: Zip Code: Phone:
WESTHAMPTON MA (413) 527-3465
Proiect No: Cate2ory of Work: Const. Class: Cost Estimate:
JS-1998-0054 $16,000.00
Description of Work:
Renovate upstairs kitchen and bath to family room
GeoTMS®1997 Des Lauriers&Associates,Inc. Signature: