The URL can be used to link to this page

28-006 2 7v 'v CT; v :s7 �► eta l- 3 .. r, z pm C� S R i a: °: -� Z > v, O r v 0 _a rfl Zoning Miscellaneous Additions,Repairs,Alterations,etc. Tel.N o. ` ~g Alterations NORTHAMPTON, MASS. 6(4, 11- 19 Additions APPLICATION FOR PERMIT TO ALTER Repair Garage 1. Location L Lot No. 2. Owner's name DO PJA-UD le l r� �- Address gb I S�L� -� flO. 3. Builder's name V y affV J- Address 2�6 Sy O W( 5"T l u'LUIA-P1-t5 ,+C Expiration Date 2--0 5-9 Mass.Construction Supervisor's License No, 0 0 /4 �- p' 9 4. Addition l (�liA e 6euUT STCP-S 5. Alteration Ho 6. New Porch 4—rb 7. Is existing building to be demolished? Xr d 8. Repair after the fire At b 9. Garage At A No.of cars Size 10. Method of heating /1!6 PC- 11. Distance to lot lines N��" 12. Type of roof pbl\j f" 13. Siding house AVA-- 14. Estimated cost- h The undersigned certifies that the above statements are we to the best of his, her knowledge and belief. Signature of responsible app,icant RemarksQ � //1tiQ G�mil{ �9'✓ d� � I.�P Lill G ed'A-t �0 Oy �'��'+7th{ o7r ay{ a t }l � 6 - F�C�C� i/. f�asattchttsctts I'DEPARTMENT OF BUILDING INSPECTIONS 212 Main Street • Municipal Building ' Northampton, Mass. 01060 y WORKER'S COMPENSATTON INSUIUNCE AFFIDAVIT CyC-6bN LOOM 6U1L9(-R-j (li censeeJpermi tt ee} with a principal place of blisiness/residence at-. lkl/74 3SI W)CCIA d ,1— JAA D109 4(phoner#) �'�°/3z� (stmx"t/city/stalrla p) do hereby certify, under the pains and penalties of pequry, that: I am an employer providing the following worker's compensation coverage for my employees working on this job- (TO~ InrsaAriet Flow G0weeg14 (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 worker's compensation policies, (Name of Contractor) (Insurance Company/Policy Number) (Expiration Date) (Name of Contractor) (Insurance Company/Policy Number) (Expiration Date) (Name of Contractor) (Insurance Compauy/Pokcy Number) (Expiration Date) (Name of Contractor) (Insurance Company/Policy Number) (Expiration Date) (atIadl addidc"shoot if noccniry to include information perburj_ng to all radon) ( ) 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 Ybilo homcowocn who ctnploy persom to do mxadmaacx coostuctioa'or repair work on i dwelling of not morn than thr"units in which the homeowner resides or oa the uoun6 appurtmu th=W arc not gcoerally oomtda to be employers under tbo workat"s compcxssatioa Act(GL152,ss 1(5)),application by a homeowocr for a Geese or puma may evidence tho legal etRbu of an employee under the Wocka'a Compomatioa Act I undMttnd thsi a copy of this mtcmcat may bo focwartW to tbo Depart of IndzLi3ia1 A,6&=&OEfioo of L.x. aoe for the coverage verificatioa and that failure to secure coverage under section 25A of Mot,152 can lmd to the impos Oa of aimin l Penaltics oomisiing of a fine of up to 51,500.00 and/or of up to one year end civil pcmltia in the form of a Stop Work Order and a fine of 5100.00 a day&&&insYme- 1 Signed this ��' day of_a C_� 199 Far dqMrta1=W u•o ply Permit Number Lot# Si of Lit /Permitt cE r 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 COMPLE'T'ED, or PERMIT CAN BE DENIED DUE TO LACK OF INFORMATION. MU.s cola= to be fillad in by the Building D�pnztment 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 ' &P_E,ved i3ark_Lnr J # of Parking Spaces # of Loading Docks Fill: -(volume -& location) 13 . Certification: I hereby certify that the information contained herein G is true and accurate to the best of my knowledge. DATE: �U_-l 6 - °1 APPLICANT's SIGNATURE NOTE: lunuanoe of a zoning permit does not relieve an ap ioanYs burden to oompty With all zoning requirements and obtain all required permits from he Board of Health. Conservation Commission. Department of Publio Works and other applioable permit granting authorities. FILE # J- File No jlJ l ! 1 ZONING PERMIT APPLICATION (§10 . 2 PLEASE TYPE OR PRINT ALL INFORMATION 1. Name of Applicant: Address: �6 S�]/ f ✓��. W/Wpfi 50 CtZ- -- Telephone: 2. Owner of Property: D6 N 4-t—Q Address: A') 5 yLV i 5Tr r— �_'O. Telephone: 3. Status of Applicant: Owner _Contract Purchaser Lessee I Other(explain): at-Pl1-4if- e,?% J��'�� 4. Job Location: Parcel Id: Zoning Map# C�57191 _ _ Parcel# District(s): � (TO BE FILLED IN BY THE BUILDING DEPARTMENT) 5. Existing Use of Structure/Property 6 , e_eS 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. S. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO DON'T KNOW J 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 .5'fi-A5'DAQt: 3p_VV L 12-0' -N er s 17-P 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) t File#BP-1999-0409 APPLICANT/CONTACT PERSON James Locke ADDRESS/PHONE 26 South Street (413 26�_ 8=9323 PROPERTY LOCATION 401 SYLVESTER RD MAP 28 PARCEL 006 ZONE RR THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOS REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Buildinp,Permit Filled out Fee Paid `'�� ✓ Type of Construction: New Construction Non Structural interior renovations Addition to Existing Accessojy Structure Buildin Plans Included: Owner/Occupant Statement or License# 3 sets of Plans/Plot Plan I F OWING ACTION HAS BEEN TAKEN ON THIS APPLICATION: pproved 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 Board of Health Well Water Potability Board of Health Permit from Conservation Commis 7 � Signa,.!re of Building Officia Date Note: Issuance of a Zoning permit does not relieve a applicant's burden to comply with all zoning requirements and obtain all required permits from Board of Health,Conservation Commission,Department of public works and other applicable permit granting authorities. Department: Reference No: ...... Building,Electrical & Mechanical Permits ......................................................................................... Fee Type: Receipt No: Non structural interior renovations ......................................................................................... REC-1999-00.1106 Paid By: Pa.i�.i.n.Fu------I I 0.n:.......... James Locke ................................................................................... Wed Oct 21,1998 .. . ...... ...... ceived By: .Check. . .No:................... Linda Lapointe 9317 ...................................... DEPARTMENT'S COPY Amount: $20.00 ........................... DEPARTMENT FILE COPY 401 SYLVESTERRD 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: BP-1999-0409 $20.00 GIS Map Block: Lot: Address: Zonina: Use Group: Lot Size: 4669 28 006 001 401 SYLVESTER RD RR 58370.4 Contracte r: License Type: Insurance: James Locke CSL Workers Compensation Address: License No.: Insurance No.: 26 South Street 001992 wc2-0026852 City: State: Zip Code: Phone: WILLIAN4SBURG MA 01096 (413) 268-9323 Pro iect N,-: CateL-ory of Work: Const. Class: Cost Estimate: JS-1999-0316 Non structural interior renovati $1,150.00 Descripti ri of Work: REPLACE FRONT STEPS GeoTMS@ 1997 Des Lauriers&Associates,Inc. Signature: