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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations
NORTHAMPTON, MASS. 19 Additions
APPLICATION FOR PERMIT TO ALTER Repair
Garage
1. Location /(2 f�4� 'iZ f ��17�'r�:- Lot No. SIB 3 5
2. Owner's name Address iLiYti Iz z Srn�°r; ��%2,�r�»yrf',ev✓
3. Builder's name L'✓��✓3»/ L v,.f �T� Address &U S- r S:i G" rr,A4
Mass.Construction Supervisor's License No. UJ.3 2�7_� Expiration Date/c
4. Addition
5. Alteration �Ttzw f x tJr)r4,4 1&T AdO
6. New Porch A ;4-
7. Is existing building to be demolished? PVC)
8. Repair after the fire A�)C
9. Garage nc4, No.of cars Size
10. Method of heating
11. Distance to lot lines
12. Type of roof AVH,-q, i-
13. Siding house
14. Estimated cost:- v
The undersigned certifi at a about statements are we to the best of his,
kn edge`�and belief.
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Signature of responsible appicant
Remarks Ile
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eMAY 71999 i j�lassanc�csrtts
S" EPARTMENT OF BUILDING INSPEC'T'IONS
DEP?OF BUFt dl!NG INSPECTIONS 212 Main Street • Municipal Building '
INSPECTOR NORTNr,I-MlLjad ��
"" Northampton, MA 01060
Applicant Information
Name r —
_ ��-����:��— ---------------
Location ------------
City � TLL1 —o�c�� -------------
❑ 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 this job.
Company Name--------------_------ --
Address -----------------------------
CitY------------------- Phone#--------
Insurance Co.------------_—Policy#------ ---
Company Name P, _r, i�;.�os,.�
Address s_n �,X I�-�2 t2; 9
City_ Qr:?l c N Phone# -'8 2
Insurance Co. HS`� `z -� l v CC Policy#bi2 Fr-k-- 2�r�
Failure to secure coverage as required under Section 25 A of IVIGL 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 against me. I understand that a copy of this statement may be
forwarded to the Office of Investigations of the DIA for coverage verification.
I do hereby certi�under the pats nd pen2lti of perjury that the information provided above is true and correct.
Signature
Date
Print Name tAu ( Z ,r � Phone 0
Official Use Only Do not write in this area to be completed by city or town official
City or Town PermitiLicense ❑ Bu>U g Dept
Lrensing Baud
Check if immediate response is required ❑
Contact Person Phone El Selectmen'Dept.
❑ Health 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 Col.== to be filled in
by the Building Department
Required I
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
&paned parking)
# of Parking spaces
# 'of Loading Docks
Fill:
-(volume -& location)
13 . Certification: I hereby certify that the inforr tiojn cory,�aine hereilv
G is true and accurate to the best of my knowlec ' e.
DATE: jUlit�, 4 /�> APPLICANT's SIGNATURE
NOTE: lusuanoe of a oning permit does not relieve an appliioant's/,b en to co ittr all
zoning requirements and obtain all required permits from the Bolirsp of Health. Conservtation
Commission, Department of Publio Works and other applicable permit granting authorities.
FILE #
MAY 71999 '
�i
` File No �C/
a
DEPT OF8—MILF,NG INSPECTIONS
PERMIT APPLICATION (§10 . 2
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant:
Address: .,Cpl� ��.;_ j�5 r�� , ;(rAy Telephone:
2. Owner of Property:
Address: 16C N( ti(Z-rL �;�z Y_r- ?.i ` �c.�; Telephone: ]YS'' C5 yLTa
3. Status of Applicant: Owner Contract Purchaser Lessee
Other(explain): re)r,
4. Job Location: 1 (f, �v( �f2 2ti `rYz-C i�,�r�,�
Parcel Id: Zoning Map# IS Parcel# 36 District(s):
(TO BE FILLED IN BY THE BUILDING DEPARTMENT c
5. Existing Use of Structure/Property
6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary):
t �7 t2 O x iS�iw E=sVc CST' 1_X'c
'4i -02-e 7-
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5 _
.)Z= H. c'117(Lti C 4S
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 ! v 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)
16 MYRTLE ST BP-1999-0929
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 31B-035 CITY OF NORTHAMPTON
Lot: -001
Permit: Building
Category:roofing BUILDING PERMIT
Permit# BP-1999-0929
Project# JS-1999-1590
Est.Cost: $4600.00
Fee: $20.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: Brian Greenwood 053724
Lot Size(sq.ft.): 4530.24 Owner: POWERS CHARLES B&AMY E MORAN
Zoning.URC Applicant: Brian Greenwood
AL. 16 MYRTLE ST
Applicant Address: Phone: Insurance:
366 East St (All) ';)-7-1-N31
EASTHAMPTON 01027 ISSUED ON:517/1999 o:oo:oo
TO PERFORM THE FOLLOWING WORK.-STRIP & SHINGLE 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 5/7/1999 0:00:00 $20.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Building Commissioner-Anthony Patillo
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16 MYRTLE ST BP-1999--0929
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map.-Block:31B-035 CITY OF NORTHAMPTON
Lot:-001
Permit: ° Building
Category:roofing BUILDING PERMIT
Permit# BP-1999-0929
Project# JS-199-1590
Est.Cost:$4600.00
Fee:$20.00 PERWSSIONIS HEREBY GRANTED TO:
Coast.Class: Contractor., License:
Use Group: Brian Greenwood 50 3724
Lot Size(sg.ft.): 4530.24 Owner: POWERS CHARLES B&AMY E Iy]GRAN
Zoning:URC Applicant Brian Greenwood
A_T. 16 , ST
Applicant Address: Phone: Insurance.
366 East St (413)527-3531
EASTHAMPTON 01027 ISSUED ON.-31711999 o.00:oo
TO PERFORM THE FOLLOWING WORK.-STRIP & SHINGLE ROOF
POST THIS CARD SO IT IS VISIBLE FROM THE STREET
Inspector of Plumbing Inspector of Wiring D.P.W. Inspector of Buildings
Underground: Services 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 NORTHAMPTON UPON VIOLATION OF
ANY OF ITS RULES AND REGULATIONS.
Certificate of Occupanc Signature:
Fee Type: Receipt No: Date Paid: Check No: Amount:
Building 5/7/1999 0:00:00 $20.00
212 Main Street,Phone(413)587-1240,Fax:(413)587-1272
Building Commissioner-Anthony Patillo