12C-082 (2) tv 0
Z m
N
='e� -- r -t p
n: C'` N Z
cn O
Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations
NORTHAMPTON, MASS. 19 Additions
APPLICATION FOR PERMIT TO ALTER Repair
a /�j �-1 � Garage
1. Location �7 AgIt� L i � --"(e� Lot No.
2. Owner's name 'Ti -1 /fir Address
3. Builder's name e%9�l �'� `�S 064 S Address -7 2- --
Mass.Construction Supervisor's License No. Q -41,4l,L 8- Expiration Date
4, Addition �2
5. Alteration C.-6tt.y4,,
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:- IIt
The undersigned certifies that the above statements are we to the best of his, her
knowledge and belief.
Signal of responsib app icani
Remarks
� �
; �
s
t
`,
.,4 ,�, �
� ;
r
� :
t
i
i
i
is
i
; .
i
� .
! :
E
, ,
� ;
}
z
i
I �
_- � #
a
j
Feb 2 i9 �a
uJki �
s
f
���rar
�° °y,
°g 2 , GZt� of 'Nart 4aillp toll z
3 �C►7 '� jfflassRchnsctta
1
D PARTMENT OF BUILDING INSPECTIONS
-
M � ""` ... • 212 Main Street ' Municipal Building '
Northampton, Mass. 01060
WORKER'S CON PENSATION MSUIZANCE MIMAVrr
�1�5 �UGAS
(li censecJpermi tree)
with a principal place of busmessJresidence at:
2- 2- �; �r.� A - (phone#) sV 7 O g l V
(sti-eet/city/stalrJ�p)
do hereby certify, under the pains and penalties of peoury, that:
( ) I am an employer providing the following worker's compensation coverage for my
employees working on this job.
(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 Comparry/Policy Number) (Expiratioa Date)
(Name of Contractor) (tnsurancc Company/Policy Number) (Expiration Date)
(Name of Contractor) (Insurancz Compaq}•/Policy Numb(-'r) (Expiration Date)
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(anaeh add?dcail sheet ifnooc=uy to inchu6c infamarion pertaining to all eca r3)
( 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 mth to how-cownen wtro crnplay pawns to do mx;••f.T,*^K comtruetioa or repair work on a dwelling of
not morn than thtoo traits is which the bomoowncr residcs or oa the grounds appurtenant tbacto arc not generally oomida-ed to be
cmployrra under tha vmrkct`s lion Act(GL.152,ss 1(5)),application by a homcow=for a Gccnse oc permit may cvidrnoe tho
Itg l status of an omployec undor tho Workods Compms.tioa Act
I undavAnd that a copy of thin rtatemcat may bo forw vded to tho pcputa of 1-1,, i d Ao idw&OfE o of Ia3xw—for t6a
oovc!T vaification and that fa urc to aeatre covcmp under scctioa 23A of MOL 152 can lead to tha imposition of aiminal penalties
ooasuting of a-fine of up to S1,500-00-N-i apriso of up to one year end civil pcwhe,in the form of a Stop Work Ocdcr and a
Gro o(5100.00 a day agnimt ty.
1 `l
Signed _day of 199 =__
Si of Li �
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 cclu= to be filled in
by the Building Department
I Required
Existing Proposed By Zoning
Lot size
Frontage
Setbacks - front
- side L: R: L: R:
- rear
Building height
Bldg Square footage
%Open Space:
(Lot area minus bldg
&paged park._ng}
# of -Parking Spaces
# '6f Loading Docks
Fill:
_t volume -& location)
13 . Certification: I hereby certify that the information contained herein
4 is true and accurate to the best of my kno=1 ,,
DATE: —2^ APPLICANT's SIGNATURE
NOTE: Issuanoe of as zoning permit does not relieve an applioant-s r gn to#ompty with $11
zoning requirements and obtain all required permits from the Board of Health, Conservation
Commission, Department of Publio Works and other applioable permit granting authorities.
FILE #
FEB 2 1998
t
File No.
,,r x
PEST APPLICATION (§10 . 2
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant: "�t7 IS '-2)OX,2 S
Address: 2 2 lL"J- A d f Telephone: -S-a2 7'0'�19 lr
2. Owner of Property: �i J lyw'�
Address: IV 014-0 Telephone:
3. Status of Applicant: Owner Contract Purchaser Lessee
Other(explain)::
4. Job Location: �� �CQlC G d/"L //�
Parcel Id: Zoning Map#�a6 Parcel# e 7% District(s):�
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
S, Existing Use of Structure/Property / 1 6kLe—
6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary):
('Z'�fi A C�c,c� ( X q r j rc v14-, 114 l�-
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 6C YES IF YES,date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO DON'T KNOW X 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)
FILE I (� r
F 2 s
APRICAI�T/CO CT PERSON: H J �`7Zt1�Z,
PROPERTY LOCATION:
MAP /a PARCEL:Za ONE
THIS SECTION FORAFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FH,T,VT) 011T
Fee Pnid
lffiiildin2 Permit Filled wit
Type-of Constniction-
Additinn to Existing
C�
i
l� l
✓'
THF�OLLOWING 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: § -,Y/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-Bd of Health Well Water Potability-Bd Health
Permit from Conservation Commission
Signature of Building Inspect6T V Date
NOTE:Issuanoe of a zoning permit does not relieve an applionnt's burden to comply with all
zoning requirements and obtain all required permits from the Board of Health, Conservation
Commission, Department of Publio Works and other applioable permit granting authorttles.
City of Northampton REQUIRED INSPECTIONS
BUILDING DEPARTMENT 2. Struccttugral Walls Components in Place*
3. Complete Building*
No. 1262 Office of the Building Inspector
Zoning Form No. 963193 Date 2/2/98 Fee$40.00 Check#1540
Page, 12C Parcel 82 ,Zone URA/WSP Section 127 ❑ Yes No
BUI]LDINGPERMiT
*Plumbing and Electrical Inspections required
THIS CERTIFIES THAT Denis Duaas Construction before Building Inspections
has permission to �
Construct bathroom in basement In lion on Site—Foundations
situated on 19 Marc Circle - James Hardy Inspection of Plumbing—Rough
provided that the person accepting this permit shall in every respect Inspection of Plumbing—Finish
conform to the terms of the application on file in this office, and to the Gas Inspection
provisions of the Statutes and the Ordinances relating to the Construction, Inspection of Wiring—Rough
Maintenance and Inspection of Buildings in the City of Northampton.
Any violation of any of the terms above noted is an immediate revocation Inspection of Wiring—Finish
of this permit.Expires six months from date of issuance,if not started. Building Inspection—Rough
Note:A certificate of occupancy will be issued by this office upon return Insulation Inspection
of this card signed by the Plumbing,Wiring and Building Inspectors.
Building Inspection—Finish
Smoke Detectors(Fire Department)
Other
THIS CARD MUST BE DISPLAYED IN A CONSPICUOUS
P C 0 P ISES
Certificate of Occupancy
Building Inspector
� y ��
��
rt Up,N II ��
, . -. .; 3 �" J 'A
p �S.
y I ON
w
, ,
k ,� - k R
* _ > 1 O,'
A s
C j
mA* S 5 .
n t ' _ 7, "
a
„ a ,,- .z s sw fi T 3 „-
-T
� ,
4
y "7:# s. �, r. �. x
-+ `tea ''4z , ^�
xr t a '' ' `. ..�- X `s' 'E s X � S ' "n
'°"` ^" ,,.`a,` ..„'�... ,.rq "' s, .a? , r z
_
r F z' r rf'4M' ::.F h w ksy g d i-pt
t - o,XTOMM x z %
3; a ' # r z :
� Y
A: '{ Jaz 0. �?�� '
tf t ¢% Y 2 :'rra�� �
# t t �> �
..:f' ,, m
y :¢ - A -_
S Y< Y S t L k .v A >
a i a 1,5_'M - _ — a
,� ; --�, "�� - - _� ,71;"P,&�,:l-P,
[,� x t M1 {te a, i T v"�t ''€ 4 s. Spy, z'. r,
-"" 's ' mss. }� x„ i;t�` ` .F
# '.
A _ R _ 'T A=S' 1
, . -� Wo I'TT.5
s: fi �` " -.
:: - �,: :. "� t M
a ar 4v k -_
k< _.
" i
F q r#
i
rt
Y f �.
p t A who 5A ME A
? j §fy TOO
{. td". �' S �.
� P �11
4 2. ; � M ', $ fie' �+�""t,r .{ x'� �``cc
.j .:; p."I },NMI . 11
t y�, A s 3'
t k z :€ 7 '' i '-.t¢`.�€'� s � ?,�3 + r` cd :7*' t` -4 e" $" rc. 'wr ✓air`s�1 ,spa' �;11
a x 't -�r wu h� '•�. s s.TT
t fie' a. ,* s{ + 5-f s ''
' !=a'T r 'xc�j° d st vas ,,� ,ya ;~4 �`�.
a r,y.„,n *- �`a�d're' �', rr ,` s* '" '€r ,.`,�ss'�,"' � ,..�� a 's r'v�ss s p'
.* k s" ex �' - , `�, .a^d d +n»s.'}"' j s »�, k k r 'w--$ a.
-, -wo-t. `^`" �^ .,",Y.' a#' ' as t� �` krab' ' x, rr 'L ' ' ^: r - .- 2 `' { s 3$' ae.w�,': "r`3"n, .
Cd ., r Y' �.>. .?�
�..�
sY d r a. v" s ' ^,'sa ,'� as #.rFk "a``fir?' 1'*„,, x a r',
t $s g 'z k $ S Sri%
City Northampton of REQUIRED INSPECTIONS
Footings and Walls
BUILDING DEPARTMENT 2. Structural Components in Place*
3. Complete Building*
No. 1262 Office of the Building Inspector
Zoning Form No. 963193 Date 2/2/98 Fees40.00 Check#1540
Page, 12C Parcel 82 ,Zone URA/WSP Section 127 ❑ Yes El No
BUIULDING PERMIT
*Plumbing and Electrical Inspections required
THIS CERTIFIES THAT Denis Dugas Construction before Building Inspections
Construct bathroom in basement
has permission to Inspection on Site—Foundations
situated on 19 Marc Circle - James Hardy Inspection of Plumbing—Rough
provided that the person accepting this permit shall in every respect Inspection of Plumbing—Finish
conform to the terms of the application on file in this office,and to the Gas Inspection
provisions of the Statutes and the Ordinances relating to the Construction, Inspection of Wiring—Rough
Maintenance and Inspection of Buildings'in the City of Northampton. ,-
Any violation of any of the terms above noted is an immediate revocation Inspection of Wiring-Finish
of this permit.Expires six months from date of issuance,if not started. Building Inspection—Rough
Note:A certificate of occupancy will be issued by this office upon return a, Insulation Inspection
of this card signed by the Plumbing,Wiring and Building Inspectors.
Building Inspection—Finish
Smoke Detectors(Fire Department)
Other
THIS CARD MUST BE DISPLOED A CONSPICUOUS P ON P ISES
Certificate of Occupancy
Building Inspector