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12C-067 (5) .> o �_ ; 0 Ln > > VO 1 r D I � '7 Zoning Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. �` <° Alterations NORTHAMPTON, MASS. i 19 " Additions APPLICa ATION FOR PERMIT TO ALTER Repair 2 / Garage 1. Location c� ro �� f r `-e n( e- ' iW Lot No. 2. Owner's name t�G r fr',�, -1 0►'-) Address c�� �-f G�/G 1 �� F C ,�,) 3. Builder's nam ��`�( I]_��3 ,���C • Address Mass.Construction Supervisor's License No. Expiration Date 0 4. Addition 5. Alteration Pe o (P men' � ) v'� 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 statcments are we t is, her knowled a and belief. signatur o responsible app ican( Remarks 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 ccluam to be filled in by the Building Department 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 &paved parki_ngi # 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: / O APPLICANT's SIGNATU NOTE: Issuano@ of a zoning permit does not relieve n plioant's burd n to o4Vnpty w .� zoning requirements and obtain all required permits from the Board of Health. Conse tatiof n Commission. Department of Publio Works and other appiloabla permit granting authorit s. FILE # NOV 17 x�. File No.. t fiING PERMIT APPLICATION (§10 . 2 PLEASE TYPE OR PRINT ALL INFORMATION 1. Name of Applica 2�� �� CJ cc), Address: 1 l-/ - 1�� � Telephone: � �� �YY1 G� 2. Owner of Property: c Address: Gam'O � � Telephone: 3. Status of Applicant: Owner Contract Purchaser Lessee Other(explain):_�Ci��IYG 4. Job Location: Parcel Id: Zoning Map# Parcel#_ o62 District(s):�,(L� (T BE E FILLED IN BY THE BUILDING DEP RTMENT) 5, Existing Us e of Structure/Pro e rQc=-'s)ty de-k--�h- D 6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary): Incer-,ie r-4- d o c-4--,3 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 KNO:^:_,L,,,-- 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___,_ OON'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) Reference No: BP-1999-0530 Department: .......... ........................ Building, Electrical & Mechanical Permits ......................................................................................... Fee Type: Receipt No: replacement windows 1tEC-1999-001448 ......................................................................................... Paid By: Pa.id.'i'n'Full­0'n............. Larry .Tubb Tue Nov 24,1998 ..•........••...•.•............•.....•.... .............................................. .. • .•.•.. ..... Received By- Check. . .No ................... Linda Lapointe 3121 ....................................................................... ...•.....•..•.... ................•...•.•.. •...••.•.... DEPARTMENT'S COPY Amount: $20.00 --------------------------- DEPAR71'MENTFILE COPY 23 HAROLD ST 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: Trackiny,No.: Fee: 24 Nov, 1998 BP-1999-0530 $20.00 GIS 4: Map Block: Lot: Address: Zoning: Use Group: Lot Size: 856 O1 23 HAROLD ST URA 10193.04 Contractor: License Type: Insurance: Larry Jubb HIC Workers Compensation Address: License No.: Insurance No.: P 0 Box 429 10001 246Y5352UB Liy_i State: Zip Code: Phone: GREENFIELD MA 01302 Proiect No: Category of Work: Const. Class: Cost Estimate: JS-1999-0790 windows replaced $2,500.00 Description of Work: INSTALL REPLACEMENT WINDOWS GeoTMS(D 1997 Des Lauriers&Associates, Inc. Signature: