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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations
NORTHAMPTON, MASS. U►'t 19 Additions
APPLICATION FOR PERMIT TO ALTER Repair
f C Garage
1. Location 13 O&V t, B o Irk-Vt C 19-- Lot No.
2. Owner's name c; O W 4 Address 1-3 00-L St. Env re-vlC e-
3. Builder's name maa&w 16- a Address 2-q0 i2 �Vf k- DIE, - 464(f y
Mass.Construction Supervisor's License No. O! U'7 8-2 Expiration Date 31 t Y / 2-00
4. Addition
1
5. Alteration Dals4e ZX �I -tU 4kev I'VX ��aY 1►�4 Wd 5 1JrJr�i nq tc�o� cin�ct Q�OOVe- . �J-o1
6. New Porch
7. Is existing building to be demolished? N o
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:- ( I O
tom"L [ 0 .0 The undersigned certifies that the above statements are we to the best of his, her
knowledge and belief.
Signature of responsible app,icant
Remarks
EMENNOW
04`-tjiA?fP�O
a Cr )afantfan.
JUN ( 7 I x�sxctitnsctte
�
DEPARTMENT OP BUILDrNO INSPECTIONS
212 Maiu Street ' Municipal Building
Northamptoo, Mass. 01060
WORICER'S COMPENSAUON TN UIZA..NCI; AT+FEDAVIT
-
(li censcrJpermi i�cc)
s,rith a principal plat of busu�es�Jresidenee at:
2.qo
(s city/staLJzaP)
do hereby cerffy, under the wins and p,eaalties Of perjz!ry, 111,1 _
( ) I am an employer providin« tl!e follo� n� ;or'.:cr�s c:�rnnens�uon coverage nor my
employe wor�-mng on thi.,job:
(Insu (PoLcf Numlc--r) (�tipil2r�oa Date)
O I am a sole proprietor genera contractor or homeonr-Ier (circle one) znci have hired
the contractors listed below whO have he fo OWIDg compensation policies:
— --------------
CL`:1IDC Oi �,Oil[i;'.l:iQO �I115Ui1C�: Lo111Oa! j/—PO t1Cj NGG1C•::i) ci'�7L'aC:OR
(�1II1C Or C OUtt ,i0r) (111SZ t il]C CO III pal y/-Po1iCy Nkn-ii cr) ApLr<;0(1 Date)
(Name of Conmctor) ([nst!ra?nc� Compam-l'olicy Nualty_r) (EmLr-crnoo Date)
(Name of Conti (In_surance CompaaayflloGcy NumlKj) Dae)
(-tudt zC�iticci!:�_<t u�rcx_.:y to:x}ud:infcrraiti«i tr.--t,�:ir.�to.Ll ctYGr�or3)
XZ am a sole proprietor and have no one wort ng for 1ne.
( ) I a-m a home O�Vncr performing all tale work myself.
NOTE please be a{rx t dui wlrilo Lb_cm—�_-i�v�c�r�� vbo employ perzom to du m e=:' etioo:or rcpa wok on d,-AUog of
not mc"than tbrb lma w trhici the h, lC ><+L>�redo a m tbo�uuo i�:pp,�tbazso uc oot Ecn,.1jy eowAcred W lx
cmPtoyrrs under thb wotkcl+ x oo ,him Ad(G L152,=I(5)�npplicxtioa by a 6omcovrncr far a 60=c cc perma may cvidm c the
ke etahit of an aMptoyec under tho Woctce(s Conxpcoo.iiou Ad
I—Icsri cl tivd a oopy of tali.catcmc.�tu.y bo fot-vrardod to t1w DW i,,xat of Io6utrie1 Aeodcarl plfioo of lawn000 fa tam
covcrtgcti&caSioa and that Cssltur to c«urc oo�crn�o tmcicr zazion 1S it oL MdL I52 aai lc+d to tba'impoirtioa of aitnmit pca+taca :,
O° of x�c uCup to 5100.00 emd/or imprisoavaccd oCup to.00t year eod viva pm=2tia iu the ftxxa of a'Stop Woik0cdcr.ind a
fi>m of S IQ0:00'a 4
. For dcputmcOb-t
wo
opty . .-
&=t:HtuIIbCY
�..:i
St SCC7k?crm-1.
n'..rA1 a....a.
13 Oak ' f, — F(c re nce__
JUN 1 7 '998
o�+tv�edl u�
�et V-0 d-vv.,
�Jo�b�� Z��o'�' he�d�•ecr—
�cacx�Y� o�eri n�
q -0 61- less --- OK 3G 06
J
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 y
IF YES,describe size,type and location:
11. ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE DENIED DUE TO
LACK OF INFORMATION.
This colm= to be filled is
by the Building Departmsat;
Required
Existing Proposed By Zoning
Lot size
Frontage �- l ��CW-
Setbacks
- side L: R: L: R:
- rear
Building height
Bldg Square footage
%Open Space:
(Lot area minus bldg
&paired parking)
# of -Parking spaces
f %f Loading Docks
Fill:
(vol-ilme--& location)
13 . Certification: I hereby certify that the information contained herein
is true and accurate to the best of my knowledge.
DATE: ���,1 l �� APPLICANT's SIGNATURE
NOTE: issuanoe of a zoning permit does not relieve an aPPlitranta burden to oomph/ 110W,A it-
zoning requirements and obtain all required permits from the Board of Health, Conservation
Commission, Department of Publio Works and other applionble permit granting authority:
FILE #
JUN I i 998
Fi 1 e No. �(L%/
C'
ZQNING PERMIT APPLICATION (§10 . 2)
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant: ]j0aoj-ec
Address: 2 qc) v e_r �4Cx&(V-c Telephone:__
2. Owner of Property: &lrey\ �IL)r?
Address: V3 nok (S+.— i- oy-enLCt Telephone: c67 5-0 2.3 '
3. Status of Applicant: Owner Contract Purchaser Lessee
—%60ther(explain): (fGv1tmc±O y-
4. Job Location: 13 Parcel Id:Id: Zoning Map# `(_ Parcel# 2 District(s):
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/Property
6. Description,of Proposed,Use/Work/Project/OcFup lion: (Use additional sheets if nece ary):
Qpe-n �e up bec.�('c`y>c, i.�l � ge�e�r C'X�St ivlq Secoy�cQ �{oo,r- �,4(rooy✓�
dLyj- >nreyivu5��t co - �Jors✓k (oi'� Q 0-- less w04 k o}x Vtt�Vtq r
%"Douye Z�(O ��ec�ck - �oe� orn�ct cL�JC�Vt
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 KNOWS 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 DDocument#
9. Does the site contain a brook, body of water or wetlands? NO t/ 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 # 963630 7;�
APPLICANT/CONTAC PERSON:
:1DRESS/PHONE•
PROPERTY LOCATION:
MAP PARCEL: ,o°( ZONE r---�
THIS SECTION FOR-OFFICIAL USE ONLY:
PERMIT APPLICATION_CHECKLIST
ENCLOSED REQUIRED DATE
7,ONTNG FORM FILLED OITT
Fee pnifi
Biiildin2 Permit Filled 011t
Fee pa i fi
Type nf Cnmqtntrtinn- 17
'New Cnnstriirtinn / 7
C'
THE LLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION'
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:
x ' 94S�tx?>pPW� t�:t - Water Availability Sewer Availability
Sep#ic Approval-Bd of Health Well Water Potability-Bd Health
t
it C,gwe n�Ce on
Signature of Building Inspector Da e
NOTE:issuanoe of at zoning permit does not relieve an applioant's burden to oemply with all
zoning requirements and obtain ail required permits from the Board of Health, Conservation
Commission, Department of Publio Works and other applionble permit granting authorities.
r
REQUIRED INSPECTIONS
1 10
A ,
UMrN 1. Footings and Walls
2. Structural Components in Place*
3. Complete Building*
No. 1723 Ol ice ofth,3 3uilding Inspect®r
Zoning Form No. 963690 Date 6/19/98 Fee $40.00 Check# 6857
Page, 17C Parcel 10 Zone URB Section 127 ❑ Yes 0 No
MIT
k T-T
------ 14 R
* Plumbing and Electrical Inspections required-
THIS CERTIFIES TEAT—Matz-hew Rasanen before Building Inspections
has permission to open bearing gall & install dou�-.1_._ 2' x 10 header Inspection on Site—Foundations
situated on 13 Oal. St - Karen Rode Inspection of Plumbing—Rough
provided that the person accepting this pemlit 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. p
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 ofissuance,if not started. Building Inspection—Rough Ge' 6--,2 Ye S' "k-
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
** Install per Manufacturer's information: windows, vinyl siding,roofs Smoke Detectors(Fire Department)
and woodstoves
} Other
THIS CARD MUST ICE DISPLin SEC I N A CONSPICUOUS C T ISES
Certificate of Occupancy
Building Inspector