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17B-026 (2) 2 v b �• m 3 ' OZ m > Z © N z<. 7 m QL CZ-4 L Zoning Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations NORTHAMPTON, MASS. c .1J lg Additions APPLICATION FOR PERMIT TO ALTER Repair ll _ y, Garage I. Location 35S k'i � /6 ��G�' /�/0— ,Loot No. 2. Owners name Sl-, JVz c±;&2 k Q fV Address S F� Sel�o- C!l-p. 0 3. Builder's name 3��% �°� r� Address )5i Roo) ` 11, 9111�7 � k1 a Mass.Construction Supervisor's License W.. 414" Expiration Date 6'1- )- 4. Addition 5. Alteration 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:- y00 The undersigned certifies that the above statements are true to the best of his knowledge and belief. Signature of r sponsible app,ieant Remarks 4Z1tAMP7'` � � �asshtcbnscfts ego Grit� ,f cNart4amptau ►t�ING►�ts� �;, EPARTMENT OF BUILDrNG INSPECTIONS t 212 Main Street ' Municipal Building ' Northampton, Mass.' 01060 ,. WORKER'S COIIPENSAITON INSURANCE AFFIDAVIT (licenstc/permittce) with a principal place of business/residence at: (phone#) ��'"y� ( 'ty/stalrJrip) do hereby certify, under the pains and penalties of perjury, that: (�am an employer providing the following worker's compensation coverage for my employees working on this job: c% ��J gnsuuance Company) (Policy Number) (Expiration Dam) ( ) 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) (Expim6on Date) (Name of Contractor) (Insurance Compauy/Policy Number) (Expiration Date) (Name of Contractor) (Insurance Company/Policy Number) (Expiration Date) (attach additional shoot irnocenary to include infwmitioa patainiag to all 000tra ors) ( ) I ant a sole proprietor and have no one working for me. ( ) I am a home owner performing all the work myself. NOTE:plate be aware that t+Wo homro%%ven wbo employ pcnons to do-- ore coostructimor rcpair work on a d-Wing of not more than throe units in which the bomo ,ncr rcudes cc on the grouahs zpptuunwA thactn acs oa gcaa ally coosidcred to be employers under the wockees oom9cmation Act(GL152,ss1(5)),application by a homeovr=for a Gccox or parnit may evidcow the legal status*fan employer under the Woclroes Compemation Act I unde stied that a copy of lhia ttatcmcat may be focwandsd to the Depeataacma of Industrial Aoddmtr Office of Iaxuaaoe for tbs cover tp verification sad that failure to secure covaaga under soctioa 25A of MOL 132 an lead to tbd ia>pos—of-imioal Pwaitia coolutntg of a fine bf up to SI'S00.00 and/or i gW600mcat of tip to ore year and Civil pmaltia in the form of a Stop Wodt Order sad a :1 fitio of 5100.00 a day sgainA mtr For iqpatiAm use ooh! PGim11 N11m1XS y signature 0rU SC&-P F 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 column 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: (Lotarea minus bldg &paired parking% # of -Parking Spaces f of Loading Docks Fill: (vol-ume-& location) 13 . Certification: I hereby certify that the information contained herein is true and accurate to the best of my knowledge. DATE: ^ APPLICANT's SIGNATURE NOTE: Issu e o® f a zoning permit dos not relieve an applicant's burden to comp witf��$11 zoning requtrBments and obtain all required permits from the Board of Health, Con rvation Commission, Department of Publio Works and other applioable permit granting authorities. FILE # — ~ �'�L' SEP 2 SW �~l Fi 1e No' � «� (§10 . 2) � ====~� �= � =�==��==, PLEASE TYPE OR PR= ALL 1WFORMATXON 1. N a rn e o KAp Address: ' &ephone 2. Owner of Property: 3. Status mfApplicant: Owner ontract Purchaser Lessee Other(explain): 4. Job Location: Parcel Id: Zoning Map# Parcel District(s): (TO BE FILLED (NBY THE BUILDING DEPARTMENT) �-- 5. Existing Use ofStructure/Property G. Description nf Proposed Uso/VVork[,rojecb{}ooupobon: (Use additional sheets ifnecessary): 7. Attached Plans: Sketch Plan -Site Plan nginaenad/Gun/eyedP|ans Answers to the following 2 questions may be obtained by checking with the Building Dept or Planning Department Files. O. Has a Special Perm dyVehanom/Finding ever been issued for/on the site? NO DON'TKND YES IF YES,date issued: rFYES: Was the permit recorded et the Registry ofDeeds? NO DON'T KNOW YE IF YES: enter Boo Page and/or Dooumnant A' Does the site contain a brook, body of water orwetlands? NO DON'T KNOW YE IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs tobeobtnine Obtained— .date issued: (FORM CONTINUES QN OTHER SIDE) 385 BRIDGE RD BP-2000-0232 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 17B-026 CITY OF NORTHAMPTON Lot:-001 ` Permit:- Buildina Category:vinyl siding BUILDING PERMIT Permit# BP-2000-0232 Project# JS-2000-0371 Est.Cost:$4000.00 Fee: $25.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: B & R Siding 100465 Lot Size(sa ft.): 11238.48 Owner: STANDER STEVE P&PATRICIA POW Zoning:URA APP licant, B & R dina Si AL-33a3RIQ-QEM Applicant Address: Phone: Insurance: 781 Bridge Rd (413) 586-4167 Workers Compensation NORTHAMPTON 01062 ISSUED ON.91211999 0:00:00 ` TO PERFORM THE FOLLOWING WORK.-INSTALL VINYL SIDING 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 9/2/1999 0:00:00 $25.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Building Commissioner-Anthony Patillo