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RE: 96 N. MNtLE sL� ;ioRLNCE - HAL1.
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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. _ Alterations
NORTHAMPTON, MASS. o 1, ! Additions
APPLICATION FOR PERMIT TO ALTER Repair
Garage
1. Location , ^ Lot No.
2. Owner's name PHI * nT,1pjF �'tT' LI- Address ,� p �r�
3. Builder's name Ey (fit- Vf—=R- Address �'�"4 IL-1, j `71 ,, F1'
Mass.Construction Supervisor's License No. Expiration Date govt
4, Addition
5 Alteration"z L`� 'ry U�Ijc>gy g arAb'>61--
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� '��i4 �
11. Distance to lot lines
12. Type of roof
13. Siding house
14. Estimated cost 4,000
w The undersigned certifies that the above statements true to the best of his, her
knowledge and belief.
fll"—/ �
$ignaiure of responsible 6p,icani
Remarks
s D ti
s JUN 1 g 2000 ' Asssrtchuselts
G -
JR ENT OF BUILDING INSPECTIONS
RERI Or Bs;,� sir err rtT1+1NS
,$1n Str eet a Municipal Building '
Northampton, Mass.' 01060
WORKER'S COAITENSATTON INSURANCE AFFIDAVIT
with a principal place of business/resi''deuce at:
!�(1 00 hone#) bi 6
(sur:W 'ty/staldap)
do hereby certify, under the pains and penalties of perjury, 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:
PM
(Name of Contractor) cc Company/PoLicy Number) (Expiration Date)
NT-v :3
(Name of Contractor) (lnsuranov Company/Policy Number) (Expiration Due)
(Name of Contractor) (lnsuranct— Compauy/Policy Number) (Ea-piradon Date)
(Name of Contractor) (Insurance Company/Policy Numb,-r) (Expiration Date)
(attacb additional sit ifnooass.ry w include inrormsfioa pertaiaing wall o.Cdra o)
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 awue that wbilo bomco%m,=,%bo employ person:to do w:.,t—� const tctioa'or repair work on a dwelling of
not mote tbsa throe unit in which the bomoowocr ruidca or oa tb,o grounds apptutcnant tbacw an oa gaocrany ooasidcrcd to be
employas under the woemes poop ssdion Act(GL152,ss 1(5)).appticatioa by a homcow-oir fora Sornse ee permit may cvi�the
legal status of as employer uoder the Workces Compoonation Art
I uadcrdaad that a oopy of tbu critcmmi may be forwarded to tbo Dcpartmms of Industrial Alf Ofoe of Iu3ua-anos far tb-
oovaage verification and that Uwe to secure coverage under section 25A of MOL 151 can lad to tbd impozitioe of aimiaal pmaltia
coausti g of a-fine brup to 11'$5 0.00 and/or kVrisoomcat of tip to one yw and civil pcoaltia is the farm of a Stop Wodc order sod a
find of 5100.00 s dry against Mt
For dcpatiz-s vn mil!
Mte
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M y
10. Do any signs ebst 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 —1u to be filled in
by the Bailding Department
Required
Existing Proposed By Zoning
Lot size �
610o
Frontage `75
Setbacks
- side L: R: L:
- rear
Building height 36
Bldg Square footage WOO
%Open Space:
Lot area minus bldg �� / 0
&paved parkingi
# of -Parking Spaces 4-
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 knowled
DATE: G`--I I APPLICANT's SIGNATURE
NOTE: lssunnoe of a zoning permit does not relieve an app n 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 applionble permit granting authorities.
FILE #
JUN 2000 File No �
DEPT OF81,11 I°r ; PERMIT APPLICATION (§10 . 2)
-- ° - -- PASS TYPE OR PRINT JUL INFORMATION
1. Name of Applicant: El?o cons 111 r.'��EL]
Address:�� unw Telephoner
2. Owner of Property:__- � ^J `lam t�ls/
Address:��l 9 vt J i F n Telephone:
3. Status of Applicant: Owner Contract Purchaser essee
Other(explain):
4. Job Location:
Parcel Id: Zoning Map# Parcel# District(s):
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/Property glaa I pi—P�
6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary):
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 Fifes.
8. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO DON'T KNOW > YES IF YES,date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO_ N'T KNOW " YES
IF YES: enter Book Page and/or Document#
9. Does the site contain a brook, body of water or wetlan . � 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)
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File#BP-2000-1155
APPLICANT/CONTACT PERSON Edwin Olander
ADDRESS/PHONE 44 Willow St (413)584-6364
PROPERTY LOCATION 86 NORTH MAPLE ST
MAP 17C PARCEL 027 ZONE URB
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out
Fee Paid
Typeof Construction: REMODEL KITCHEN BATH&LAUNDRY
New Construction
Non Structural interior renovations
Addition to Existin¢
Accessory Structure
Buildin Plans Included• --
Owner/Statement or License 049348
3 sets of Plans/Plot Plan
7 TH OLLOWING 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:
Curb Cut from DPW Water Availability Sewer Availability
Septic Approval Board of Health Well Water Potability Board of Health
Permit from Conservation Co ion Permit from CB Archite1con'i
mittee
Signat ure of Building Official Da e
Note: Issuance of a Zoning permit does not relieve a applicant's burden to comply with all zoning
requirements and obtain all required permits from Board of Health,Conservation Commission,Department
of public works and other applicable permit granting authorities.
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86 NORTH MAPLE ST BP-2000-1155
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 17C 027 CITY OF NORTHATMPTON
Lot:-001
Permit: Building
Catep, :Non structtral interior renovations BUIL"ID"ING PERMIT
Permit# BP-2000-1155
Project# JS-2000-2038
Est.Cost:
Fee:$200.00 PERMISSIONI,S HEREBY GRANTED TO
Const.Class: Contractor: License:
Use Group: Edwin Olander 049348
Lot Size(sq.ff.): 9888.12 QWner. HALL PHILIP S&JANE P
Zoning:URB AWficant. Edwin Olander
AT: 86 NORTH MAPLE ST
Ayplicant Address: Phone: Insurance:
44 Willow St (413) 584-6364
FLORENCEMA01062 ISSUED ON.•6128100 0:00:00
TO PERFORM THE FOLLOWING WORK.REMODEL KITCHEN, BATH & LAUNDRY
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: DK q12 Pa 90!9 Rough:�'.2S,P� House# Foundation:. -
Final: d gf511V*'6 Final: l �
Rough Frame:,/7/<' V
Gas ly Q Fire Department Fireplace/Chimney:
.W`
Rough: Oil: Insulation:
Final: Smoke: Final: LP)-(,
THIS PERMIT MAY BE REVOKED BY THE CITY 'ORTIL41MP ON UPO "L ATION F
ANY OF ITS RULES AND REGULATIONS.
Certificate of Occu anc signature:
Fee Ty»e• Receipt No: Date Paid: Check No: 'Amount:
Building 6/28/00 0:00:00 1460 $200.00 f
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Building Commissioner-Anthony Patillo