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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations
1 NORTHAMPTON, MASS. /l' 7 19 Additions
' APPLICATION FOR PERMIT TO ALTER Repair
Garage
'-'
1. Location ���'��:�c,i. �Y-l_� Lot No.
2. Owner's name ti/'=1 �'►� rs�t`' ��rh Address ` t t'I ►^+i�t�t. 1�"�
3. Builder's name 1JCi�-ti,_'i `�:.�� _ Address ;:6xNe-t. I I
Mass.Construction Supervisor's License No. (? gS-C1 Expiration Date 7/9
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- 13do
The undersigned certifies that the above statements are true to the best of his, her
knowledge d belief.
nn ,
Sig&Wure of responsible appicant
Remarks Ns)ri rt,�.� � C.ytr�-,F`i -+3�^� no-F. . ,57jral/ Mtic- -4-,
o�txn�r
a � Crz of Wortljampton
B F 2 2 %7
DEPARTMENT OF BUILDDIG INSPECTIONS
212 Main Street ' Municipal Building '
Northampton, Mass. 01060 '+
WORMER'S COMPENSATION INSURANCE Al AVIT
1)Qu01 AJ� X1
(li�ns�/permi ttrc)
with a principal place of business/residence at:
9z ��c�-e2 tad (phone") S'T,�i-4't�7
(stTr.."I/ci t)/stairiz�p)
do hereby certily, under the pains and penalties of perjury, th?i:
O I am an employer providing the following %vor'r_er's compensation cove age for my
emptoyces worming on this job:
(Insurance Company) (Policy 1,1umber) (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) [QImuran>x Company/Policy Number) (Expimtion Date)
(game of Contractor) (Insurance CompauyiPotuy Number) (Expiration Date)
(Name of Connector) (Lnswrancz- Company/Policy Namlxr) (Expiration Date)
(Name of Contractor) (Insuiancz- Compauy/Policy Number) (Expimdon Date)
(enxh-kVr ioml rhoet ifnoocs.ery to i ch>de informsaoo pertzimng w nll ocdrrdon)
( 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 awlrc thri wi ri)o bomcown-m wbo employ parsons to do mmij=ancr,coamue oo"or rrysir work on a duelling of
act most than throo twits in wbiefr the homoowu,r resido oc co the gouts xpprutcatnt tbarto arc cot gcacrvlly oomidcred to be
cmptoym under tbo%Ycpr `s o=p=sttim Act(GL152ss 1(5)�appdmDoo by a bomoow mr for a loom=cc permil may evidence the
lcitl rt-t- of an employer uodcr rho Woe .compoosaiioa Act'
I uodaitaud dx4 a copy of thu carcm<at may bo forwarded to the Dcp rtmmt oflndu,,!riJ Acodmrl ofsoo of tea unnoc for rho
coverage verificidoo and that failurr to soasrc eovaabro under soctioa 23A of MoL 152 can lad to tbd impoaibon of airmail pataltics
oom i.sting of a fioe bf up to S 1X00.00 andlor imprioomerst of up w orx year and civil pcsnttia in ibe form of a Stop Wort order and a
find 0(5100.00 a day tgdnst tzx
Signed this �-2- day of 199 7 For dcpatmadst u,o oaty
Permit Number
tvfap-4 Lot Ii
Signer of Li camittcc
10. Do any signs exist on the property? YES NO `.t.
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 cols to be filled in
by the Building Department
Required
Existing Proposed By Zoning
Lot size
Frontage
Setbacks
- side L: R: L: R:
- rear
Building height
Bldg Square footage
%Open Space:
(Lot area minus bldg
' &paved parking)
# .of Parking spaces
f rof Loading Docks
Fill:
4 vol-time-& location)
13 . Certification: I hereby certify that the information contained herein
is true and accurate to the best of my knowledge.
DATE: -22-q APPLICANT's SIGNATURE
NOTE: Issuance of a zoning
g permit does not relieve an applioanYs bu n to comply witl�,.$ll
zoning requirements and obtain all required permits from the Board Health, Conservation
Commisaion, Department of Publio Works and other applicable permit granting authorities.
FILE #
JUI. 2 2199
µ
File No.-
ZONING PERMIT APPLICATION (§10 . 2)
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant: D co-tid �J,,A'L
Address: ";Z) G 4ZIctf�c e. ad Telephone: is(-/— &Ct 7 7/A6
2. Owner of Property: Dhd'3 L' S.
Address: 1 gil-CA4 t I10 g C4 Telephone:
3. Status of Applicant: Owner Contract Purchaser Lessee
Other([explain)):
—1
4. Job Location: r -I gr'osL ryc;U
Parcel Id: Zoning Map# /76 Parcel# District(s):
(TO BE FILLED IN BY THE UILDING DEPARTMENT)
5. Existing Use of Structure/Property !'
6. Description of Proposed UseNllork/Project/Occupabon: (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 Files.
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 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 = 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 # 9G25- 72--763
' °
� jUL 2 21997
. a-.. APPLICANT/CONTACT PERSON:
ADD SSIYItONE: 6-0 61
er+,r.w.uN. P
PROPERTY LOCATION: / n
MAP 117B PARCEL: I/ ZONE
THIS SECTION FOR.OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM M,T,FD 0111
Fee pnid
lRi6lding Permit Filled nllt,:� Sic
Fee Paid O
New Cnnstrnrtinn
Addition to Existing
n ,sue
TI HI
DLLOWING ACTION HAS BEEN TAKEN ON TS 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:§ 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-Bd of Heal Well Water Potability-Bd Health
it f C se Sion
Z
Signature of Building Inspector 16ate
NOTE:lssuanoa of a zoning permit does not relieve an applicant's burden to comply with all
zoning requirements and obtain all required permits from the Board of Health, Conservation
Commission, Department of Public Works and other applicable permit granting muthoritles.
?��� �~
City of Northampton REQUIRED INSPECTIONS
�
BUILDING DEPARTMENT 1. Footings and Walls
2. Structural Components in Place
3. Complete Building*
No. 703 Office of the Building Inspector
Zoning Form No. 962572 Date 7/29/97 Fee$20.00 Check# 1092
Page, 17B Parcel 16 ,zone URB Section 127 ❑ Yes ® No
BUI]LDINGPERMIT
* Plumbing and Electrical Inspections required
THIS CERTIFIES THAT David Nunez before Building Inspections
has permission to shingle roof over existing roof Inspection on Site—Foundations
situated on 419 Bridge Rd — Jagdish Singh Inspection of Plumbing—Rough
provided that the person accepting this pemut 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
** Install per Manufacturer's information: windows, vinyl siding,roofs Smoke Detectors(Fire Department)
and woodstoves
Other
THIS CARD MUST BE DISPLAYED IN A CONSPICUOUS MISES
Certificate of Occupancy
Building Inspector