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Zoning
Miscellaneous Additions,Repairs,AlterationsaON - fTel.No. /y �i/� Alterations
4
NORTHAMPTON, MAS0 19� Additions
' APPLICA PERMIT TO ALTER Repair
oilGarage
1. Location gnl4� �g�9 Lot No.
2. Owner's name ` Address��v ` C
3. Builder's name Addray
Mass.Construction Supervisor's License No. C O w Expiration Date
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 E O k
14. Estimated cost:- o
The undersigned certifies that thZaboveptcmcnts are true to the best of his, her
knowledge tef.
Signature of responsible appucanl
Remarks
4K tiA�!p7,
�OCe
JUL 2 81,
qQ _
B }� ""r �r<saxchnsrtta
m - DEPARTMENT OF BUILDING INSPECTIONS
212 Main Street ' Municipal Building 'o
Northampton, Mass. 01060
WOMCER'S COMTENS TION I NSVx-xCE t �.vrr
(licens�/permiticc)
with a principal place of bU ness/residen at:
G�3G�
.10 _ (phooe". i
(st1�i/ci t}'/slat cJb p)
do hereby certify, under the pains and penalties of perjury, thal:
O I am an employer providing the following %worker's compensation cove age for my
employees worling on this)ob:
Once Cony) (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:
(Name of Contractor) Insurance Company/Pobcy Number) (Expiration Date)
(Name of Contractor) (Insurance CompanytPohcy Number) (Expiration Date)
(Name of Contractor) (Insurance Compaay/Poticy Number) (Expiration Date)
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(anach uklitioml db d if noo=ss Zy to io-i inforrai:ioo pertaining to all M't' ton)
I am a sole proprietor and have no one working for me.
( ) I am a-home owner performing all the work myself.
NOTE:Pleax be awue thid v&i-lo bomcowners wbo cm lay pa-row to do nza:rrtmla c c==uudioa-or rryair work oa a d—Lung of
not most than three units in which the bomoowacr r=des or ca the gvaod,appttrtcnsat tba,cto arc oot Pcacrn cowidcrcd to be
cmployt r3 ttndcx tbo-'O k --pcasitim Act(GL152-=1(5)),application by a bomcowncr for a tic case a permil may cvidcocc the
legal Fb Ui of as caployor tindertho Wocicoea CompooaAIi AcL
I undcrst and that a oopy of thin eutemcat may ba rotworded to tbo Dtpart co_ of lodu trial Aoadea&Of oa of laau.mo for tbn
oovan,*c vaificsiion acid that failmu,e to somm covcraso trader soctioa 25A of MOL 132 can tmd to tbd imposition of criminal pcaelbcs -
oomisaag of a fine bf uP to 51,50 0.00 nodlor of up to om year and civil pannier in the form of a Stop Work Order and a
firm oC5100.00 a day t&dnrst me.
Signed day 199,1 For dcpatMC0W—onl-f
Pcrmit Number
Mapa Lot#
Signa of Liccnse,JPct:m t=
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.
Thin colsmm 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 parking)
.of -Parking Spaces
of Loading Docks
Fill:
Vol-lime--& location)
13 . Certification: I hereby certify that the infor n contai ed rein
is true a acc rate to the best of my kno edg .
DA'L'E: APPLICANT's SIGNATU ,
NOTE: Iss anon } oning permit does not relieve an a oanYs burl n to oom wit ,,
P Phi hl,.$ll
zoning uira ants and obtain all required permits from the Board of Health, Conservation
Comma lion, apartment of Publio Works and other applionble permit granting authorities.
FILE #
A 2 81997
File No.
drat
ZONING PERMIT APPLICATION (§10 . 2)
PLEASE TYP OR PRINT ALL INFORMATION
1. Name of Applicant:
Address:
2. Owner of Property.
Address: 6 ptfi
3. Status of Applicant: Owner Contract Purchase Lessee
Other(explain):
4. Job Location:
Parcel Id: Zoning Map#?P Parcel# —114-1 District(s):
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/Property
6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary):
o �
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)
(n] Fa 1
FILE. # _ 6 ',)6n
d
,gyp„ 81997
MLICANT/CONTACT PERSON:
ADDRESS/PHONE: JO
PROPERTY LOCATION: G
MAP PARCEL: ZO
THIS SECTION FOR-OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
Fee Paid
BT TilffinZ Permit Filled njit
1/
c g c.,--
.
-Rerrindelin2 Interior i.
Addition to Exist n2 C�j_e__ Qd.Lfd4 2-
T�E�LLOWING ACTION HAS BEEN TAKEN ON THIS AP ICATION:
" Approved as presentedfbased 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 Health Well Water Potability-Bd Health
lPermit from Conse ' C n
/2-22 137
Signature of Building ffiAtor Vate
NOTE: Issuanoe of a zoning permit does not relieve en applioant's burden to oomply with all
zoning requirements and obtain all required permits from the Board of Health, Conservation
Commisalon, Department of Publio Works and other applioabie permit granting authorities.
A�°���' "•g Cit y Northampton TIof REQUIRED INSPECTIONS
1. Walls DEPARTMENT 2. Structural Components in Place*
3. Complete Building*
No. 717 Office of the Building Inspector
Zoning Form No. 962600 Date 7 29 97 Fee 20.00 Check# 5839
Page, 17D Parcel 44 ,Zone URB Section 127 ❑ Yes ❑ No
BUI]LDING PERTVHT
* Plumbing and Electrical Inspections required
THIS CERTIFIES THAT Robert Thibodo before Building Inspections
has permission to install vinyl siding on house & garage Inspection on Site—Foundations
situated on 62 Straw Ave — Sarah/Bonafacio Clay Inspection of Plumbing—Rough
provided that the person accepting this permit shall in every respect Inspection of Plumbing—Finish
conforni 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 PLACE ON THRPREMISES
Certificate of Occupancy
Building Inspector