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17C-095 (2) !� O D p Z rn ..., .�. M Z Z v m I � Zoning Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. J 15d_c)- Alterations K NORTHAMPTON, MASS.)J 3 1912 Additions ' APPLICATION FOR PERMIT TO ALTER Repair Garage I. Location_ 131r ( 1'1.tt4 `.e o Lot No. 2. Owner's name AV, Address 3. Builder's name i'. M U ( Address i��L� 4,Stj� Mass.Construction Supervisor's icense No. L9 Expiration Date 9 4. Addition 5. Alteration yna ;— Pe aelN t`/t%dL K au c' =/r,�' d /d Jl} 6. New Porch L7A L' 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 cosL- The undersigned certifies that the above statements are true to the best of his, her knowledge and belief. �r Signature of responsible appicant Remarks oQ-(1tAMPTO �y ) -`-' a �? OC1 � t �aesncFtnscila S DEPARTMENT OF BUILDrNG INSPECTIONS 212 Main Street ' Municipal :Building 'a Northampton, .Mass. 01060 ,~ WORKEW S, COMPENSATION INSURANCE AFFIDAVIT I, Nelson A. Shifflett / valley Home Improvements Inc. (llcen-ue/Permltiec} with a principal place of business/residence at 320 Riverside Drive Northampton, MA 01.060 __(phone#) (413) 584-7522 (strcet/city/state/ip) do hereby certify, under the pains and penalties of penury, that: M I am an employer providing the following worker's compensation coverage for my employees working on this job: Eastern Casualty Ins. Co. WC9660047 2/1/98 (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 workers compensation policies: (Name of Contractor) (Insurance Company/Policy Numbcr) (Expiration Date) (Name of Contractor) (Insurance Comparry/Policy Number) (Expiration Date) (Name of Contractor) (Insurance Conlpauy/Policy Number) (Expiration Date) (Name of Contractor) (Insurance Company/Policy Dumber) (Expiration Date) (artsch additioaal sheet if neoensry to include iafbnnshou pertaining to ell ooa4adon) ( ) 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 awam that vdaBo homeowners who cmplcy persons to do mamtn+snce comtrucdon or repair work on a dwelling of not more than throe units is which tha homeowner resides or on the grounds apVadanaat thereto are not genersay oomidcred to be employers under the workeez oopcasatim Act(GL152 ss 1(5)},awtication by a homeowner for a 60a90 cc permit may evidence the legal status of an employer under the Workees Compemdion Act I understand that a oopy of this s>slemeni may be forwarded to tho Deputmcoa of Industrial Ao6de&Offioo of rnaauanoo for the coverage vaification and that failure to aaure coverago under soct:ioa 2 5 A of MGL 132 can lad to the iarposition of Criminal penalties oomisting of a Sex of up to S 1,300.00 anNor impr6onmcra of up to one year and civil pensltia in the form of it Stop Work Order and a fum of 5100.00 a day apAinst me Signed this day of 199 For depatmeaw use only /J Permit Number f Map# Lot# Signahue of Li ermi 0 0 V \ �-- GFI BAT H 6'3 x 7'4 STORAGE 9'4 x 117 BEDROOM 13'2 x 10'4 /3 // N C P- BEDROOM 1 2'7 x 10'5 7 C ®Valley Home Improvement, Inc. 1997 '`O (07 "�� 'r/00/2 Not Not to be duplicated or used for any purpose without (� written permission of Valley Home Improvement,Inc, fu\ 320 Rivers'Ide Or.P.O.Box 60627 NorftmptoN MA 0101 Tel:413-584-7522 Fax:413.585-0820 IL I ' UP LIVING AREA 644 sq ft m Valley Home improvement, Inc. 1997 Not to be duplicated or used for any purpose vrithout written permission of Valley Home Improvement,Inc. 320 Riverside Dr.P.O.Box 60627 Northampton,MA 010W Tai:413-584-7522 Fax:413-585-0820 0 0 BATH > GFI 6'3 x 7'4 STORAGE3� 9'4 x 117 -J BEDROOM IV 13'2 x 10'4 \ i3 \ N P BEDROOM 127 x 10'5 *Valley Home Improvement, Inc. 1997 Not to be duplicated or used for any purpose without written permission of Valley Home Improvement,Inc. 320 Riverside Dr.P.O.Box 60627 Noftmproo,MA 0100 Tel:413-564-7522 Fex:413%%S-D820 t OCT 71997 XI I a i i UP 1grorr a r-lDolt L X 1 s7-i1uG (dejDi )-W5 LIVING AREA 644 sq ft ®Valley Home Improvement,Inc. 1997 Not to be duplicated or used for any purpose vrittwut written permission of Valley Home Improvement,Ina 320 Riverside Dr.P.O.Box 60627 Northampton,AAA 010W Tel:413-584-7522 Fax:413-585-0820 10. Do any signs ebst on the property? YES NO l/ 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: 21. ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE DENIED DUE TO LACK OF INFORMATION. xhas cow to be hued 1II by the Pn,`+s+>; D&partmeat Required . Existing Proposed By Zoning Lot size Frontage Setbacks - side L: R: - rear Building height p� Bldg Square footage 11�� %Open Space: (Lot area minus bldg &paved parking) # ,pf -Parking Spaces of Loading Docks Fill: 4 vol-ume--& location) 'r 13 . Certification: I hereby' certify that the information contained herein _ is true and accurate to the best of my knowledge Ga. DME.Vt9—�� �, APPLICANT's SIGNATURE ' r{Q NOTE: Isauanoe of in zoning permit does not relieve an mppiioant' burden to oomply with all zoning requirementa and obtain all required permits from the Board of Health, Conservation Commission, Department of Publio Works andr other appiiooble permit granting authorities. Oil" FILE � i�EPI vE'oUi';Cikl`iG 1tfis�itiS fvORit1F, 9r!`tfN ?A OIub� Fi I e No�&26f;o ZONING PERMIT APPLIGATTON (§10 . 2) PLEASE TYPE OR PRINT ALL INFORMATION 1. Name of Applicant: aAihj Ar',A�, Address: 3-4) /c P' G'dd Telephone: 2. Owner of Property: rda�4�V k 6 L'3� Address: 7 11,1, Telephone: 3. Status of Applicant: Owner /� Contract Purchaser Lessee .Other(explain): J616 1'ej y 4. Job Location: )3 I lam.( ruysw1 4- Parcel Id: Zoning Map# / 7 C7- Parcel# District(s):�/li� (TO BE FILLED IN BY THE BUILDING DEPARTMENT) 5. Existing Use of Structure/Property Ci�� All 6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary): ?5Y /i"MG� lCG Ca;,a 7�i'G yiL1, eXI`�� tj C r�`�r� �Ocl,' 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 PermitNadance/Finding ever been issued for/on the site? { NO — d 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 if 1 OCT APPLICANT/COI ITACT PERSON: e°-A �,? C� t7E.FT uF /P +� j e3 0� %AAw PROPERTY LOCATION: A36 CAwti MP PARCEL: ZONE THIS SECTION FOR-OFFICIAL USE ONLY: PERNITT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE Rnilding Permit Filled mit Fee Pnid Additinn to Existing ',0 . Cad T OLLOWING ACTION HAS BEEN TAKEN ON THIS 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 Health Well Water Potability-Bd Health Pe it from C� at' Co 6 Ole'' Signature of Building Wector Date NOTE:laauanoa 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 applioabie permit granting authorities. City of Northampton REQUIRED INSPECTIONS fl 1. Footings and Walls BUILDING DEPARTMENT 2. Structural Components in Place* 3. Complete Building* No. 969 Office of the Building Inspector Zoning Form No. 962869 Date 10/10/97 Fee $120.0Opmeck## 8241 Page, 17C parcel 95 ,Zone URB Section 127 ❑ Yes © No BUI]LDINGPERMII * Plumbing and Electrical Inspections required THIS CERTIFIES THAT valley Home Improvement Inc before Building Inspections has permission to remodel 2nd floor & add bath Inspection on Site—Foundations situated on 136 Chestnut St - Dorothy Kocott Inspection of Plumbing—Rough provided that the person accepting this permit 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 Smoke Detectors(Fire Department) Other THIS CARD MUST BE DISPLAYED IN A CONSPICUOUS PLACE ON THE P ISES Certificate of Occupancy Building Inspector