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7
Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations
NORTHAMPTON, MASS. 19 Additions
APPLICATION FOR PERMIT TO ALTER Repair
Garage
1. Location 7 ST/Z- so V Lot No.
2. Owner's name 77--,1a Address )F
3. Builder's name L141 7ZFW EF-LE e Address IWIZWLJ -�7— 1441OLF-tv
Mass.Construction Supervisor's License No. S-!!7 Expiration Date 1 �>o 0
4. Addition
5. Alteration k i fC LC
6. New Porch
7. Is existing building to be demolished?
8. Repair after the fire
9. Garage /,L/4) No.of cars— Size
10. Method of heating 's 4-e
4-
11. Distance to lot lines ,/S—
12. Type of roof
13. Siding house
14. EstimatedCOSL-
The undersigned certifies that the above statements true to the best of his, her
knowledge and belief.
Signature of responsible app,icant
Remarks-
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DEPARTMENT OF BUILDrNG INSPECTIONS
212 Main Street ' Municipal Building
_M"—Northampton, Mass.' 01060
WORKER'S COIITENSATION INSURANCE All IAVIT
(li ceiserJpermi ttec)
Anti a principal place of businesslresideerijce at:
(Phoned)
(str'e..t/ci ty/statrin p)
do hereby certify, under the pains and penalties of peol ry, that:
O I am an employer providing the folio«ring worker's compensation coverage for my ,
employees worming on this job.
(Ins-cQ Coady) (Polic-r Number) (Expiration Date)
(✓}'I am a sole proprietor, general contractor or homeowner (circle one) and have hired
the contractors listed below who have the followiog worker's compensation policies:
T f Conratctor aP.Sii? C� Con an1/Pohc!? l IlCCI) (~\?JLrnCoa Datc)
(Nutll° Oi )
(Name of Contractor) --_ Zrs r ice Como r`iPotie,Nurncer) (E�:piradon Date)
(Name of Contractor) (Lnsuranc:� Compauy/PoLcy Numlxr) (Expiration Date)
(Name of Contractor) (insurr.uct- Comoa�/Policy Nlumber) (Expiration Date)
(mach:<1Milicait zhcct ifncoa to iorjudc iafcK- iica pctL-i^ to nU ooa7>c-o�)
I am a sole proprietor and have no one working for me.
( ) I am a home owner perforr all the work myself.
NOTE_please be atrarc that wbilo bomcow c,-s wbo a-aptay pons to do m=int ,cc, coasnvctioo or repair work oo a(,N clUiag or
not morn than throo units is w-lvch the bomoow o r rc=,1=or oa the uoun6=pWrtz° tbc=ct°ue cot Witty considered to be
cmployaa under tho woric.ct o=gcisztim Act(GLI52.=1(5))L,application lry a homcow=for a G«nso oc permit may cvid—thc
legal ru us of an aarployoc under the Wockoet Compom+tioo Art
I undcrsts.nd that a copy of this ctatcco—d a y bo forrtvdod to the Dcpnrtxncoa of lnriastriol Amy t7isoo of rrn.r for tb.
covaxgc vaificatioo and that failtuc to secure covcrabo under sociiofl 25A of MGL 152 can lid to tbd imposition of criminsl prniltia
oomistiag or x fine of up to s 1,50apo and/or>zapruocmcat of tip W am yc3r nod civil p®2G3 in the form of a stop Wort Order and a 1
fim of 5100.00 a day agaiwl 1nG
For dcpafir>rn�1 tiro only
Permit Ntlmbes
;;fit Lot
_ iP,x�-1tuz�of l,iccnscdPcrmiticc ��
bate
..^.4..rt�.- cy.`ti.4'F.u/wa,i.:'ililiti..si���.y��,. .+�.::t. _. d ... s::.�.1•r.ww..,1, .. .
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 X
IF YES,describe size,type and location:
11. ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE DENIED DUE TO
LACK OF INFORMATION.
This —.I== to be filled in
J37 the Building Dhepart n t;
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
&paced parking)
# of Parking spaces
# 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.
DA'Z'E: /v Z y / Q APPLICANT's SIGNATURE
NOTE: Issuance 06f as zoning permit does not relieve on appiioant'a burden to comply witty ali
zoning requirements and obtain all required permits from the Board of Health. Conservation
Commission, Department of Publio Works and other applionbla permit granting authorities.
FILE #
Fi 1 e No.
ZONING PERMIT APPLICATION (§10 . 2)
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant: �e
Address: M Oct I-C IMA Telephone: -Q�l -6 S �! b
2. Owner of Property: " R 3H(" lS l�(�-(PE ✓-
Address: 1'2 STr)_So.N 1,9 OF f/o F/l rrTelephone: G -C)10 l
3. Status of Applicant: Owner Contract Purchaser Lessee
Other(explain): C�LA,--� ( (1-0"�c 'f-
4. Job Location: /7 S )z-solu /--),.)77 t fC,(C ,, Q
Parcel Id: Zoning Map#� Parcel# District(s):
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/Property )ZQS j de— f
6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary):
1< ,+c A2, )'-y"ade l
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 KNOWS ig� YES IF YES,date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO DON'T KNOW X 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#BP-1999-0464
APPLICANT/CONTACT PERSON Peter Casten
ADDRESS/PHONE P O Box 648(413) 584-6590
PROPERTY LOCATION 17 STILSON AVE
MAP 17C PARCEL 103 ZONE
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Buildin Permit Filled out
Fee Paid AIL
Type of Construction:
New Construction _
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/Occupant Statement or License# ✓
3 sets of Plans/Plot Plan
THE 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
Well Water Potability Board of Health
MP
Permit from Conservation ommission
Signature of Buildin ficial Date
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.
Department- Reference No: BP-1999-0464
...................................
Building, Electrical & Mechanical Permits
........... ...................................................... ......................
Fee Type: Receipt No:
Non structural interior renovations R11,C-1999-001266
................................ ........................................................
..... ................................
Paid By: Paid in Full On:
Peter Casten Thu Nov 05,1998
.........................................................................................
......................................
Received By: Check No:
Linda Lapointe 1368
.........................................................................................
................. ....................
DEPARTMENT'S COPY Amount" S40.00
----------- -------
1)U',PARTM E NT F 11,E CO 11 V 17 STILSON AVE
CITY OF NORTHAMPTON
BUILDING PERMIT
Owner's pulling their own permits or dealing with unregistered contractors for applicable work do
not have access to Guaranty Fund(MGL 142A)
Issued: Permit No: Inspector: Trackint!No.: Fee:
BP-1999-0464 $40.00
GIS Map Block: Lot: Address: Zoning: Use Group: Lot Size:
1738 17C 103 001 17 STILSON AVE URB 9888.12
Contractor: License Type: Insurance:
Peter Casten CSL
Address: License No.: Insurance No.:
P 0 Box 648 068959
Liin State: Zip Code: Phone:
AMHERST MA 010040648 (413) 584-6590
Proiect No: Category of Work: Const. Class: Cost Estimate:
JS-1999-0884 Non structural interior renovati $8,000.00
Description of Work:
KITCHEN REMODEL
GeoTMS(D 1997 Des Lauriers&Associates, Inc. Signature:
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RFICIPIEWFS COPY 17 STILSON AVE
CITY OF NORTHAMPTON
BUILDING PERMIT
Owner's pulling their own permits or dealing with unregistered contractors for applicable work do
not have access to Guaranty Fund(MGL 142A)
Issued: Permit No: Inspector: TrackinIZ No.: Fee:
BP-1999-0464 $40.00
GIS #: Map Block: Lot: Address: Zonin Use Group: Lot Size:
1738 17C 103 001 17 STILSON AVE URB 9888.12
Contractor: License Type: Insurance:
Peter Casten CSL
Address: License No.: Insurance No.:
P O Box 648 068959
City: State: Zip Code: Phone:
AMHERST MA 010040648 (413) 584-6590
Project No: Category of Work: Const. Class: Cost Estimate:
JS-1999-0884 Non structural interior renovati $8,000.00
Description of Work:
KITCHEN REMODEL
This permit is a license to proceed with the work and shall not be construed as authority to violate, set aside or cancel
any provisions of the State Building Code, except as specifically stipulated by modification or legally granted variance. All
work shall conform to the endorsed application and stamped plans for which this permit has been issued and any
ammendment thereto.
The Job Card is to be displayed on the premises at all times. The applicant is to call the department to schedule the
following minimal inspections(as applicable): EXCAVATION-REINFORCING - FOUNDATION (after damproofing and
bracing,but prior to backfilling)-FRAME(after signoffs on rough plumbing,gas,electrical, and building is weathertight)-
INSULATION-FINAL(after signoffs for plumbing, gas,electrical,fire).
This permit expires if the work authorized by is not started within six(6)months and continued thru to completion.
The building cannot be occupied until a Certificate of Occupancy has been issued. Please allow 2-3 working days to
process the Certificate of Occupancy as many approvals must be checked and other departments must be contacted.
THE STAMPED PLANS ARE TO BE KEPT ON SITE AT ALL TIMES.
GeoTMS®1997 Des Lauriers&Associates, Inc. Signature: