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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations
NORTHAMPTON, MASS. 19 Additions
APPLICa ATION FOR PERMIT TO ALTER Repair
Garage
1. Location 11)e,6 Lot No.
T
2. Owner's name TO h iu ,- )5�N rul./ Address
3. Builder's name M&Erl N IA4)4 N P)a c Address o'LO (anr ktt- D r�vu
Mass.Construction Supervisor's License No. U 1" 0 z Expiration Date — 1
4. Addition _
5. Alteration ty LRCr— kX 1-S)Ai 6 10001 `7u "DZCk f A-SC lt:-17&I
6. New Porch
7. Is existing building to be demolished? -VV
8. Repair after the fire
9. Garage Aj J No„of cars Size
10. Method of heating
11. Distance to lot lines
12. Type of roof
13. Siding house
14. Estimated cost:-�/ ,
vU-
The undersigned certifies that the above statements are true to the best of his, her
knowledg d belief.
liter. A,11
Sign ure of responsib app icant
Remarks 4�)Oxek :Z-; V P e S , �L f / l✓G� C
4� lot i ti G >tr,J
04f PLO
B AN�
' 2 1998 �x3sxcansrtCa
DEPARTMENT OF BUILDU? G INSPECTIONS
f iSPf
1214.E Main Street ' Municipal Building
f Northampton, Mass. 01060
WORICER'S COMPENSAUON MSURA_NCE ' t A.VI'T
(lI censerlpermi tta;}
v"Ith a principal place of busiiies Jresidence at:
>Ii --��!t�1 (phone#)
—, ---r- ( city/statrJzip)
do hereby certify, under the pains and penalties of perjury, that.
O I uB an employer providing the following worker's compensation coverage for my
employees working on this )W
(La=a-rice Conp?ay) -- -- (Policy Nu--ab r) -- _-- (✓Ypiration Dace)
( ) I am a sole proprietor, general contractor or homeowner (circle one) and have hued
the contractors listed below vrho have the followlu viorker`s cnsatiOil policies:
(N'1111 o! Coi.tr,ctor) (Ilt�ut�_�,c C0uIpa'1)'A:ohc} Numt-f) (�spu<:uonDate)
(Name of Conn-actor) (IIlSZI=c� Comp"M-1110hCY Nutnb^r) (Expli-abon Date)
(Name of Contractor) (Iasul-�Ilce ComoaIIyRo Ili cy NTulnber) (Expel,inon Date)
(ntLi dt a.dditi ccsal zbcct ifno--Y to to>lJ cratradon)
I ani a sole propnctor and have no one working for me.
( ) I am a home owner performing all ffie work myself
NOTE please be a ra e ttut wtnlo hem otivncra vbo employ perzom to do rt .�n awn 2 oo'.ar rr�n r wo k oa■d vclling oC
not—than tbmo unite in trbicjj the bow —L7 a o lho oappun lbad o uot ecay mukmd to be
employers under tbo wvtk :c Vic= iica Act(GI-152--�C(5)�nP Lic 6cm by a homeowner for l case a p-met may cvidcmc Abe
ItVd rtatit of an employee under tho Wo ki e'Com�""t A j-
I undez:tand d-L� py of tbii r 1-1 m y bo f«wnrod to Lb.Dep:rt o1 of Inbr i Amd�BOO of Inxuwoo for the
Do
coverage vuifiouioo and that Lulurc to tcoa"co%crago=dcr scctioa 23A,of MGL 132 cart Ic d 14 tba-ix'�Oa of criminal pcaaitica
x,fnoc of up to SQ00.00 Kmdla imprisomic of up to one yrpr and civil pcn�Itira in the form oC a stop Woik Ordcr.xnd a
- fino of S1QO.00'x dry i t� ... - ,
Foedcyrimc�il"'°Daly
Pcrmlt Number
" Sigi�a3urc tifL, crmai
10. Do any signs exist on the properly? 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:
I1. ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE DENIED DUE TO
LACK OF INFORMATION.
This cola to be filled in
by the Banding Department
Required
Existing Proposed By Zoning
Lot size ,
Frontage
Setbacks
- side L: 4/'R: L: R:
- rear
Building height
Bldg Square footage
-Uv
%Open Space:
(Lot area minus bldg
&paved parkingi
# of "Parking spaces
# 'of Loading Docks
r
Fill:
4 vol-lime--& location)
13 . Certification: I hereby certify that the information contained herein
is true and accurate to the best of my kn7/;Z*
DATE: �� APPLICANT's SIGNATURE J, /I//.:�, //v I I , .. I
NOTE: Issuanoe of a zoning permit does not relieve an applioant's burden to mplt► wit",all
zoning requirements and obtain all required permits from the Board of Hen h. Conservntion
Commission, Department of Publio Works and other applionble permit gra ing authorities.
FILE #
JM 1 21998
G�
i Fi 1 e NO.
NG PERMIT APPLICATION (§10 . 2)
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of
Applicant: kkp_zza Ll�',qL'Y'zzy
Address: /) i1I�/' �v n�/� v; ��i° Telephone: G2
2. Owner of Property: J�l�
Address[lam 4 X 11 fs L � D Telephone:
3. Status of Applicant: Owner _Contract Purchaser Lessee
Other(explain):
4. .lob Location: r�J
Parcel Id: Zoning Map 4_z7A Parcel# District(s):
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
S. Existing Use of Structure/Property 1c_f D i✓
6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary):
7. Attached Plans: Sketch Plan Site Plan Engineered/Surveyed Pfans
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 U 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 9 6 3 F '7
AID I(:MTONT'ACT PERSON:
�ESS/PHONE-
PROPERTY LOCATION: d
MAP PARCEL: ZONE
THIS SECTION FOR-OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FUZED OUT
Fee PAid
Wilding Permit Fill, mit
Remndt-lino Tnterinr
Addition t
ArreSSOrvTrtpre
$niltii P nc Tnclnderl-
THE FOLLOWING 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
!Permit from Conservation Commission
Signature of Building Inspector Date
NOTE:Issuance of a zoning permit does not relieve an applioant's burden to oompty with all
_ zoning requirements and obtain all required permits from the Board of Health, Conservation
Commission, Department of Publio Works and other applioable permit granting authorities.
Department: Reference No: BP-1998-0049
..................................
Building, Electrical &Mechanical Permits
.........................................................................................
Fee Type: Receipt No:
Non structural interior renovations REC-1998-000053
.........................................................................................
......................................
Paid By: Paid in Full On:
Martin Mahoney Fri Jun 12,1998
.........................................................................................
......................................
Received By: Check No:
Linda Lapointe 554
.........................................................................................
......................................
DEPARTMENT'S COPY Amount: $20.00
...........................
DEPARTMENT FILE COPY 188 Bridge Road
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: I�qb Inspector: Tracking No.: Fee:
12 Jun, 1998 BP-1998-0049 963672 $20.00
GIS #: Map Block: Lot: Address: Zoning: Use Group: Lot Size:
1355 17A 044 001 188 Bridge Road URA 11238.48
Contractor: License Type: Insurance:
Martin Mahoney CSL
Address: License No.: Insurance No.:
20 Fort Hill Rd 040602
City: State: Zip Code: Phone:
HAYDENVILLE MA 01039 (413) 268-3296
Proiect No: Category of Work: Const. Class: Cost Estimate:
JS-1998-0050 $1,500.00
Description of Work:
replacement doors,misc interior bathroom renovations
GeoTMSO 1997 Des Lauriers&Associates.Inc. C. P• �