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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. �y Alterations
NORTHAMPTON, MASS. /4u'�irST 19 7� Additions
• Repair
APPLICATION FOR PERMIT TO ALTER
Garage
1. Location Lot No.
2. Owner's name Address n
3. Builder's name Be7`T c3Y-r- , Address 4&C!/�
57'
Mass.Construction Supervisor's License No. 67 `Y/So Expiration Date ZI -3 0
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 er A 5 i�,4 T ,s-��.. a 0e,
13. Siding house
14. Estimated cost- SC.i,ZS�
The undersigned certifies that the above statements are true to the best of his, her
knowledge and belief.
$ignalure of responsible app icanl
Remarks
l
}o�T ter p�O
a k 4199� Crzf 'Warf1juiltpfIIn
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8 AX3%Kchniclt0
»fit DE<pARTMENT OF BUILDING INSPECTIONS
'"..w 212 Main Street Municipal Building
Northampton, Mass. 01060
WORZC-,-R'S CONITENSATION INSURANCE ,t AVTT
(l i�nsc:J p✓tali t tom:,)
with a principal place of busioess/residcnce at:
(str�Uci t}/stairJn p)
do hereby cer dfjr, u-nder the p;ins arid peDalhes of perjury, th'-i
( ) 1 am an employer providilig die following comperlsadon cove:-age for my
employees working on this job:
(Insu=cn- Compzny) (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) l--c-- Comparry/Poky Numbe7) (Expiration Date)
(Name of Contractor) (Insurance CompanyEPolicy Number) (Expiration Due)
(Name of Connector) (Insurance Compaq/policy Numbs) (F--piration Date)
(Name of Contractor) (L surancz- Company/Poucy Number) (E)qpiration Date)
(,11xh idditiom.l cboci if❑oc _,y to cxkvdc info�,n.aoa perr_imng to all oodr-..d.on)
(/am a sole proprietor and have no one worm g for me.
( ) I am a-home owner performing ali the work myself.
NOTE_please be awatc thud wbilo bomoov,,=wbo employ priori:to do mz:..e'..3ooc cocztm tioa-cr rcp'.ir work,oa a dwelling or
not more th-.n tb—units in wbocb the bomoowncr raid,=«oo the V oundi apVadcamA tb=:ro arc cot gcoamily coandcrod to be
employ—under tbo ':o dioa Act(GL1 application by a bomcown.�r for a licence cc permd may cvidcaoc the
legit rizhsa of sa employeruodeetho Wockrch Compomilion Act
I undetstaad Hvi a copy oftbia—t—nd may be forwsrd.d to rho Dep-t=ai ofloau-k-t id Aocdmte OfSico o(Iaasnooe for db
oova-c verification and that failurr to tease cow ngo under soctioa 23A of MoL 152 c2n tcsd to tbd impos fioa of aimiatl pcualdcs
ooau3=g of x rmc bf up to S 1,5ooxio mdt«unprisoomcst of up to ooc ysar and ava p=LW cs is the form of a Stop Woct Ocda and a
fVW 0(:S 100.00 adry Lgsiinnsi.mc
Signed this "/ day of (i .GJT 199 7 l or dgautmc�.l u.'o oaky
Permit Number
Map'a L of>Y
Signalzlre of Licrnsc&PccmRtm
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.
This colama 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
of Loading Docks
Fill:
Avol-ume--& location)
13 . Certification: I hereby certify that the information contained herein
G, is true and accurate to the best of my knowledge.
WOE: �'��f 7 APPLICANT's SIGNATURE
NOTE: lasuanoe of a zoning
g permit does not relieve an apptioanYs burden to comply wlt4,,all-
zoning requirements and obtain all required permits from the Board of Health, Conservation
Commission, Department of Publio Works and other applionble permit granting authorities.
FILE #
AUG- 4 G9
File No.
4p
ZONING PERMIT APPLICATION (§10 . 2)
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant: Z--D
Address: e-1 ke,:P/ S T Telephone: �� 5
2. Owner of Property: 41119 JD61ez
Address: r7/c Telephoner
3. Status of Applicant: Owner Contract Purchaser Lessee
Other(explain):
4. Job Location:
Parcel Id: Zoning Map# / — Parcel# District(s):_ .�
(TO BE FILLED IN BY THE BUILDING _DEPARTMENT)
S. Existing Use of Structure/Property
6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary):
SJ�r� /'—c�d�— , �,�if7�-// Yl(i`�G✓ S' ,-y� COS
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)
fi) �! "��' .h n''1
4 �
.. FILE # 9G °?624
tw
41997
APPLICANT/ ONTACT PERSON: ,�`��
VH NE:
DES i `
PROPERTY LOC TION:
MAP PARCEL: ZONE
THIS SECTION FOR-OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM EHLET) OUT
Fee Paid
lRyii1ding Permit Filled mif
t./
Fee Pgid
g'
-30
THE,,VMLOWING 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
Septic Approval-Bd of Health Well Water Potability-Bd Health
Pcr4Qit from Co�a ' Co 's ' n
Signature of Building Loector Date
NOTE:Umuanoe 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 authorities.
CRY of Northampton REQUIRED INSPECTIONS
1. Footings Walls DEPARTMENT 2. Structural Components in Pl ace*
3. Complete Building*
No. 735 Office of the Building Inspector
Zoning Form No. 962624 Date 8/5/97 Fee 520.00 Gfieck# 2295
Page, 17A Parcel 152 ,Zone URA Section 127 ❑ Yes No
BUI]LDING PERNUT
* Plumbing and Electrical Inspections required
THIS CERTIFIES THAT Ed Corbett Jr before Building Inspections
has permission to strip & reshingle roof Inspection on Site—Foundations
situated on 54 Fox Farms Rd- Helen Judd 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
** Install per Manufacturer's information: windows, vinyl siding,roofs Smoke Detectors(Fire Department)
and woodstoves
Other
THIS CARD MUST BE DISPLAYED IN A CONSPICUOUS PAC �N,T P ISES
Certificate of Occupancy
Building Inspector