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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. , Z-2- Alterations
NORTHAMPTON, MASS. Z Z 19 ° Additions
APPLICATION FOR PERMIT TO ALTER Repair
_ Garage
1. Location �' �'" `� 1 �S Lot No.
2. Owner's name k %A Address 3e? J AJ 43 y ZI 3 w �.
3. Builder's name e C-tc W'\PJ Address S 09'-1`c `-
Mass.Construction Supervisor's License No. b 9 8 Expiration Date ( buy
4. Addition � ��`� 0 2
5. Alteration
6. New Porch YC- S
7. Is existing building to be demolished?
8. Repair after the fire
9. Garage No.of cars Size
10. Method of heating y L
11. Distance to lot lines 3 t �=�'� S t d �= T L l 'i ►�► �� " Cat
12. Type of roof
13. Siding house
14. Estimated cost-
The undersigned certifies that the above statements are true to the best of his, her
knowledge and belief.
Signature of responsible app,icant
Remarks
M
° °
B '! SM w ^ M �aS4Rth ttSflt6
r
m DE AR ENT OF BUILDING INSPECTIONS
DEPT U BUILDIN in Street ' Municipal Building '
NORTHAMPTON MA O1+)
`° - Northampton, Mass. 01060
W ORICER'S COAITENSA'ITION INSURANCE ATTIDAVIT
(licenser/permiuee}
with a principal place of business/residence at:
S &?" C ITt (phone#)
(sta=r/city/state/a p)
do hereby certify, under the pains and penalties of perjury, that:
( ) I am an employer providing the following worker's compensation coverage for my
employees working on this job.
L, 15 ( q -OV'
(Insurance Company) (Policy Number) (Expiration Date)
( ) I am a sale 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 Comoary/Po&-f Number) (F iraaon Date)
(Name of Contractor) (Insurance Company/Poky Number) (Expiration Date)
(Name of Contractor) (Insurance Compauy/Palicy Number) (Exp,ration Date)
(Name of Contractor) (Insm-ance Company/Policy Number) (Expiration Date)
(attach additional sixci ifnaccrsiry to inc}udc inf«nuIIoa pcstaiaing to all ccatradon)
( ) 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 aware thst whilo homcowncn wbo cmplay persons to do mairdcasnc r,C004rucuoa or repair work on a dwelling of
not more than throe units is which the homoowncr resides or co the gfoundz apparrteaurt thacto uc not gcsxraily oomidcrcd to be
employcm under the worker's coa4=rAfion Act(GL1 52,=1(5)),application by a homeowner for a Uccn5c or permit may evidence the
legal ctshra of an employer under the Worker's compcczAtion Ad.
I understand that a copy of this rtucmcat may be fomiuded to the Dtputmrn2 of I d int Acadm&woe of luwra000 for a*
covaag vmficatioa and that failure to ur a=coverage under sectioa 25 A of MGL 152 can lead to the imposition of criminal penalties
oomisiiag of a fine of up to S I RO.00 anNcr kaprisoumait of tip to o=year and civil penalties in the form of a Stop Work Order and a
find of S 100.00 a day aglainA me
For dgaat Mdntd—only
permit Number
map#-Lot#
SiVmbl r of Licensce/Permittec Date
10. Do any signs exist on the property? YES NO 1
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 col— to be filled in
by the Banding Department
Required
Existing Proposed By Zoning
77
Lot size 97 G '7
Frontage
Setbacks N Fhli� U
- side L: Jc7� R:2o,� L:-�V : a,-,
- rear �-
J (j G
Building height 3�-
Bldg Square footage L)
%Open Space:
(Lot area minus bldg Q
&Paved parking) C�
# of Parking Spaces (j
f of Loading Docks l
Fill:
{vol-ume--& location)
13 . Certification: I hereby certify that the information contained herein
is true and accurate to the best of my knowledge.
DATE: 9( 2 Z APPLICANT's SIGNATURE cL---f�
NOTE: Issuanoe of a zoning permit does not relieve an appiloant's burden to oomply With .4ali
zoning requirements and obtain all required permits from the Board of Health. Conservation
Commission. Department of Publio Works and other appiioobie permit granting authorities.
FILE #
d
2
DEPT OF BUILDING INSPECTi tl$ File No.
NORTHAMPTON MA
F
ZONING PERMIT APPLICATION (§10 . 2)
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant: I;e c-(-t.-- V", ^
Address: S (::� c'�k Telephone: DK Y t 2 ZLt
2. Owner of Property: <,A �- Lcc�,-:NR-o W S 12tiy
Address: .-� () i A--Z v3 'fin I l C'b,0-J Telephone: S Ra -& C,C z
3. Status of Applicant: Owner Contract Purchaser Lessee
�c Other(explain): (-Q
4. Job Location
Parcel Id: Zoning Map# Parcel# c2 District(s):
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/Property 5( -�4 G( L �-- 1\Y,t L-`1 P j s"o L�
6. Description of Proposed Use/VVork/Project/Occupation: (Use additional sheets if necessary):
SCA-SaA— Ptpc V c�) X02
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/Vadance/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 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-1999-0322
APPLICANT/CONTACT PERSON Robert Reckman
ADDRESS/PHONE 36 Service Center (413)584-1224
PROPERTY LOCATION 395 AUDUBON RD
MAP 05 PARCEL 020 ZONE RR/WSP
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out
Fee Paid Aril �s xl '
Type of Construction:
New Construction
Non Structural interior renovations G
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/Occu„pant Statement or License#
3 sets of Plans/Plot Plan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION:
�pproved 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 Board of Health Well Water Potability Board of Health
Permit from Conservation Commission
Signature of Buikffing Officil 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.
Reference No: BP-1999-0322
Department: ...............•........•••...•..•.
I Building, Electrical & Mechanical Permits
.........................................................................................
Fee Type: Receipt No:
Building- Renovation REC-1999-000825
.........................................................................................
Paid By: Pa.id..i.n..Full..0.n:...........
Robert Reckman Wed Sep 23,1998
...... ...•.. .....
.. . ...... •......
eceived By: .Check. . .No:...................
Linda Lapointe 81,85
.........................................................................................
......................................
DEPARTMENT'S COPY Amount: $80.00
.................. --------
DEPARTMENT FILE COPY 395 AUDUBON RD
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: Tracking No.: Fee:
BP-1999-0322 $80.00
GIS#: Map Block: Lot: Address: Zoning: Use Group: Lot Size:
80 05 020 001 395 AUDUBON RD RR 386377.2
Contractor: License Type: Insurance:
Robert Reckman CSL Workers Compensation
Address: License No.: Insurance No.:
36 Service Center 009498 151900097491
LkE State: Zip Code: Phone:
NORTHAMPTON MA 01060 (413) 584-1224
Proiect No: Category of Work: Const. Class: Cost Estimate:
JS-1999-0666 alteration-addition $20,000.00
Description of Work:
ADD 20 X 22 3 SEASON PORCH
GeoTMS@ 1997 Des Lauriers&Associates,Inc. Signature:
City of Northampton
k �
Buildin D
g epartment
Office of the Building Inspector
g p
Permit No: BP-1999-0322 Date issued 25-Sep-1998 Fee$80.00
Map 05 Block 020 Lot 001 Zone RR/WSP Section 116 ❑ Yes ❑ No
Bt"J"ILDING PER.MIT
This certifies that Robert Reckman CSL009498 L E c G k ! Jr q`
has permission to ADD 20 X 22 3 SEASON PORCH Inspection on site-Foundations
at 395 AUDUBON RD Over❑
provided that the person accepting this permit shall in every respect Inspection of Plumbing-Rough
conform to the terms of the application on file in this office, and to the Over 11
provisions of the Statues and the Ordinances relating to the construction Inspection of Plumbing-Finish
Maintenance and Inspection of Buildings in the City of Northampton. Over❑
Any violation of any of the terms above noted is an immediate revocation Gas Inspection
of this permit, Expires six months from date of issuance,if not started. Over❑
Inspection of Wiring Service Over❑
Note: A certificate of occupancy will be issued by this office upon return Inspection of Wiring-Rough ^ Over❑
of this card by the Plumbing, Wirinl;and Building Inspectors. Inspection of Wiring-Fi�iish IgAr //hr/�k�ll Over❑
*Plumbing and Electrical Inspections required before Building Inspection-Rough Over❑
Building Inspections Insulation Inspection
Over❑
Building Inspection- Finish 11-7 Over❑
Smoke Detectors (Fire Department)
This card must b sted ,on site visible from Public way
Certificate of Occupancy
77;;
Buildi g mmissioner