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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations
NORTHAMPTON, MASS. �U6 19 Additions
- Repair
' APPLICATION FOR PERMIT TO ALTER
Garage
1. Location J C) �OUJe G- �, 7� ��/I Elt, C Lot No.
2. Owners name _�'e}� Address �jP�GUeL ST 1��d�E'/1/C
3. Builder's name d-� � �� �� Address /� L/ l/"f�2ti ST fJ��7/�A1_`/,,°7a(-1
Mass.Construction Supervisor's License No. (5)_6_6 6Z ?13 Expiration Date
4. Addition -All
S. Alteration 0 4— Al
6. New Porch L)
7. Is existing building to be demolished?
8. Repair after the fire /V A!A
9. Garage d 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 statemcnts are true to the best of his.
knowledge and belief. Signature of responsible appicant
Remarks
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SEp 1 3 W ..�.j
m DEPARTMENT OP BUILDrNG INSPECTIONS
DF.FT vI BUi��� r,��jcnF,TCtt�S 2# Main Street ' Municipal Building '
;,
Northampton, Mass.' 01060
WORKER'S CO►19,P' ENSATION INSURANCE A Mi A.VTT
I, / R � r=� .9,y�=�r2 z� N1a�✓z t�D Me 1/tfP 90 0Le-/14e-A'r
(li cen_sceJperm i tt e e)
with a principal place of business/residence at:
TN/4!°t P 7CA) M� (phone#)
(Sttet/city/statr/zip)
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:
(Insuranm Company) (Policy Number) Ulxpi ation 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) (Insurance Company/Policy Number) (Fxpimtion Date)
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(attach add 0021 sheet ifnooexlUy to ioerude infortnariou pertaining to aU oOCtr rs)
( I am a sole proprietor and have no one worlang for me.
( ) I am a home owner performing all the work myself.
NOTE:please be aware that while hocnco%mcra wfio employ pcmaos to do mxid=n,>,o=str,a on-or rryaa work on a dmlling of
not moo than throe units in which the homoowocr resides or on the grouaciz appurteasat thacw arc not geaesally aoazidcrod to be
employtxs uodet the wocke oompansuoo Act(GL152.ss t(5)),application by a homeow w for a Gcowe or permit may evidcoee the
legal stwha ofan employer uuderthe Workee,coova=&Lioa Ace_
I undetstaad that a copy of tibia zUtcma xt may be forvnudad to the Dopartmmt of Indurtrid Aocadmt�f offioo of Iasuraaoe for the
ooverwW vcnficdiae and that fad=to Beata cov=p under:action.25A of MGL 152 can lad to the imposition of aimi[W P-dties
oonsistmg of a due tat vp to 51,500.00 anNct kq r6oamca!of sip to one yt at and civil pcmtties io the form of a Slop Wort�Order and a '1
fine of 3100.00 a day t VII)a mc.
For dvwtialsue oaiy
_ G���`G' Ptxmit_Number
19�.�Iyf20 Lot
Signature etmittee
10. �"''T tn� exdst 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 col=a to be filled in
by the Building Department
Required
Existing Proposed By Zoning
Lot size
Frontage
Setbacks - front
- side L: R: L: R:
- rear
Building height
Bldg Square footage
%Open Space:
(Lot area minus bldg
&Paved parking']
# of Parking Spaces
f 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.
kD70E: `��// /> APPLICANT'S SIGNATURE �7j;�
NOTE: lauuanoe of a zoning permit does not relieve an appiioant's burden to oomply witty,A%[[
zoning requirements and obtain all required permits from the Board of Health, Conservation
Commission, Department of Publio Works and other appiioable permit granting authorities.
FILE if
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0131M
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3 6
File No. �Qy�'? DEP10F BUILDING INSPECTIONS
NORTHAMTON,WOl !?..._._
ZONING PERMIT APPLICATION (§10 . 2)
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant r2�� to G'
Address: , Telephone: 2
2. Owner of Property: GC-pFIRD R. VA0AS5E' /NtAIJCY g. NIANASS--
Address: 30 Powrru- '5r., F�-o�tEwc�; r". 216&A Telephone: 574-00 414
3. Status of Applicant: X Owner Contract_Purchaser Lessee
Other(explain):
4. Job Location: 30 POWELL ST , F(-oREhlcE,MA• o l6162.
Parcel Id: Zoning Map# 1711- Parcel# 175 District(s):
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/Property .DWEL-L-►01-'
6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary):
RerAODL-:LING DINNIuG Raonn
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 Perm' ariance/Finding ever been issued for/on the site?
NO DON'T KNOWS 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/7DON'T ument#
9. Does the site contain a brook, body of water or wetlands? NO 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)
r ,
File#BP-2000-0267
APPLICANT/CONTACT PERSON SERGE BELANGER
ADDRESS/PHONE 164 PARK ST (413)527-2414
PROPERTY LOCATION 30 POWELL ST
MAP 17A PARCEL 193 ZONE URB
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out
Fee Paid l
Typeof Construction: REMODEL DINING ROOM
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/Statement or License 056293
3 sets of Plans/Plot Plan
THE I�QCLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION:
Approved as presentedibased 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 Co on
Signature of Building Offi ' 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.
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30 POWELL ST BP-2000-0
GIs#: COMMONWEALTH OF MASSACHUSETTS
Nlap,:Block: 17A- 193 CITY OF NORTHAMPTON
Lot:-001
Permit: Building
Category:Non structural interior renovations BUILDING P
Permit# BP-2000-0267
Proiect# JS-2000-0422
Est.Cost:$1500.00
Fee:$50.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Grouu: SERGE BELANGER 056293
Lot Si .ft. : 8668.44 Owner. VANASSE GERARD R&NANCY B
Zoning,,:URB Applicant: SERGE BELANGER
AT. 30 POWIELLST
Applicant Address: Phone: Insurance:
164 PARK ST (413) 527-2414
EASTHAMPTON 01027 ISSUED ON.-0911611999 0:00:00
TO PERFORM THE FOLLOWING WORK.-REMODEL DINING ROOM
POST THIS CARD SO IT IS VISIBLE FROM THE STREET
Inspector of Plumbing Inspector of Wiring D.P.W. Inspector of Buildings
Underground: Service:, Meter;
Footings:
Rough: Rough:� � House# Foundation:
Final: Final: i � G
1- /1�f.yg1AP Rough Frame: 0� � �,i k� ✓ G 7 G
*
Gas Fire Devartment Fireplace/Chimney:
a �
Rough: Oil: Insulation: d K v-qq
Final: Smoke: Final: 6 k f a-;7-f Q
THIS PERMIT MAY BE REVOKED BY THE CIT OF NORTHAMPTON UPON VIOLATI OF
ANY OF ITS RULES AND REGULATIONS.
Certif of Occupancy-.-
i afore•
Fee Tune: Receipt No: Date Paid: Check No: Amount:
Building 09/16/1999 0:00:00 $50.00
1I
212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 �r i
Building Commissioner-Anthony Patillo