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05-039 (4) > Z rl Z > Z rri Zoning Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations - -7 19_1_ --T�L Additions NORTHAMPTON, MASS. 7 APPLICATION FOR PER IT TO ALTER Repair Garage_ 1. Location V Lot No. Z Address 53-f kt Wyq0(,i 0 2. Owner's name �,k, A 3. Builder's named C Address— Y7L Mass.Construction Supervisor's License No. CS Expiration Date 4 4. Addition 5. Alteration 6. New Porch 7. Is existing building to be demolished? &0 8. Repair after the fire NO 9. Garage No.of cars Size_ 10. Method of heating 11. Distance to lot lines r-f-0 q 7-- C-K Z 12. Type of roof f 1 f r- 13. Siding house 14. Estimated COSL- The undersigned certifies that the above statements are true to the best of his, her knowledge and belief. ) Signature of responsible app!cant Remarks II' 0 ate' LoT — i Y N n �� ro v � � N r w 2 64� o ,. o 'Icgr a, e. Q 3-) r �,�� =zs•a; 1 ti= /p/o 1 I hereby report that the premises shown on this plan is not located within a Flood Hazard Area as shown on Department of H.U.D. Federal Insurance Administration Maps, Community N er 250167-0001A Identificati n ate A ril 3, l 8 By:_ _ TO THE NORTHAMPTON CO-OPERATIVE BANK OWNER, DEBRA E. SMITH AND IRA HELFOND A14D THE AMERICAN TITLE INSURANCE CO.-only LOCATION= To the best of my knowledge, informa- 551 KENNEDY ROAD, LEEDS, NORTHAMPTON, MASS. tion and belief, I hereby report that I ALMER HUNTLEY ASSOCIATES, INC. have examined the premises and that this , ,JR.& inspection plat shows the improvement or SURVEYORS -ENGINEERS -PLANNERS improvements as located on the premises de- 125PLEASANT STREET P.O. BOX 568 scribed, that the improvement or improve- NORTHAMPTON, MASSACHUSETTS 01060 ments are entirely within lot lines , and that there are no encroachments upon the SCALES premises described by the improvement or °� improvements of any adjoining premises, �a _ o except as indicated. I further report that DOUGLAS DATE there are no easements of record affecting W. the tract shown hereon, except as noted. THOMPSON No. 28088 - 4FC,s�ta JOB NO.: 04Th.pT0 of 'Na rf1jaili /toll 71991 gasaxchnsrtts DEPARTMENT OF BUILDDIG INSPECTIONS 212 Main Street ' Municipal Building 'a Northampton, Mass. 01060 VYORICER'S CON PENSA`I'ION INSURANCE ATTITDAVIT 1, S4q1�CCCl( (Lie:nseJpermittct;) %vith a principal place of busmi eesslresidence at: (sticct/ci ty/stairizn P) do hereby certify, under the Pains and penalties of perjury, thal. O I am an einployer providing 1die following compensation coverage for my employees worldng on this job: Gnsu_rance Company) (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) (Insurance Compan•/Policy Numlxr) (`r.�n-ation Date) (Name of Contactor) (lasv.rance Company/Policy Number) (Expiration Date) (Name of Con me-tor) (Lasurancz- Company/Policy Nusbez) (1xpimbon Dale) (Name of Contractor) (l-nstuanct- Company/Policy Number) (Expiration Date) (anach'addition!mod iFnc«v�ry co inctcsdc infxnufioa peril wing to du oodrndon) (t/) I am a sole proprietor and have no one worm g for me. ( ) I am a home owner performing all the work myself. NOTE:please be awatc that wbito homcove c=wbo cr=p!ay persona to do n c=5trvetioa or repair work on a dwelling of not mom than thtoo tails is which the homoowncr r=d=or oa the grounds xppurteasnt tbetcw arc not grncrally coandcrcd to be cmployrra undo the-nrkcr's.ccwpcas4ca Act(GL152,=l(5)�application by a homnowrxr for a!icc we or pamz id may cvidcacc the leg:d o-tu of an employer under tho Workoet Compomitioa Act I understand that z copy of thu cat®c at may bo forwnrdod to tho Dcpnrm,m2 of lndu cj Axi&c &Offioo of Ia urwoo for tba eoversge verification and that kdutc to soeure covcmV under stcdoa 25A of MGL 152 can lead to tbo imposition of aiminzl prnalties ooausung of a fine of up to 51,500.00 and/or imprisc�of up to coe yarn and civil p�Itia in the form of a Stop Wort[Or dtt and a fiw of 5100.00><day against � rn— Signed this day of J % 199 7 For dcpatnr�nl u.o y Permit Number Map-4 Lot# Signa ia:nsce/Pcrmiticc 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 —I== to be filled in by the Building Departaent Required Existing Proposed By Zoning Lot size �; J Frontage f SCV Setbacks - frnnt ' - side L: (0 R: 37 L: 6'0 R• 37 a O - rear � r Building height Bldg Square footage J S �3 � V FE %Open Space: �Li3, �, (Lot area minus bldg ' &paved parking) of 4Parking spaces # of Loading Docks Fill: 4Vol-ume--& location) �0 d,� px�,r-fit — , Q. 611 6,k 13 . Certification: I hereby certify that the information contained herein is true and accurate to the best of my knowled D?II E: APPLICANT's SIGNATURE NOTE: Issue no® of a zonin 7 g permit does not relieve an app nYs burden to oomph wltl�,,all- zoning requiramants and obtain all required permits from the Board of Health. Conservation Commission. Department of Publio Works and other applioable permit granting authorltles... FILE # _ 7 199 f Q Fi 1 e No. ZONING PERMIT APPLICATION (§10 . 2 PLEASE TYPE OR PRINT ALL INFORMATION 1. Name of Applicant: G S�u & Address: %�r l _I t(0(-a4- Telephone: 2. Owner of Property: 71 0- 't-ias k �~ Address: � � 11'�nh erL`I 71�L 1,R��/�' Telephone: s [ 3. Status of Applicant: Owner Contract Purchaser Lessee Other(explain): / 4. Job Location: Parcel Id: Zoning Map# �3— Parcel# District(s): (TO BE FILLED IN BY THE BUILDING DEPARTMENT) 5. Existing Use of Structure/Property 6. Description of Proposed UseMlork/Project/Occupation: (Use additional sheets if necessary): 7. Attached Plans: Sketch Plan vl 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 J 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) C, ' 9 FILE # �� .> � ' . 71991 APPLICANT/CONTACT PERSON: 11 RFS5% C E 0 ef i PROPERTY LOCATION: MAP 67" PARCEL: ONE 1V4e1UYJ0 _ THIS SECTION FOR.OFFICIAL USE ONLY: PERNUT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FULE11) TT Type of Congtnirtion- New Construction !I� THE LLOWING 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 rdVal-Bd of Health Well Water Potability-Bd Health Permit from Conservation Ommission Signa e NOTE:1"uanoe of e..ning permit does not relieve an appiioant's burden to oomply with all zoning requiremants and obtain all required permits from the Board of Health, Conservation Commission, [department of Publio Works and other applioable permit granting authorities. City of Northampton REQUIRED INSPECTIONS g 1. Footings and Walls BUILDING DEPARTMENT 2. Structural Components in Place* 3. Complete Building* No. 636 Office of the Building Inspector Zoning Form No. 962490 Date 7/10/97 Fee$148.00 Check 01084 Page, 5 Parcel 39 ,Zone RR/WSP Section 127 ❑ Yes © No BUI]LDING PERM III' * Plumbing and Electrical Inspections required THIS CERTIFIES THAT Gerry Shattuck before Building Inspections has permission to construct 2 story addition Inspection on Site—Foundations situated on 551 Kennedy Rd - Leeds - Judith Leeds 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 Smoke Detectors(Fire Department) Other THIS CARD MUST BE DISPLAYED IN A CONSPICUOUS PLACE ON T PREMISES Certificate of Occupancy W-Bu' d�.ng Inspec