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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations
NORTHAMPTON, MASS. q Additions 1
APPLICATION FOR PERMIT TO ALTER Kepair
Garage
1. Location 3 C/ T, Q Lot No.
2. Owner's name J Address 14 1 c /
3. Builder's name Y Address J 47 Z e
ell
Mass.Construction Supervisor's License No. ILK 6 2.62 7 Expiration Date (�7
4. Addition
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5. Alteration 7� 417
CT
6. New Porch e- `' G - iG-z2 .
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
13. Siding house
14. Estimated cost:-
The undersigned certifies that the 4abboves ents are true to the best of his, her
knowledge and belief.
Signatur applicant
Remarks '
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s Cr%zt Irfr7zI1�ntatt
9 6 ' 1991 assachnsctta
DEPARTMENT OP BUILDITIG INSPECTIONS
212 Main Street ' Municipal Building
Northampton, Mass. 01060
'WORKER'S COMPENSATION INSURANCE A I t AVIT
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(li�nserlpetuvttc:.}
,with a principal place of bus mess/residence ai:
(stmt/C7 t}'�st2uin p)
do hereby certify, under the pains and penalties of perjury, tllai.
( ) I am an employer providing the followil)g %vorr_er's compensation cove 11ge for my
employees working on this job:
(Insurance Company) (Policy Number) (Fxpiration 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) (lasuran(-- CompaM, Policy Number) (E>pimtion Date)
(Name of Contractor) (Insumc-- Companyi?oky Number) (Expiration Dale)
(Name of Contractor) (Insurance Compan�,/Pot cy Numbu) (Expiration Dale)
(Name of Contractor) (Insurance Company/Poky Number) (Expiration Date)
(r_ciach additioml sboct ilneocuiry to ivc}udc infvrmitioa pertaining to all ooatrndon)
( ) I am a sole proprietor and have no one worming for me.
( ) I am a-home owner performing all the work myself.
NOTE:please be aware that whi]o homcowocts wbo employ pcmom to do mayWxz�coa!-- c oa or repair work on a dwttling of
not More th-.n rhroo nails in winch the bomoovaxr r=dc3 or oa the gtvunds xpVadcaud tbercto arc Dot gcoanily ooan6cmd to be
emplaycrs under the tvoriccel,cc iica Act(GL152-=1(5)} appliatioo by a homeowner for a Beta=cc permit may evidmoe the
legal ct2i"of an employee undertho Workcet compaosstioa Ad
I undustand dLA x copy of this rrx f ut rn.ay bo foewwr to tho Dcpartmoof of lodus:ri al Ao6&af5'Ofr7oo of In uranoo for ti-
coverage vcrificstioa and that Caam-c to socum covcrabo uoda sccdoa 23A of MoL 152 can la.d to tba'imposition of mmi W pcm cs
comiztiag of a fine bf trp to S 1 500.00 andJor inrpris�of up to ooc year aad civil pcadtia in the focm of a Stop Work Ordcr and a
flan of S 100.00 Idly&gaunt the
Signed this I y of al ' 1997 For dcpsrtm cal uao only
Pcrm.it Number
Map# Lot#
Signature of Liouj crmi
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1312-e,064 zrto F-4-aGiz-
�wrJ l--scc7- 06d"t
7-1-47
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10. Do any signs exist on the property? YES NO
f
IF YES,describe size,type and location:
Are there any proposed changes to or additions of signs intended for the property?YES NO L�
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 is
by the Sanding Department
Required
Existing Proposed By Zoning
Lot size
IX
Frontage /�gQ / 4�1
Setbacks
- side L: �pC R:j
- ream
Building height 2 '
Bldg Square footage 3Z I
%Open Space:
(Lot area minus bldg
' &paged parking) b
l
:Pf 4Parking spaces
# of Loading Docks
a
Fill:
(vol-time--& location) C>
13 . Certification: I hereby certify that the information contained her 'n
is true and accurate to the best of my knowledge. �-
DA II'E: � �— APPLICANT'S SIGNATURE VT-
?" NOTE: lasuanoe a zoning permit does not relieve an applloanYs urden mply wltf�t,,rplt
zoning requirements and obtain all required permits from the Board of Health, Conservation
Commission, Department of Publio Works and other applioabla permit granting authorities.
FILE #
JUL I 1997 ,
File No. 117 �
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ZONING PERMIT APPLICATION (§10 . 2)
PLEASE TYPE OR PRINT ALL INFORMATION
t
1. Name of Applicant: yd�re �E
Address: �� 42 /l��t//' yip Telephone/// 3
2. Owner of Property:
Address:T/ // el'4,e_L Telephone V132 ,9-,g 6
3. Status of Applicant: Owner Contract Purchaser Lessee
Other(explain):
4. Job Location: .�J Q C 8
Parcel Id: Zoning Map#� Parcel District(s):L
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/Property
6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary):
N
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 I -' 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)
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FILE
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y APPLICANT/CONTACT PERSON: E
"DRESS/PHONE: 61 O(
e
PROPERTY LO ATION:
MAP PARCEL:PARCEL: Z
THIS SECTION FOR-OFFICIAL USE ONLY:
PERNM APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING F01RM EITLED OUT
Rnilding Permit Filled 0jit
Addition to Existing
_ V
THE LOWING 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
!Permit from C servation C sio
Signature of Building bwKtor Date
NOTE:issuanoe of a zoning permit does not relieve an applioant's burden to oomply with all
zoning requirements and obtain all required permits from the Board of Health, Conservation
Commission, Department of Publio Works and other appiioabie permit granting authoritles.
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-� I City of Northampton REQUIRED INSPECTIONS
i e 1. Footings and Walls
BUILDING DEPARTMENT 2. Structural Components in Place*
3. Complete Building*
No. 634 Office of the Building Inspector
Zoning Form No. 962473 Date 7/10/97 Fee $40.00 Check## 6900
Page, 17A Parcel 288 ,Zone RR Section 127 1 ❑ Yes ® No
BUI]LDINGPERMIT
*Plumbing and Electrical Inspections required
THIS CERTIFIES THAT Valeriy Foksha before Building Inspections
has permission to construct 2nd floor exit door/decking & stairway Inspection on Site—Foundations
situated on 340 Bridge Road - Fitzgerald Properties 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 TfWPREMISES
Certificate of Occupancy
Building Inspector