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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations
a NORTHAMPTON, MASS. 3 �o ` 19 Additions
APPLICATION FOR PERMIT TO ALTER Repair
Garage
1. Location 666 /� "/"/ Lot No.
2. Owner's name Address � rz
3. Builder's name �� �����— Address,
sT
Mass.Construction Supervisor's License No. /'/t L //IIGc 5; Expiration Date Zd
4. Addition
5. Alteration
6. New Porch
7. Is existing building to be demolished?_
S. 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-,,?//a
The undersigned certifies that the above statements are we to the best of f
knowledge and belief.
Signature of responsible appicani
Remarks �T�j( �°J� E %e✓J
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a ♦ 1�
fNSPV! :4
t DEPARTMENT OP BUILDrNG INSPECTIONS
212 Main Street ' Municipal Building
Northampton, Mass. 01060 y '
WOR E,R'S COMPENSAUON INSURA-NCE A t t AVIT
(li censerJpermi ttee)
with a principal place of business/residence at:
`7 S� �Al l0/l (phone#) /L/-
(stmt/ci ty/stazr/zi p)
do hereby certify, under the pains and penalties of pegJury, that:
( ) I am an employer providing the following worker's compensation coverage for my
employees working o this job:
(Insurance Compaay) (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 Contracto:) (Insuancc Company/Policy Number) (Fxpimtion Date)
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(Name of Conti-actor) (l.nsurance Compauy/Policy Munber) (Expiration Daze)
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(attach a6ditiocal slxi ifnooc uLry to iocWc mfortnstion pertain ng to all oo�rndon)
(L-' Iam a sole proprietor and have no one working for me
( ) I am a home owner performing all the work myself.
NOTE:please be awatc dint�ulo txxtxoµixrs Abo amploy 1h iom w do a n n co Iry oo or repair wort;on s d"cIrrlo of
not morn than throo units in rebel the bomooaver mian or oe the Rounds appurtensni the,-do arc oct 6axr lly ooaridertd to be
employers under tbo worker's.( salioo Act(GL152_:1 1(5)�application by a bomcoavcr for a Uccwc cc permit may evidcooc the
acgal etahrs of an omployor under tho Workce,Compcnut Aa-
I undcrsaaud that a oopy of this czstcmrot may bo focv^ud<d to tho Dr�artnxa2 of Iad:tsirid Arxidcat�Clfroa of Inxicxnoo for Ib.
covcnge va-ificatioo and that failure to accrue covcrav under sccdoa 25A of MOL 152 cxn lord to the imposition of criminal prnallics
ooausting of a fine of up to 51,500.00 anchor mTrrsoameat of up to one year and civil penalties in the form of a Stop Work Ordcr ind a
fine or 5100.00 aAay against,ate
For&9-ta—I—only
Permit Number
3 /Q—
71 Map# Lot#
Sigimb=of Li ?crmiticc Wte
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 col— to be filled in
by the Building Deportment
I (Required
Existing Proposed By Zoning
I Lot size
Frontage
Setbacks - frnnt
- side L: R: L: R:
- rear
Building height
Bldg Square footage
%Open Space:
(Lot area minus bldg
&Paved parkingf
# of 'Parking Spaces
# of Loading Docks
Fill:
-(volume-& location)
13 . Certification: I hereby certify that the information contained herein
G is true and accurate to the best of my knowledge.
DATE: �-f�— 1�J� APPLICANT's SIGNATURE_C �
NOTE. Issuanoe of a zoning permit does not relieve an applioant's burden to oompty witty alt
zoning requirements and obtain all required permits from the Board of Health, Conservotion
Commission, Department of Publio Works and other applioable permit granting authorities.
FILE ,
}n' F
u11t� O P Fi 1 e No.
F I -717 ZONING PERMIT APPLICATION (§10 . 2)
a..a_.:.....
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant: efc—1 t'=1
Address: 'q Aal S;r- Telephone:
2. Owner of Property: USS r ri SL
Address: We
YLL
e'Wui 1CL Af�f Telephone:
3. Status of Applicant: Owner Contract Purchaser Lessee
Other(explaii):
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 UseNVork/Project/Occupation: (Use additional sheets if necessary):
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 KNO:^: 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)
�;3�
` ,�_
�,
600 HAYDENVILLE RD
BP-1999-0746
GIs#: COMMONWEALTH OF MASSACHUSETTS
Ma Block:06-003 CITY OF NORTHAMPTON
Lot:-001
Permit: Building
Cat ea :windows replace d BUILDING PERMIT
Permit# BP-1999-0746
Project# JS-1999-1370
Est.Cost:$2110.00
Fee:$20.00 PERMISSION IS HEREBY GRANTED TO
Const.Class: Contractor: License:
Use Group: Ed Corbett Jr 116069
Lot Sipe(sg.ft.): 28357.56_ Owner: COGGSWELL RUSSELL&PATRICIA
Zoning:SR Applicant., Ed Corbett Jr
AT: 600 NAYDENVILLE RD
Applicant Address: Phone: Insurance:
4 Reed Street (413) 584-6571
NORTHAMPTON 01060 ISSUED ON:311011999 0.00:00
TO PERFORM THE FOLLOWING WORK.-INSTALL 5 REPLACEMENT WINDOWS
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:
Rough Frame:
Gas Fire Department Fireplace/Chimney:
Rough: Oil: Insulation:
Final: Smoke: Final:
THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF
ANY OF ITS RULES AND REGULATIO
signature:
Fee Type: Receipt No: Date Paid: Check No: Amount:
Budding 3/10/1999 0:00:00 $20.00
212 Main Street,Phone(413)587-1240,Fax:(413)587-1272
Building Commissioner-Anthony Patillo