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17C-148 (9)
.�> sv �p m 3 0 0 > N Z m N V 70 v' Z C) a Lo Zoning Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations NORTHAMPTON, MASS. 19 Additions i APPLICATION FOR PERMIT TO ALTER Repair Garage 1. Location 3 3 t4 u P S tvj= _!—foV,&wCp r N� . _Lot No. 2. Owner's name Ad v'p K I4a v IP en tr Address es-kA.-e 3. Buildeisname rivv. Ea 4,e5-v— Address_PO d©V 69-7 A At yt�1yS'3;11 1.0t004- Mass.Construction Supervisor's License No. 66 W44-5- Expiration Date a-6 00 4. Addition ^, 5. Alteration &'kA&$A ce6% .�in�c� 77esov RC*Jc CC d7_wiv.�e , 6. -New Feely Re X&Lb cre o V%P- vt o v.— 6,-&rtL.4 w a-l t s e v en 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:- "�t X00 The undersigned certifies that the above statements are true to the best of his. knowledge and belief. — Signat a of responsible appicant Remarks � t r • OCT 2 2 1999 lasaackasrtts DEPARTMENT OF BUILDING INSPECTIONS 212 Main Street a Municipal Building Northampton, Mass. 01060 WORKER'S COMPENSATION INSURANCE AFFIDAVIT (licensee/pernlittee) with a principal place of business/residence at: Oe box 07",rev--- ,,. A (phone#),-2-�:5` TO-7. (st =Uczty/statrlap) 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: (Insurance 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 Company/Policy Number) (Expiration 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 doaal shoot ifnocessary to include information pertaining to an ooadredois) el am a sole proprietor and have no one working for me. ( ) I am a home owner performing all the work myself. NOTE:pl=w be aware that while homeowners who employ person:to do ma— akcr,comtrvdion or repair work on a dwelling of not more than throe traits is which the bomeowncr resides or an the grounds appurtenant that+cw aro not geaemity 000ndcred to be employers under the work='s o=pcnsation Act(GL152,ss 1(5)),application by a homeoww for a liocwe or permit may evidence the legal status of an employer under the Warkoes Compemation Act I understand that a copy of this uatemad may be forwarded to tba Depuumad of Industrial Aoddm&OtSoe of In%AVI a for the coverage vetificatian sad that Uu-to"Curt aoverago=odor saxioa 25A of MOL 152 can lead to the imposition of criminal penalties oomiating of a fine of up to$1,500.00=Nor imprisonmerd of up to one year and ciV11 penalties is the form of a Stop Work Order and a fm of 5100.00 a day against ttx For dgnrtcae&d use only Permit Number Map# Lot# of Licensw4ermittce We- 10. Do any signs ebst on the property? YES NO IF YES,describe size,type and location: Are there any proposed changes to or additions of signs intended for the property?YES NO IF YES,describe size,type and location: 11. ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE DENIED DUE TO LACK OF INFORMATION. This —.I== to be filled in by the Building Department Required Existing Proposed By Zoning Lot size GSA � Iy0 So��.tic, � a© o Frontage , Setbacks - side L:—/` R: `�° L: 5"x"-R: Sv�e - rear `} S w. F Building height ,;2 3 Bldg Square footage %Open Space: (Lot area menus bldg o-� &paved parking)SS l cc.-W-� # of Parking Spaces f of Loading Docks Fill: (vol-ume--& location) 13 . Certification: I hereby certify that the information contained herein is true and accurate to the best of my knowledge. D-k E: /.0 A r q APPLICANT's SIGNATURE NOTE: 1"ua oe 46f a zoning permit does not relieve an ap lloant's burd6h to oomply wlti� .rpll zoning requirements and obtain all required permits fronf the Board of Health. Conservation Commission. Department of Publio Works and other appiiombla permit granting authorities. FILE # OCT 2 2 1999 Ei1e No. ZONING PERMIT APPLICATION (§10 . 2) PLEASE TYPE OR PRINT ALL .INFORMATION 1. Name of Applicant: d i w. Address: Goo (3ox 697 Telephone: ,;� S 3 •—9 4 0 3 2. Owner of Property:_ K&vrEvn �L* ,n&v- Address: S1 e S S$. F6`v e"`o%lephone: 5-F It-— 4-g 8'6 3. Status of Applicant: Owner Contract Purchaser Lessee Other(explain): r® yX" -V-ac`f o �o v s re'u.o Q 01-+1 C w 4. Job Location: [©.r eve C-t. Parcel Id: Zoning Map# Parcel#_ /qy7 District(s):��/�/'L� (TO BE FILLED IN BY THE BUILDING DEPARTMENT) 5. Existing Use of Structure/Property _RCS'&&'. +"'-I 6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary): C R-I-4 5 flo a V Tip vii 5 h �V 4 wc� s2euuova s2 i,�+ ��e�s �V1 0. t 3c.3` .n�e"� CIC�v.o�s� yto•i-�ov�N w�� 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 r/ 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 r./ 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-2000-0439 APPLICANT/CONTACT PERSON JIM EAGAN ADDRESS/PHONE P O BOX 697 (413)253-9160 PROPERTY LOCATION 33 KEYES ST MAP 17C PARCEL 148 ZONE URB THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Buildin Permit Filled opt Fee Paid 1 0' Typeof Construction: INTERIOR RENOVATIONS KITCHEN CABINETS,DRYWALL,REMOVE 2 WINDOWS&INSTALL 3 WINDOWS,REMOVE NON-BEARING WALL New Construction Non Structural interior renovations Addition to Existing Accessory Structure Buildina Plans Included: Owner/Statement or License 068445 3 sets of Plans/Plot Plan 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 Septic Approval Board of Health Well Water Potability Board of Health Permit from Conservation Comm' io Signature of Building Official 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. 33 KEYES ST BP-2000-0439 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 17C- 148 CITY OF NORTHAMPTON Lot:-001 Permit: Building Category:renovation BUILDING PERMIT Permit# BP-2000-0439 Project# JS-2000-0756 Est.Cost:$9500.00 Fee:$50.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: JIM EAGAN 068445 Lot Size(sy ft.): 10890.00 Owner: HARPER KAREN&THEODORE HARPER Zoning:URB Applicant: JIM EAGAN AT: 33 KEYES ST Applicant Address: Phone: Insurance: P O BOX 697 (413) 253-9160 AMHERST 01004 ISSUED ON:1012711999 0:00:00 TO PERFORM THE FOLLOWING WORK.-INTERIOR RENOVATIONS, KITCHEN CABINETS, DRYWALL,REMOVE 2 WINDOWS & INSTALL 3 WINDOWS, REMOVE NON-BEARING WALL 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 REGULATIONS. Certificate of Occupancy Signature: Fee Type: Receipt No: Date Paid: Check No: Amount: Building 10/27/1999 0:00:00 $50.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo