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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations
NORTHAMPTON, MASS. 1 q Additions
APPLICa ATION FOR PERMIT TO ALTER Repair
Garage
1. Location �J +� o mfo c e Ct Lot No.
2. Owners name S' /h ea Address
3. Builder's name"1 =�% - Address
Mass.Construction Supervisor's License No. CX (9G 310? Expiratio Date �/�Z.f�/999
4. Addition
5. Alteration �'e'` " _ v
6. New Porch
7. Is existing building to be demolished? N�
8. Repair after the fire
9. Garage No.of cars Size
10. Method of heating 0-
11. Distance to lot lines
12. Type of roof
13. Siding house
c
14. Estimated cost-
The undersigned certifies that the above statements are true to the best of his, her
know ge d belief.
Signature of responsible app,ican!
Remarks 6k� 1 -�f �� f d ` ""m ��(J e/4,"
MPT
200 '°
R {ir LLit.X717 $11t�7fIIYT. i
BH '--axssxcattsrtta
JM-m 5 10DEPARTMENT OF BUII,DiTjC ITISPEC7'IONS
212 Main Street ' Municipal Building
is
Northampton, Mass. 01060
WORT ER'S COMPENSA'T'ION INSURANCE A AVIT
(licenserlpetmitiec}
v✓ith a principal place of businesslresideoce at:
(phone#) \Je �777
(strrtii/city/satch p)
do hereby certify, under the pains and penalties of perTUry, that:
( ) I am an employer providing the following worm-er s compensation coverage for my
emplovees worL-illg ou this job:
(Im -u-raace Compaay) (Policy Number) (Expiration Date)
( ) I am a sole proprietor, general contractor or homeowner (circle one) and have hired
the contra-ctors hsted below who have the following worker's compensation policies:
(Name of Contractor) Company/Policy Numk-r) (Expiration Date)
(Name of Contractor) (Iasumnee Compan),/Poticy Number) (Ezpirauon Date)
(Name of Contractor) (Laammce Compamy/PoLicy Numb,7 r) (Expuaaou Daie)
(Name of Contractor) (Insurance Compaay/Policy Number) (ExpLmdon Date)
(attar_tl additioml vhcci if nocci�ry w inch3dc infixmstioa patinin£to drl o�radors)
( ani a sole proprietor and have no one working for me.
( ) I am a home owner performing all the work myself.
NOTE_please be am.^c thzt vd ilo hom�wbo cm I(rf perxcm to do mi,f�cons v omao or rcyair work on x ckwning of
oot mero than tbcuo units in rich the bo�r=6.or oo tbo vouods appurtenant tbcrcto arc not generally oomidacd to be
cmployrra under tba woclCCr`s anon Act(GL152-�::,1(5))�application by a homeowner for a licrnsc cc permit may cvidcnoc the
IcpIrtaYuaofano mpl oyecunderthoworicaexcomp�xiioa k c
I ursda-st iad dv1 a copy of thix m f—A mAy bo fot-wnrdad to tho Dcpar�xo2 of In�utri as nuido dJ cM.00 of Iawrinco rx tba
covcrxgc vaifieatioo and that f dm--to Lcct=covamV uodcr suction 23A of MGL 152 c-A t-d to tbo'boa of criminal pcaeltics ,.
oomisQttg oIx litx bfUP to S1,S00.00 aodlor imprisoonicut oCup Lo.00c year rnd civil pmatiia in the form oCa Stop Woilc Otdcr.►nd a
fioo oCS100:t)D'�diy' tta ..
gor, 1 u-oaty
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10. Do any signs exist on the property? YES NO
IF YES,describe size,type and location:_ L"r
Are there any proposed changes to or additions of signs intended for the property?YES N01G
IF YES,describe size,type and location:
11. ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE DENIED DUE TO
LACK OF INFORMATION.
This cols to be filled in
by the Building Department
Required
Existing Proposed By Zoning
Lot size
Frontage
Setbacks - frnnt
- side L: R: L: R:
- rear
Building height
Bldg Square footage
%Open Space:
(Lot area minus bldg
&paved parkingi
of -Parking spaces
it of Loading Docks
Fill:
(vol-ume--& location)
13 . Certification: I hereby certify that the information contained herein
G is true and accurate to the best of my ledge.
RATE: U S yf APPLICANT's SIGNATURE
NOTE: Iss ance of a zoning
g permit does not relieve an applio nt's burden to comply witi�l,,+pll-
zoning requirements and obtain all required permits from th Board of Health, Conservation
Commission, Department of Publio Works and other applicable permit granting authorities.
FILE #
� 5 ;998
File No. 3
of Butt .
Jc'
ZONING PERMIT APPLICATION (§10 . 2)
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant:
Address: ev S"r--e-d 'j1q1-eace Telephone:__
2. Owner of Property: 1 ( vvr 5 keQ
Address: Telephone:
3. Status of Applicant: Owner C/o_ntract Purchaser Lessee
Other(explain): �o-r�-1� f?I/�
4. Job Location: erzcP
Parcel Id: Zoning Map# 11C. Parcel# District(s): (7'�
(TO BE FILLED IN BY THE BUILDING DEPARTMENT))
5. Existing Use of Structure/Property MU St c S fos-e
6. Descri lion of Propose UseM/ork/Pr�ject/ ccu �tion: (Us additional sheets if nece ary
o�S l7 G - 2y 2 caw
S
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 c--' 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)
FILE
Jd 51,996 //t
APPLICANT/CONTACT PERSON: i�)� �
ARESS/PHONE: !/2z�� ,
PROPERTY LOCATION:
MAP / 70— PARCEL: ZONE &,H
THIS SECTION FOR-OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FULED 0111
Fee pnid
_Ruildin2 Permit Filled nitt
tit
7 �'�lllX�Q
ArrPtcnr-v �trii�i�rP
./
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS AP ICATION:
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
t MR. '
Septic Approval-Bd of Health Well Water Potability-Bd Health
leer it from Conservatio ommis/si�a
Signature of Building IKector Date
NOTE:lasuanoe of a zoning permit does not relieve an applioant's burden to oompty with ail
zoning requirements and obtain all required permits from the Board of Health, Conservation
Commisslon, Department of Publio Works and other applionble permit granting authorttles.
Reference No: BP-1998-0065
Department: ...................................
Building, Electrical & Mechanical Permits
Fee Type: Receipt No:
Non structural interior renovations REC-1998-000069
......................................................................................... ......................................
Paid By: Paid in Full On:
Barry Elbaum Tue Jun 16,1998
......................................................................................... ......................................
Received By: Check No:
Linda Lapointe 1333
................................•---.....------------...........................---...--- ......................................
DEPARTMENT'S COPY Amount: $40.00
...........................
DEPARTMENT FILE COPY 125 MAIN ST
CITY OF NORTHAMPTON
BUILDING PERMIT
Owner's pulling their own permits or dealing with unregistered contractors for applicable work do
not have access to Guaranty Fund(MGL 142A)
Issued: Permit No: I-?oq Inspector: Tracking No.: Fee:
16 Jun, 1998 BP-1998-0065 963638 $40.00
GIS #: Mau Block: Lot: Address: Zonin Use Group: Lot Size:
8854 17C 222 001 125 MAIN ST GB B 12763.08
Contractor: License Type: Insurance:
Barry Elbaum CSL
Address: License No.: Insurance No.:
25 Hatfield Street 063208
City: State: Zip Code: Phone:
HATFIELD MA 01038 (413) 584-5777
Project No: Category of Work: Const. Class: Cost Estimate:
JS-1998-0065 Non structural interior renovati $5,000.00
Description of Work:
Construct interior wall for office space
GeoTMS®1997 Des Lauriers&Associates,Inc. Signature: