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17C-226 (5) a > o � c m � > = o twi Z ^` m -� Zoning Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. ��� W-12 Alterations NORTHAMPTON, MASS. 19 Additions APPLICa ATION FOR PERMIT TO ALTER Repair Garage 1. Location I>-,V zdA44-- Lot No. 2. Owner's name �J�S /�.?rG� cji�i � ��'' Address 1 3. Builder's name r,�Ae--iS X 5 Le—f c'--Z Address Mass.Construction Supervisor's License No. UG fa-3`1`1 Expiration Date SYeol 4. Addition A ,fir �rC- l� �d�� �0 31 _ 5. Alteration 6. New Porch 7. Is existing building to be demolished? �d 8. Repair after the fire '4�� 9. Garage /(ld No.of cars Size 10. Method of heating ICA" 11. Distance to lot lines ^ 12. Type of roof 13. Siding house 14. Estimated cost , Ped The undersigned certifies that the above statements are we to the best of his. knowle a and belief. Ygnuture of responsible app,tcant Remarks O� g ° GZo of 'Nortil iillpfoll i �.��..WVVV� 2 2 M Aas%aClt ns etts � . a 1 DEPARTMENT OF BUILDrNG INSPECTIONS OF r 212 Main Street ' Municipal Building ' Northampton, Mass. 01060 WOR=R'S COMPENSATION INSURANCE AFFIDAVIT 5/L /cam Q /Cr'G l�rmi (licensee/Pe ttee) with a principal place of business/residence at: (phone#) 5,5' Y (strcei/ci ty/statehi p) 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: h44�&�- :�,3 ZOE5z-4a _Q ce >Lpany) (Policy Number) (Expiation 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) (lnnlrancc Comparry/PoLicy Number) (Expiration Date) (Name of Contractor) (Insurance Company/PoLicy Number) (Expiration Date) (Name of Contractor) (Insurance. Comparry/Policy Number) (Expiration Date) (Name of Contractor) (Insurance Company/Policy Number) (Expiration Date) (attach additioml sheet ifnccrssary to include infixma .p<xtnining to all caGtra m) ( ) I am a sole proprietor and have no one working for me. ( ) I am a home owner performing all the work myself. NOTE:please be aware that whilc homeowners who=mphoy persom to do n. niter,i ace constn=oo or repair work on a dwalliag of not mom than throe units is which the homeowner r=dca or oo the grounds appurteaarrt thereto are not generally oo=dacd to be employers under the workers compeas4on Act(GL152,ss 1(5)),application by a homeownc for a license or permit may cvidcaoc the legal o—, of an employs under the Woriceet C.ompemation Art t! I understand thai a copy of this ctatcmcat may bo forwarded to tho D}=partmcni of h.&L-,uial Amdm&Offioc of luwranm for the coverage vcrificatioe and that failure to s=ire covcrngo under s6=oa 25A of MGL 152 can lead to the im�on of criminal pcaal - oomisting of a fine of up to S1,500-00 and/or unprisoamai of up to one year and civil penahtits in the form of a Stop Work Order and a fine of 5100.00 a day against me. For 6ga1 use oaty Permit Number z dl% Maps Lot# Signahire 0 f erm. e a• t ,+';. ,'Y1� ";. ty,"'t u. g,•+i'S t e t..-l:. F {t,�t4 -% � t •s !, r1�:j, rJ`. iG t�.. } .}f,� �'r .r ynritr.+ '�,,�7r :,� ,jyr� ,,�. .e, •y' M ,e - : 03,1;-i ' '1Y,r� �� C. �'r•,-_rfi � '� •,�'If'r .cue 'Y.,? ,yr� r . ff yy M T• , ���,tws�.'F. � !" '}�+t' l s '.y 4 •i � + .e 3A�.��,jyi ?,. �, ir�� � f t Y.Ll'/'I,�.u. y G .t jrYY•��s f.yr jet...>a-. +�, ,r 1 rR „, 5*n.: s'�_rprl7' a 'p .r.?, Y°-, ,;,w,. ryS•f�J. 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L� 2r , t,' a+ .r,Y4"t rr r n n!^ ,t � •'r #' s 1, jfTy/y' y 4 j�y�y.li/j�4Tyr� ��pt`� I; �1,�r 1. �. t d) -���/T+ r' r ., +' <•/I l. lt � irr�,t�;�+�i'�� ':43tc�.tM•!�J b4� ..j t(4,e+�, �y�"y�Jk T 7�.. /y, � y+y�a�'4� .r= ,,J� "'"�4„y. •� ,.• .c �',,_ r`�, .y A`sT k'✓W.t nFi tT:t,R'''r � 3•,}+ �� ,+ �`�Y+� � �Y �I",TL� �.�h.� R tY�``�jt: LAMONTAGNE � ,��r„{tj� ,�, .y(�$/i}g't},y�}}�[[j�'j�f�� � a � ,'�a ,'��''� (���, `� {°�`y,'.��`'{—.4ry, � �'."��fi��''�•�Y PAINT & HARDWAR 4't�''� '•/ M.�.I J" r4t (C- .IYl,�tr-i.L-7M/. �7r:l IJy',��'-t�� tl A,i•, T,,� S1.R4 J•` NORTH r J + ,' fi` W s y t {y ti aT�Y 3 1,Z d'" tf�p � « F F��i t •t r r'v V.k N •jy 1 f ;�}t!p1T M' fY'. '{'.. .�t !G'', ,"�T:t / '�1',' ""Fa k{' ?+ R.c'^"•, , ,�'- y� _! :"P`, •1060 r{ •i' : .RY. K t ,aFrnt yJ 4s j �~.r ' 3 Y �'y����•r" V w A .. l,, :' t, /; 1 !... // .// T I, fj�tS 1 �{ J _ _- /fJ/ 1 I , J \. _..._.- s // ` d _%� �, .�- _ . ___-�„-"".r""_ F" FEB 2 2 2000 r o p o S tt l Page No. of Pages MARNEY BUILDERS P.O. Box 128 • Leeds, MA 01053 Craig Marney • (413) 585-5512 License #MA057159 PROPOSAL SUBMITTED TO = J// J� {� PHONE C�,7/�/ {}f DATE , J!E.Z ✓- / - 5 v`�- 7 s✓ STREET JOB NAME ; (/` ✓ T CITY,STATE and ZIP CODE JOB LOCATION J' ✓IBC t /� /!11 C v ARCHITECT DATE OF PLANS JOB PHONE We hereby submit specifications and estimates for: 1 1. C'"c`ev/, ��:•M 'y' 't/... C. ?'le=- .. -J �.J..Lr.i.l �<':._. ...C> x�`i .X'�r3..J�.'...".'t�✓^.�"F'�Cr_ L�'^�.K�!l?S" /.v.1. ��'r�c/ %(.f1 �!'".� ._.__. J �lJ�..� �..'�.� �•1'��.. Sfr./�c.'�'v �'^ 'IC� ./^,C /.�,r �eo .L 4- / / V'— f.�c Ile .L�v- / � / k�.C....�✓• ..�<' �_/''ti / / ^,t3 .. � l j' '�c/•4I:. %�'//,' 1`. ,2 70 �G�/'r��.!�'�' t7o ...�.s -,J/ Ga�!.sF1'f/(=.SSW •._�j, "A ....1 i..� /'.'.. (l,. .... y 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 col== to be filled in by the Banding Department Required Existing Proposed By Zoning Lot size Frontage 5 Setbacks --front - side L:o_R:_e L: R:_� - rear Building height �ty Bldg Square footage 6 %Open Space: 2 / �- (Lot area minus bldg &pac,ed parking) # of -Parking spaces # of Loading Docks Fill: C . { volume--& location) 13 . Certification: I hereby certify that the information co ained herein is true and accurate to the best of my know dge. DXTE: OiJ APPLICANT s SIGNATURE NOTE: Issuanoe of a zoning permit does not relieve a applioanY urden to oomply t4 .4111 zoning requirements and obtain all required permits from the Board of Health, Conservation Commission, Department of Publio Works and other appliomble permit granting authorities. FILE # FEB 2 2a _J f.. 3/ �7 ZONING PERMIT APPLICATION (§10 . 2) PLEASE TYPE OR PRINT ALL INFORMATION 1. Name of Applicant: X, C.4--I C- Z Address: �Erf�/De /=rOL� .��/� /� _Telephone: �; �el �- 2. Owner of Property: (f--e'4-5 k�'e Address:2:4� �/,9'f:iNG,5 Ile- /f d Telephone: 5­5 q 3. Status of Applicant: p'*r-rOwner Contract Purchaser Lessee Other(explain): 4. Job Location: T— Parcel Id: Zoning Map# Parcel# 7`� District(s): frB (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): 5 � loo.0'' /d' w 3 S,`40"4--G. 7. Attached Plans: Sketch Plan k" 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 i/ 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 t1' 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-2000-0731 APPLICANT/CONTACT PERSON FRANCIS X SIENKIEWICZ ADDRESS/PHONE 26 FAIRFIELD AVE (413) 584-1952 PROPERTY LOCATION 12 NORTH MAPLE ST MAP 17C PARCEL 226 ZONE GB THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out Fee Paid T_ypeof Construction: CONSTRUCT 10 X 34 SHED ROOF New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/Statement or License 009034 3 sets of Plans/Plot Plan THE FOLLOWING 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'Fommission Signature of Building` fficial 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. 12 NORTH MAPLE ST BP-2000-0731 GIs#: COMMONWEALTH OF MASSACHUSETTS U.Block: 17C-226 CITY OF NORTHAMPTON Lot:-001 Permit: Building Category: shed BUILDING PERMIT Permit# BP-2000-0731 Proiect# JS-2000-1358 Est.Cost: $6000.00 Fee: $50.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: FRANCIS X SIENKIEWICZ 009034 Lot Size(sq. ft.): 3615.48 Owner: SIENKIEWICZ CONSTANCE L Zoning: GB Applicant: FRANCIS X SIENKIEWICZ AT. 12 NORTH MAPLE ST Applicant Address: Phone: Insurance: 26 FAIRFIELD AVE (413) 584-1952 Workers Compensation FLORENCEMA01062 ISSUED ON:2123100 0:00:00 TO PERFORM THE FOLLOWING WORK.CONSTRUCT 10 X 34 SHED ROOF OST 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 2/23/00 0:00:00 1326 $50.00 212 Main Street,Phone(413) 587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo