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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 8 b y ft Lot No.
2. Owner's name -DA" a- L o lZ of A ht i L L RnI g Address L Au St
3. Builder's name M jX-1 )4 144 M oiq, ►! Address a n COns N,`ll /10. 144uDE.,IV, �lco
Mass.Construction Supervisor's License No. 0 4,0 & r) Expiration Date
4. Addition
5. Alteration KFnr„uo?r �lfc{.P.N AtAj-rxv� - v ��f .4TNAtjfjm � AJ, iV L-ER/t bv7)r. 121'DA����
6. New Porch
7. Is existing building to be demolished? kyt7
8. Repair after the fire —A A
9. Garage _/—V No.of cars Size
10. Method of heating ST�AM.
11. Distance to lot lines
12. Type of roof
13. Siding house
14. Estimated cosL- J�
�vou
The undersigned certifies that a above statements are we to the best of his, her
knowled and belf.
t'
ce--
le apcaf Signature oresp pnt
Remarks [ OrA/C� Ltij jA11iu/ve fir,A)Y&A-riAt eJ9J /Lc1 i!!L1'i'u
6 Dam �ll/G� ��L��/�Gl�r� � w�17
o��"AMM
-
$ S'EP 2 8 11998 �assarEjasrlla
EPARTMENT OF BUILDING INSPECTIONS
DEPT Of SUIL0ING 1NSPECTIONS
NORTHAMPT01� MA 01060 12 Main Street ' Municipal Building
Northampton, Mass. 01060
WORKER'S COMPENSATION INSURANCE Ali t AVIT
censer/permiuee}
with a principal place of busmess/residence at-.
f /
�i/)��'�
7 street/ci ty/stair/zip)
do hereby certify, under the pains and penalties of pegu y, 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 workers compensation policies:
(Name of Contractor) (Insurance Comparry/Polic Number) (Expiration Date)
(Name of Contractor) (Insurance Como any/Po1ic-,,Number) (Expiration Date)
(Name of Contractor) (Insurance Company/Policy Number) (Exp,ira,bon Date)
(Name of Contractor) (Ins-trance Company/Policy Number) (Expiration Date)
(attach addiitional ShCCt ifnC0=—ry m induae information penalising to all a�on�
(� a sole proprietor and have no one working for me.
( ) I am a home owner performing all the work myself.
NOTE:please be await tltai whilo homco"mcrz who cumplay perions to do maiatrnwce,coustrucuorl ar rtparr wow on a dwelling of
not mots than throe units in which the homoowncr rxsidcn or oo the grounds appurtenant thcrct°are not Ecacraily coasidcrtd to be
employ=un. a the workees.comper 4ca Act(GL152,a 1(5))�application by a homeowner for a Uccnx or Permit may evidcna tho
legal etatua of an employer under tho Workeet Compmsaiion ALL
I under i d that a copy of this rt3trmcn1 may be forvr-du to the Dqp tmc of Indutrw Accidea&Offioo of Iuuut<noo for the
coverage unification and that failure to acxtut a vcrngo wodcr se ctioa 25A of MOL 152 can lard to tbo imposition of criminal penalties
comist mg of a fine of up to S 1,500.00 and/or iutptiso�of up to orx yar and civil pmal6es in the form of a Stop W orit Order and a
flan of 5100.00 a day agni-t mo.
For dq=t=OU1—Only
Permit Number .]
I&P-H Lot#
sale ofLi ermittee
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 v
IF YES,describe size,type and location:
11. ALL INFORMATION MIDST BE COMPLETED, or PERMIT CAN BE DENIED DUE TO
LACK OF INFORMATION.
This aolw= to be filled in
-7 141% /zt/f ��/✓L � by the Building Depart= ent
Required
Existing Proposed By Zoning
Lot size
Frontage
Setbacks
- side L: R: L: R:
- rear
Building height
'4Z A
Bldg Square footage
%Open Space:
(Lot area minus bldg
&payed parking)
# of Parking Spaces
Zy Z4
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 know edge
DBE: 7� APPLICANT's SIGNATURE Ardern��to NOTE: Issuanoa of a zoning permit does not relieve a appiioant's b 00 wlt4 all
zoning requirements and obtain all required permits from the Board of Health, onserva�tion
Commission, Department of Publio Works and other applioable permit grants authorities.
FILE #
SEP 2 8198
File
OEPT of $UILDlNG INSPECTIONS
NORTHAMI'TOM MA 01060
ING PERMIT APPLICATION (§10 . 2)
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant: 14/'71AI 6r/iS� -/y1/L�y
Address:9 G r-ya, 8 // Telephone:c2 t,q' 12 Q
2. Owner of Property: /J f. �n,� �'0a; &0A)�
Address: 1�3 l� � Telephone:
3. Status of Applicant: Owner Contract Purchaser Lessee
Other(explain):
4. Job Location: z'$3
Parcel Id: Zoning Map# 47 Parcel# OVA District(s):
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/Property /�LsI*�)'_'//LZ
6. Desffption of Propose Use/Work/Pro.ect/Occupation: (Use additionl sheets if necessary):
l J.yu�s�3 ����
�� S '/ ✓L G' d , 14,1 �b
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 KN0A t/ 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#BP-1999-0344
APPLICANT/CONTACT PERSON Martin Mahoney
ADDRESS/PHONE 20 Fort Hill Rd (413)268-3296
PROPERTY LOCATION 18 LILLY ST
MAP 17C PARCEL 282 ZONE URB
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT ✓
Fee Paid
Building Permit Filled out
Fee Paid 5yV Sr
Type of Construction:
New Construction t Z1016711 1_'A�lw
Non Structural interior renovations
Addition to Existin .
Accessory Structure
Building Plans Included:
Owner/Occupant Statement or License#
3 sets of Plans/Plot Plan ✓
THE F,flLLOWING 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 Commission
-3- -�
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.
Reference No: BP-1999-0344
Department: ...................................
Building, Electrical & Mechanical Permits
.........................................................................................
Fee Type: Receipt No:
New Wiring REC-1999-000905
.......................................................................... . ....................................
Paid By:
Paid in Full On:
Martin Mahoney Fri Oct 02,1998
........................................
.. ...... ......
By: .. .
Received ........................................... .C.
Check No ...................
Linda Lapointe 584
.........................................................................................
......................................
DEPARTMENT'S COPY Amount: $40.00
........... ...............DEPARTMENT FILE COPY 18 LILLY 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: Inspector: Tracking No.: Fee:
BP-1999-0344 $40.00
GIS#: Map Block: Lot: Address: Zonine: Use Group: Lot Size:
1878 17C 282 001 18 LILLY ST URB 16857.72
Contractor: License Type: Insurance:
Martin Mahoney CSL
Address: License No.: Insurance No.:
20 Fort Hill Rd 040602
City: State: Zip Code: Phone:
HAYDENVILLE MA 01039 (413) 268-3296
Proiect No: Category of Work: Const. Class: Cost Estimate:
JS-1999-0712 Non structural interior renovati $4,000.00
Description of Work:
ADD FULL BATH&REPAIR FOUNDATION& SILL
GeoTMS@ 1997 Des Lauriers&Associates,Inc. Signature: