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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations
NORTHAMPTON, MASS._ 19 Additions
APPLIa CATION FOR PERMIT TO ALTER Repair
Garage
1. Location "t� Lot No.
2. Owner's name 1AACA V Address
3. Builder's name Address
Mass.Construction Supervisor's License No. Expiration Date :3 7:7 ZQn2i
4. Addition
5. Alteration
b. New Porch
7. Is existing building to be demolished?
8. Repair after the fire
9. Garage — No.of cars Size
10. Method of heating
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11. Distance to lot lines +
12. Type of roof S D g
13. Siding house
14. Estimated cost:-
The undersign ertifies that h hove statements are we to the best of his,
knowledge lief.
Signature of responsible app,icant
Remarks C�cttC+-� --7 <3� LtLL
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DEPARTMENT OF BUILDWG INSPECTIONS
212'Main Street ' Municipal Building '
Northampton, Mass. 01060 '
W RI R'S COMPENSATION INSURANCE AFMA.VI'T
(lice_ s Permittce}
with a principal place of business/resid�ence at:
q7 _ zo� (phone#) 3
(strc_-Uci ty/stalrJa p)
do hereby certify, under the pains and penalties of pefJury, that:
( ) I am an employer providing the folloWu' 19 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) (Insumnc:�Company/Policy Number) (Expiration Date)
(Name of Contractor) (Insurance Comparry/Poticy Number) (Expiration Date)
(Name of Contractor) (Insurance Company/PoGcy Number) (Expiration Dale)
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(atlacls additioQil shod ifnoccuary to includc mfocinxhon pert-a-9 to ell ooatradon)
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 aw-.trr that wElo hoamvnx-r3 who crnplay pcnom to do m.;.jcn, coasn3aioo or repair work on x dwelling of
not moea than throo units is which the homoowncr rcrida or oa tbo Bounds xppur(caant 6-do arc no(gc)cnlly oowidcrcd to be
cmployrrs under tha%V0rkcr 1 cxompcar4cn Act(GL152,n1(5)1 application by s homcoavr for a license oc pcsmmii may cvidcaoc tho
1CS21 Fixt+of as omployec under rho Woriu?a Compomalioa Act
I understand thzt x oopy of thu ctatcmmi may ba forwarded to tbo Depai of I,odsutri d Ac idca&Moo of Inwraooe for the
cova'kge vQ-tdcatioa and that failure to soot=covango under socUoa 25A of MOL 152 can lad to tbo impositioa of aimm .pcaaltics
ooasistmg of a fine bfuP to S1,500.00 W&Of kVr6o=3cnt of rip to ooc year and civil pcmltia is the form of a Stop Work older sand x 1
f»m 0(5100.00 a dry against mc.'
For&p=tm=W uao oaly
Permit Number
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SUNY-ESF - SCHOOL OF LANDSCAPE ARCHITECTURE 1
TITLE ENVIRONMENTAL STUDIES
DATE SOURCE BY
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TITLE ENVIRONMENTAL STUDIES
DATE SOURCE BY
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SUNY-ESF - SCHOOL OF LANDSCAPE ARCHITECTURE
TITLE ENVIRONMENTAL STUDIES
DATE SOURCE BY
10. Do any signs exist on the property? YES
IF YES,describe size,type and location:
NO
Are there any proposed changes to or additions of signs intended for the property?YES
IF YES,describe size,type and location:
W-3
11 . ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE DENIED DUE TO
LACK OF INFORMATION.
This cola= to be filled in
by the Building Dmpartment
P']_—..! J
13 . Certification: I hereby certify that the infor ation contained herein
�r is true an accurate to the best of my knowl /n
DATE: �{ APPLICANT'S SIGNATURE
NOTE: Issue oe of a zoning permit does not 0elieve an applioanre burden to comply With 4111
zoning requirements and obtain all required permits from the Board of Health, Conservation
Commission, Department of Publio Works and other applioable permit granting authorities.
FILE #
Existing
Proposed
Ruyuit cu 1
By Zoning
Lot size
(o%CCj
1;:2
Frontage
[c)
Setbacks - frnnt
2
- side
L: R:
L: _R:
- rear
Building height
2�t
Bldg Square foot a
%Open Space:
(Lot area minus bldg
&paved Parking)
_ q
# of -Parking spaces
# of Loading Docks
Fill:
-(volume--& location)
_-
13 . Certification: I hereby certify that the infor ation contained herein
�r is true an accurate to the best of my knowl /n
DATE: �{ APPLICANT'S SIGNATURE
NOTE: Issue oe of a zoning permit does not 0elieve an applioanre burden to comply With 4111
zoning requirements and obtain all required permits from the Board of Health, Conservation
Commission, Department of Publio Works and other applioable permit granting authorities.
FILE #
JUN 2 8 199
F3Et�L� �'r n� °`�� File No.
ZONING PERMIT APPLICATION (§10 . 2)
PLEASE TYPE OR PRINT ALL -INFORMATION
�► �
1. Name of Applicant:
Address: Telephone: ! —
1 Owner of Prope
Address: &44 Telephone: &
_iA U 3. Status of Applicant: Owner Contract Purchaser Lessee
Other(explain):
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4. Job Location:
Parcel Id: Zoning Map# 129 Parcel# '41 District(s):
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/Property ��14/ _
6. Description of Proposed UseNMork/Pr ject/Occupa n: (Use additional sheets if necessary
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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 V 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)
File#BP-1999-1142
APPLICANT/CONTACT PERSON Paul McCutcheon
ADDRESS/PHONE 87 Chestnut St (413)529-9973
{
PROPERTY LOCATION 3 HIGH ST
MAP 17D PARCEL 043 ZONE URB
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Fille4 gut _
Fee Paid
Typeof Construction: REPLACE 6 X 15 WITH 2 STORY DECK 16 X 20
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/Statement or License 062544
3 sets of Plans/Plot Plan
THE F OWING ACTION HAS BEEN TAKEN ON THIS APPLICATION:
pproved 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
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Other Permits Required:
Curb Cut from DPW Water Availability Sewer Availability
Septic Approval Board of Health Well Water Potability Board of Health
Permit fr Conservation Commiss'
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.
e
3 HIGH ST BP-1999-1142
GIs#: COMMONWEALTH OF MASSACHUSETTS
MU:Block: 17D-043 CITY OF NORTHAMPTON
Lot:-001
Permit: Buildina
Category: alteration-addition BUILDING PERMIT
Permit#_ —1 1-142
Project# JS-1999-1896
Est. Cost:
Fee:$40.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: Paul McCutcheon 062544
Lot Size(sq.ft.): 5183.64 Owner: MARTIN JOHN K
Zoning:URB Applicant., Paul McCutcheon
AT: 3 HIGH ST
Applicant Address: Phone: Insurance:
87 Chestnut St (413) 529-9973
FLORENCE 01062 ISSUED ON:71111999 0:00:00
TO PERFORM THE FOLLOWING WORK.-REPLACE 6 X 15 WITH 2 STORY DECK 16 X 20
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:
i
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 Sienature•
Fee Type: Receipt No: Date Paid: Check No: Amount:
Building 7/1/1999 0:00:00 $40.00
212 Main Street,Phone(413)587-1240,Fax:(413)587-1272
Building Commissioner-Anthony Patillo