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17D-047 (4) > o A v ro o' 1� D n Z O cry f �W �1 Z O /�/n�� C a 70 c' in Z C D > o rr O I rfl Zoning Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations NORTHAMPTON, MASS. / �ta 1910 Additions APPLICATION FOR PERMIT TO ALTER Repair Garage 1. a ( f �l'Hf l/ 1 o Lot No. 2. Owner's name f C*Vk-4A u-Li1_Xat14 7�� Address �7 v rpA�2r A U� 3. Builder's name h 4 �.- �-) �i4�n cJe��i c Address f?04 -4�. io_^ Mass.Construction Supervisor's License No. 11r© °` p Expiration Date 4. Addition 5. Alteration 6. New Porch 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 n 12. Type of roof n _ — �'1 �C–/`ae�_rZ d G A a-,In.e 6Le3� 13. Siding house 14. Estimated cost:- Yj sa a The undersigned certifies that the above statements are we to the best of his, her knowledge and belief. Signature of responsible app icant Remarks 1, �O 0 a OCT 1 6 908 �z� >xf �nxflJa»t�fan . Q �i:�snchn'scllr DEPARTMENT OF BUILDDIC INSPECTIONS 212 Main Street ' Municipal Building Northampton, Macs. 01060 WORZCER'S COMPENSATION INSU-RA-NCE t AVIT (lio-�peruu(tc;) with a principal place of busincss/residence at: i r 0. /a ' (phoocr�) do hereby cer-LiTy, under the pains and penalties of perjury, 1l? ( ) X am an employer providing the following wor'ker's compensation cove:-aoe ror My employees worming on this job. At�� C yd%f�0 9�2 2 Cot;zgzny) (Policy Number) irati n Date) ( ) I am a sole proprietor, general coo actor or homeowner (circle one) and have hirers the contractors listed below who have the following worker's compensation policies: (Name of Contractor) QMsura-DC-- Company/Poucy Number) (F im6on Date) (Name of Contractor) Rnsur-air CoMpauylPoliey Number) (EXPiraoon Date) (Nzmc of Contractor) (Caul-ancz ampao),/Po6c-f Numyzr) (Expiration Datc) (Nave of Contractor) (Inau-coon Compamy/Policy Number) (Ex-piraoon Date) (r�c?t>.dditioml ctxC yo--y to ..rccmijoo pctirnng to.0 coctr-won) ( ) I am a sole proprietor and have no one wor—Eq for me. ( ) I am a home owner perforrtt- all the work myself. o NOTE-Plc be avrarc ttut whijo boocoti 3�bo cc--:ploy pc zo w do m tc�--<�oa"or mpur work on i d—tLng or cot mat th_n ti,—units in wt,;ct,the cr co tb,:Qourals zppLgtc t tb:.,-cto arc D:x&c ,Lly coaluc c od to be —Ployrr3 uodcr tbo%Yo, r z. �,pc co/let(G L 152.E 1(5)�application by,boo-o w;i r for a 6cczt,<oc permit z y cvid ttic loV(etzhi of an—Ployer under tan Wo"L e,Compcoution lu-t I un<Sastnnd Cfv2 a copy of thl.r .-.e a.y foc}vnrSod tv the DcVu x of l—!--i d 0L —of I for th4 oovcmggc vcrifi-lioo and th-Lurtrrc to�ccurc wvm by u.cr sc oa 23A oCMOL 152 cw 1c d to tbd isrpositicn ofcritnaut pca. Ec-s oowL,t)xZ of A'fine bf up to S 1-500,00+.acJcr jaTr-j anent oCLLP W ooc ycr,rid aVa pcmhio in[hc form 0 C A Step W elk Ordcr and i Eno o(5 100.001day L&dnal.me— . Signed this day of 1997 Fordo - � —JIf Permit Number Lo t 9 Sig)oab=of Liccnsccfpc m—u6 c K 10. Do any signs east 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 colwm to be filled in by the Building Department Required Existing Proposed By Zoning Lot size Frontage Setbacks - side L: R: L: R: - rear Building height Bldg Square footage %Open Space: (Lotarea minus bldg ' &paved parking) �# of Parking Spaces of Loading Docks Fill: Avol-time--& location) 13 . Certification: I hereby certify that the information contained herein is true and accurate to the best of my knowledge. _3 DATE: APPLICANT's SIGNATURE i" NOTE: Issuanoa of a zoning g permit does not relieve an a lioant's urden to comply wittt,,oll zoning requirements and obtain all required permits from the Bo of Health. Conservation Commission. Department of Publio Works and other applioabla permit granting authorities. FILE # s+ r �d ) File No. ZONING PERMIT APPLICATION (§10 . 2 PLEASE TYPE OR PRSNT ALL INFORMATION 1. Name of Applicant: ' Ir r L/ A V y i9� Address: 0e.►r � Telephone: �o� rJ 2. Owner of Property: '� Address: J- r,4,ZV � %., Telephone: 3. Status of Applicant: Owner Contract Purchaser Lessee Other(explain): 4. Job Location: Parcel Id: Zoning Map# Parcel# District(s): � �' (TO BE FILLED IN BY THE BUILDING DEPARTMENT) S. Existing Use of Structure/Property 6. Descriptiaa-of Proposed UseA/V rk/Project/Occupation: (Use additional sheets if necessary): 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 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) Department: Reference No: BP-1999-0403 ................................... Building, Electrical & Mechanical Permits Fee Type: Receipt No: Roofing REC-1999-001093 Paid By: Paid in Full 0 n Larry Paquette Tue Oct 20,1998 ......................................................................................... ...................................... Received By: Check No: Linda Lapointe 2177 ......................................................................................... .........•••.•.........•••.•....•..... DEPARTMENT'S COPY Amount: $20.00 ........................... DEPARTMENTFILE COPY 74 STRAW AVE 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: 20 Oct, 1998 BP-1999-0403 $20.00 GIS#: Map Block: Lot: Address: Zoning: Use Group: Lot Size: 1998 17D 047 001 74 STRAW AVE URB 5183.64 Contractor: License Type: Insurance: Larry Paquette HIC Address: License No.: Insurance No.: 40 East Green Street 100679 Liba State: Zip Code: Phone: EASTHAMPTON MA 01027 (413) 527-6375 Proiect No: Category of Work: Const. Class: Cost Estimate: JS-1999-0815 roofing $4,500.00 Description of Work: STRIP & SHINGLE ROOF GeoTIVIS@ 1997 Des Lauriers&Associates,Inc. Signature: