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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. ` r �� Alterations
NORTHAMPTON, MASS. 19 k Additions
APPLICATION FOR PERMIT TO ALTER Repair
7— Garage
1. Location�/ Gl {� S/v'.� W �' �;'i �u ;, ��_ Lot No.
2. Owner's name `��Yl a n- ��� M.„ Address o S .d V/
3. Builder's name J A. r 1r y IP4 c; t1. L� Address �d
Mass.Construction Supervisor's License No. / e v Expiration Date 4 — 9
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
12. Type of roof IT
13. Siding house
14. Estimated cost:-
The undersigned certifies that the above statements are true to the best of his, her
knowledge and belief.
Signature 1-f onsible app icani
Remarks
4-�IVJrpp,
a CrlfJ of Narillanlp f oTi .
t
Q �:�sachnsclla
m DEPARTMENT OF BUILDDIC INSPECTIONS
212 Main Street ' Municipal Building
Northampton, Mass. 01060
WOMCCR'S CON PENSATION INSU-RA_NCE , = AVTP
I
with a principal place of busi0css/res1dence at:
�{C ,4t21t�. �t11 anon � ic � (phoney
Ucih/staL,/nP)
do hereby car-tiFy, tinder gibe pins and penalocs of perury, his
I am an employer providing the followMS %VO('�;ef's coa)pc )S2uon cove agc For my
employees woridng on Ibis job.
ZZZa
Ainsu=cc Company) (Policy Number) (F_xpiratio Date)
( ) I am a sole proprietor, general conrracior or homeowner (circle one) and have hired
u con•ua.ctorS listed below who have Cite Movvl.ng work-cl S compf--> luil polkles:
(Name of Contractor) QLasu ancz Com}r-uy/Poky Number) (Fxpim6on Datc)
(Name of CollLT2clor) (Inane Corop<:,},/?ol:cy (E»ira6on Datc)
(Name of Contractor) (Lnstuanc CompaM,/Polio Numb-Lr) (i=.ipinoon Daic)
(14ame of Contractor) (LnSUFMC; Cornpluy/PolicY Numb-ts) ( xpira6on Dates)
(r 11 ch adclitioml c+ax1 iloccc�ry co cc�rd�iafocmijco pc::�:ng w .11 c��rr_r on)
( ) I am a sole proprietor and have no one working for me.
( ) I am a home ovrner perfonuing all the vlork myself.
NOT plcsc be aw.,rc tha-t w�,.1)o f+o¢crnvper�.ti bo=play PaTC—to do[r�:i!cai�r�a�.'rtutioa�cc rcy��r work oa i d—ll oy or
not-oce IL-.a tlrt o gaits in c—�dc ct oo LS- -be
—TIDY—under tbo--ckcf`z ar c- fio,At(G L1 523 1(5)�appl ca on try c bocu,, —r far cc m t spy v ca<die
lc-ga.l ct--tw of na cnployoc unc:cr trio Wcre,c',Compoas..tioa kt
I understand tbai a ooyy or this rn r...ti.-..+may bo f«vwi cS.ed to cbo D-4----f OfS— IS-
co—ac ycciE=ioa and that failtrtc to enure coycraoro under sc, ioa 23A dl K)L 132 c-w.lcc.d to tba"impazitica of caiminA Pcnelt;cs
ooaiutrmg orx6mc o(tip to s 1-500.60 mc'Jor unpcoonnx oCup to ooc Yr=r Lad ciysl Pc 16 in the focm CC Stop Wok,ort'.cr and i
saoo(stoo_oo idly apiast.t�
Signcd this Of 1997 Ford9at �lt.�only
Permit Number
Mai! Lot i#
SigDaab= Licczs-c crmi
:x
10. Do any signs exist 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 column to be filled in
by the Building Department
Required
Existing Proposed By Zoning
Lot size
Frontage
Setbacks frnnt
- s 4�e L:---` :- i. _ R•
- rear
Building height
Bldg Square footage
%Open Space:
'(Lotarea minus bldg
' &paved parking)
,pf Parking spaces
# rof Loading Docks
Fill:
-:(vol-iime--& location)
'13 . Certification: I hereby certify that the information contained herein
_ is true and accurate to the best of my knowledge.
1
DANE:- _ APPLICANT's SIGNATURE cv
NOTE: Issuanoe of at zoning permit does not relieve an applio nt's bu n to comply with alt
zoning requirements and obtain all required permits from the Board f Health, Conservation ._
Commission, Department of Publio Works and other applioable permit granting authorities.
=` ' FILE #
I
' AUG 2 9 19 Fi 1 e No. ,; c
., ? Nl'�N PERMIT APPLICATION (§10 . 2)
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant: v' -
Address: TeiephoneDr K,-2
2. Owner of Property: Lt L-j — 6:1z f
Address: /� S�Y,a 2v Telephone: S y7 5 L
3. Status of Applicant: Owner _�/eontract Purchaser Lessee
Other(explain):
4. Job Location: ) s/ YA ,Ls —
Parcel Id: Zoning Map# /-)p Parcel#�_ District(s):;��
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/Property
6. Description of Proposed Use/Work/Pro ect/Occupatio (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)
FILE
Nij- 2 919 _ _
APPLICANTXONI-ACT PERSON: ,G a V, d 7Zo 3 75
PROPERTY LOCATION:
MAP PARCEL: Z
THIS SECTION FOR-OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
Fee Pnid
lRiiii ing Permit Filled Fee Pnid
/ v'
Additinn to Existing
"G 6 LIi
THE LLOWING ACTION HAS BEEN TAKEN ON THIS AP ICATION:
Approved as presentedfbased 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-Bd of Health Well Water Potability-Bd Health
!Permit from Conservatio ommission
/.�_ }
Signature of Building lkvmor Date
NOTE: Issuanoe 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 applioabla permit granting authortties.
,�r�a���"•� Cit of Northampton REQUIRED INSPECTIONS y
i e 1. Footings and Walls
BUILDING DEPARTMENT 2. Structural Components in Place*
3. Complete Building*
No. 826 Office of the Building Inspector
Zoning Form No. 962726 Date 9/2/97 Fee $20.00 Check# 1882
Page, 17D Parcel 53 ,Zone URB Section 127 ❑ Yes ® No
BUI]LDINGPERMIT
* Plumbing and Electrical Inspections required
THIS CERTIFIES THAT Larry Paquette before Building Inspections
has permission to strip & reshingle roof Inspection on Site—Foundations
situated on 106 Straw Avenue - Mary Whitwood Inspection of Plumbing—Rough
provided that the person accepting this permit shall in every respect Inspection of Plumbing—Finish
conform to the terms of the application on file in this office, and to the Gas Inspection
provisions of the Statutes and the Ordinances relating to the Construction, Inspection of Wiring—Rough
Maintenance and Inspection of Buildings in the City of Northampton.
Any violation of any of the terms above noted is an immediate revocation Inspection of Wiring—Finish
of this permit.Expires six months from date of issuance,if not started. Building Inspection—Rough
Note:A certificate of occupancy will be issued by this office upon return Insulation Inspection
of this card signed by the Plumbing,Wiring and Building Inspectors.
Building Inspection—Finish
** Install per Manufacturer's information: windows,vinyl siding,roofs Smoke Detectors(Fire Department)
and woodstoves
Other
THIS CARD MUST BE DISPLAYED IN A CONSPICUOUS PLACE ONT ISES
Certificate of Occupancy
v Building Inspector