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17D-053 z i T �• v A T 0 Z m rn -3 p R "ti F > � o z � 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