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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations
NORTHAMPTON, MASS. U6 41 19 Additions
APPLICATION FOR PERMIT TO ALTER Repair
a
Garage
1. Location I.S 6 H9 , 6 � -ST— E/_0 Lot No.
2. Owner's name nWj? MA-W--bA) Address Six
3. Builder's name /�i�( s✓�C�z.� �11� Address Y�t—
Mass.Construction Supervisor's License No. Q�17�Sd 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
12. Type of roof
13. Siding house /N✓�. / �c t i�g
14. Estimated cosC-
The undersigned certifies that the above statements are we to the best of his, her
knowledge and belie ,
Signature of responsible app,icant
Remarks
i
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�. DEPARTMENT OF BUILDING INSPECT'IONS
212 Main Street ' Municipal Building
Northampton, Mass. 01060
WORKER'S COMTENSATTON LNST V CE A FIDAVIT
(lictinr°Jpermittcc}
V:1ith a principal place of business/r�sicieuce at.
C'/-fj_ _f%Ui'✓
i
(sty e�v'Ci ty/staLJz�p)
do herclw Cc:ufy, unci : the pains acid pen-Ries oc penury, L1 i
I aI11 -11 pm,,ridinz th'! P,'GI C01111 TOi IIl`i'
employees ,,or-;iri�� oil t !is
I am a sole prOpi7ci0; gcnrtral COIIlr2ctor Or homeowner (circle 0='-`�) alad have 11' ed
the contractors listed below who have she following workers compention policies:
D2tC�
(N2Inc i C"OLtiaCi0r)
(Name ct Contractor) (Inszir n� Com�iarp/Polic� iIILIb�_r) ( xpi.radoo Date)
(Name of Contractor) (FxD1S2tlon Date)
(auach zd3i'scril r:._c;ifr.cccsrsr�tp i:r_iwSc i=JO(mi:icr.p.-:ai:—IF!n all c,n:rac%c�n)
(�I am a solo, proprietor and have no one vI,orkino for me.
( ) I am a hone performing all the work myself.
NOTE:pk-- c be nvnlc that%N-kilo bcaxo tvcra w'.),3 a�loy paTOm to do m-:r*t�cou5:ructionor rrpau work on a d«clling of
not moco than thiroo uritr in tc'aich tlx t� »ouuvrr rrs do oc oa the�,c au b apputtca.n:tb,-cto Lr no(fcr rz4 oo¢tidacd to be
cmploycn unctcr the LVOrl[r'I_oc m( ticn Ad(GL152 s 1(S)j nppiicLtion by a homco"-aa far a Gccnx a pumII may cvidcaoc the
le-94 Ltatlu of an cnployoc undor tho Workmo x Corn;>oo ioo A. i-
I undcrilaud thst�r copy otthia cht®cni may bo forvvudnd to tho 1)cpartmcnt of Indu--it" Arndmb'Ct of r for the
covaa va'f'c:t ioo nad that f"urc to acc=covcmn LDdkr 5cciioa 25A of MOL 152 can Icad to tbd imposition of criminal pca&wca
coosistwz of a fmc'ofup to S 1,500.00 and/or of Lip to onr"ytsr and civil pcn Wcs in the form of m Stop Work order Lod L
fum of 5100.00 L day tpinzl rnc.
�^ For iqnti= al use only
Pcrmit Number
Lot#
Signature of L.icca.-,c,-- crmittcc
r a.
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.
TZ-: roi== ba be filled is
by the R=2d2-n9 Dep&=t=mnt
Required
Existing Proposed By Zoning
Lot size
Frontage
Setbacks
- side L: R: L: R:
- rear
Building height
Bldg Square footage
%Open Space:
(Lot area minus bldg
&paved parking)
# of Parking spaces
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 knowledge.
DATE: 8/�- 5�� APPLICANT's SIGNATUREEi-s'�/�
NOTE: lasuanoe of as zoning permit does not relieve an appiloant's burden to oomply wR4 .4jll
zoning requirements and obtain all required permits from the Board of Health. Conservation
Commission. Department of Publio Works and other appiioabla permit granting authorities.
FILE #
J 9
Fi 1 e 0
ZONING PERMIT APPLICATION (§10 . 2)
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant:_! 6i�i�� � :1
Address: _ SJJ ,A/ Al Telephone:
2. Owner of Property/: 01;4e-1X /�/�32�7i✓
Address: ) �— ele'l s/ Telephone: Shy ��35
3. Status of Applicant: Owner Contract Purchaser Lessee
Other(explain):
4. Job Location:
Parcel Id: Zoning Map# �� Parcel#.,=::.0 District(s):
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/Property
6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary):
:5—, /. y^
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/`✓ariance/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)
Reference No: BP-1999-0191
Department: ...................................
Building,Electrical & Mechanical Permits
Fee Receipt No:
Vinyl siding REC-1999-000384
Paid Paid i n Full 0 n
Ed Corbett Jr Fri Aug 14,1998
...... ...... .... .. . ...... .....eceived By Check No
Linda Lapointe 2844
....................:.................................................................... ......................................
DEPARTMENT'S COPY Amount: S20.00
...........................
1H."111ARTMENT FILE COPV 15 GARFIELD 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:
14 Aug, 1998 BP-1999-0191 $20.00
GIS Map Block: Lot: Address: Zoning: Use Group: Lot Size:
2013 17D 062 001 15 GARFIELD ST URB 7492.32
Contractor: License Type: Insurance:
Ed Corbett Jr HIC
Address: License No.: Insurance No.:
4 Reed Street 116069
Li!3:i State: Zip Code: Phone:
NORTHAMPTON MA 01060 (413) 584-6571
Proiect No: Category
-y of Work: Const. Class: Cost Estimate:
JS-1999-0326 vinyl siding $5,575.00
Description of Work:
INSTALL VINYL SIDING
GeoTMS@ 1997 Des Lauriers&Associates,Inc. Signature: