17D-058 (6) m �
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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations
NORTHAMPTON, MASS. 145 '7 y 9 19 Additions
APPLICATION FOR PERMIT TO ALTER a Repair
Garage
1. Location Lot No.
2. Owner's name k i C 1 4 Iq9T l- F�/i, -h rc,WVV Address 1-5—
3. Builder's name NEB Se fJ Si�� <.c��✓/K1f�' *KC 7ArJAVdtlAMF 7Address 3,-76 X1 146,6 /. e-
Mass.Construction Supervisor's License No. Expiration Date Z '(7 9
4. Addition
5. Alteration /49L /w -; Tah
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
14. Estimated cost:- t�
The undersigned certifies that the above statements are true to the best of his, her
knowledge and belief.
ignaiure of responsible appicant
Remarks -' s/r GX ( (�'c t-Lt /E dw(ss-L �� `f � ,L /���f
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DEPARTMENT OP BUILDING INSPECTIONS _
212 Main Street ' Municipal Building
Northampton, Macs. 01060
WORKER'S COMPENSATION INSURANCE AF I AVIT
I, Nelson A. jfflctt / Valley Home Improvement,—Inc_.
(licensce/permittec)
with a principal place of business/residence at:
320 Riverside Drive_, Northampton, MA 01060 (phone#) (413) 584-7522
(st=UCity/s W2:ip)
do hereby certify, under the pains and penalties of perjury, that:
Cq I am an employer providing the following worker's compensation coverage for my
employees working on this job:
Eastern Casualty Ins. Co. WC9660047 2/1/99
(Insurance Company) (Policy Number) (Expiration Date)
O 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) (Insurance Cornpany/Policy Number) (Expiration Date)
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(Name of Contractor) (Insurance Compauy/Poticy Number) (Expiration Date)
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(attach arlditioosl abed hf neoesaary eo mehKi.itfvrsttatiot pers.iain;to ali ooatr.aoa)
h ( ) 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 asrun that v6 do bomoownen wbo employ pasom to do mamtem ce,c=gructioo or rtpair work oo a dwellitg of
not mote than thm units in which the bomeowoer resides or on the Vvunds appurtenant thaceo arc tot Caoemtiy comidaed to be
cmploycn under the%vorka's oocnpansation/pct(GL111,sa I(S)),application by a li mcowna for a list—a permit may evidmw tho
ItSA rtatua of an employtr under the Workeez Compamatiocs Act
I uodentaud that a copy of this atatemma may be forwardad to the Dopartmeot of leckumial A=WOAY Olrios of lrtstraoos for the
oovair veritlestioc and that Enure to secure covmgo urxw section 25A of MOL 152 an lad to the imposition of criminal pemAda
ooaaining of a fine of up to S 1,500.00 ant/tr impr6onaxni of up to one ytir std civil penalties it the form of a Stop Work Order and a
find of 5100.00 a diy apimt ax.
Signed this day of 199 For d Pwunatal un only
Permit Number
r,vim.
MaP4 Lot k
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:
i
11. ALL INFORMATION MAST BE COMPLET$D, or PERMIT CAN BE DENTED DUE TO
LACK OF INFORMATION.
This Co02= a to be Ezu 7 is
by the Ba;T.i;n4 DapartmeIIt
Required .
Existing I Proposed By Zoning
Lot size
T V
Frontage
Setbacks
side L: R: L: R:
- rear
Building height
Bldg Square footage j
%Open Space:
(Lot area minus bldg
' &paved parking)
# pf 'Parking spaces
^#
of Loading Docks
Fill:
(volZtime--& location)
'13 . Certification: I hereby certify #; at the information contained herein
_ is true and accurate to the best bf my knowledge.
}
DA'Z'E: '3 APPLICANT's SIGOWURE 1
NOTE: Issuanoe of a zoning permit does not re¢iieve an appli is burden to comply with all
zoning requirements and obtain all required permits from th Board of Health, Conservation
Commission. Department of Publio Works and {other applloable permit granting authoritles.
FILE `
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V AP, 2 6199 File No.
Z.ON-TNG PERMIT APPLICATION (§10 . 2)
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant: Ox�%
Address: -&& &9
2. Owner of Property:a iPi�` � r Kfil/1ZfVA)
P
Address: /S C M,� AIS, 1!2)t�f/Ua Telephone:
3. Status of Applicant: Owner Contract Purchaser Lessee
iOther(explain):
4. Job Location:
Parcel Id: Zoning Map# 7-P Parcel# 3 T District(s):�
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)DEPARTMENT)
5. Existing Use of Structure/Property �, , r L 7 C
6. Description of Proposed Use/Work/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 L- � 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)
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�' .. FILE # 963336
A
Ivr�i�fd._1S CONTACT PERSON: -
ADDRESS/PHONE: jo ) 1 ,
PROPERTY LOCATION:
MAP /� PARCEL: ZONE 111'z '--
THIS SECTION FMOFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
70NING FORM FH,T,FD OUT
Fee Paid 9, EL — ✓"
T 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
epic Approval-Bd of Health Well Water Potability-Bd Health
!Permit from Conservatio ommissio
Signature of Building ector Date
NOTE:Issuanoe of a zoning permit does not relieve an applicant's burden to comply with all
zoning requirements and obtain ail required permits from the Board of Health. Conservation
Commlealon, Department of Pubiio Works and other applicable permit granting authorities.
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City of Northampton REQUIRED INSPECTIONS
g
1. FootingsandWalls
BUILDING DEPARTMENT 2. Structural Components in Place*
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3. Complete Building*
Office of the Building Inspector
NO. 1392
Zoning Form No. 963336 Date 3/27/98 Fee 4$ 0.00 Check# 8856
Page, 17D Parcel 58 ,Zone URB Section 127 ❑ Yes No
BUI]LDING PERNUI
* Plumbing and Electrical Inspections required
THIS CERTIFIES THAT Valley Home Improvement Inc before Building Inspections
has permission to install new tub & shower valve Inspection on Site—Foundations
situated on 15 Garfield Ave - Richard & Kathleen Sherman 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
Smoke Detectors(Fire Department)
Other
THIS CARD MUST BE DISPLAYED IN A CONSPICUOU L E MISES
Certificate of Occupancy
Building inspector