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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations
NORTHAMPTON, MASS. 1 g Additions
APPLICATION FOR PERMIT TO ALTER a
Repair
Garage
1. Location 1� � � Lot No.
2. Owner's name Address
3. Builder's name Address Qk!,
Mass.Construction Supervisor's License No. Expiration Date
4. Addition
V�
5. Alteration ` '�C ��JSv
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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 cosL-
The undersigned certifies that the above statements are true to the best of his, her
knowledge and belief.
�Signazuresponsible appicani
Remarks
2204
24 401 121 221 3011 3011 —f— 301 281
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W21 DISH. 24" 1 S 36 i B18R i 384
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221
1.1322 38,2113
451 36" REFR-2 0 - ,
BD24.04 O B18LL ' 344
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415 WB2430 W3018 W1 830L 11
it
1144 404 65J
2201
Smith Scale : maximum Design : 05/13/97
Dwg no.
All dimensions&size designations This is an original design and must Date 05/13/97
given are subject to verification on not be released or copied unless Smith College
job site and adjustment to fit job applicable fee has been paid or job Designer
conditions. order placed.
. Scott W.Anderson
lye VIL/
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DEPARTMENT OF BUILDING INSPECTIONS
212 Main Street ' Municipal Building '
Northampton, Mass. 01060 ~ '
WORKER'S COMPENSATION INSURANCE AFFIDAVIT
L
(licenser/permittee)
with a principal place of business/residence at:
(Phone#) t��Tt
(street/city/ afe/ap) ���3�t
do hereby certify, under the pains and penalties of perjury, that:
(v'fI am.an employer providing the following worker's compensation coverage for my
employees working on this job: \71, \-\:)ovi'T
(hmuance Company) (Policy Number) (Expiration Date)
( ) 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 Company/Policy Number) (Expiration Date)
(Name of Contractor) (Insurance Compaay/Policy Number) (Expiration Date)
(Name of Contractor) (Insurance Company/Pohcy Number) (:Expiration Dale)
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(anach additional shed ifnooenuy to include udo ma ioa pertaining to all ooatm s rs)
( ) I am a sole proprietor and have no one working for me.
O I am a home owner performing all the work myself.
NOTE:please be aware that while homeowaera who employ persons to do makdc an,c�omsuua oa or repair work on a dwelling of
not morn than throe units in which the homeowner r=dca of on the grmraSs appurtenant thereto aro not gene ally coaride ed to be
employers under the vmricer's compensation Act(GLI52,ss 1(5)),application by a homeowner for a license or permit may evidence the
legal status of as employer under the Workers Compensation Act
I understand that a copy of this twemeat may be forwarded to the Dtputmcor of Idustrial Acrideatr'Offioe of Iffiurance for the
coverage verification and that failure to secure ooveragv under section 25A of MOL 152 can lmd to the imposition of criminal penalties
consisting of a fine of up to$1,500.00=&Or imprisonment of up to one year and civil penalties in the form of a Stop Work Order and a
fine of 5100.00 a day against me.
Signed this ` day of 1997 For depaiUxa l use only
` Permit Number
Lot#
Signature of LicenseeTermittee
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 col— to be filled in
by the Balding Department
Required
Existing Proposed By Zoning
Lot size
Frontage
Setbacks -frnnt
- side L: R: L: R:
- rear
Building height
Bldg Square footage
%Open Space:
(Lot area minus bldg
' &paved parking)
.Pf, Parking spaces
# of Loading Docks
Fill:
'4vol-lime-& location)
13 . Certification: I hereby certify that the information contained herein
is true and accurate to the best of my knowledge.
y
DATE: APPLICANT's $IGNATURE
NOTE: Issu o of a zonin +
g permit does not relieve an ap lloant's burde to oon -.y wlth'. "tt
X9 ning req it ants and obtain all required permits from he Board of ealth, Conservation
Commission, Department of Publio Works and other applionble permit granting authorities.--
''7
,, FILE #
MAY 2 21997 File Ivo.QHS&
ZONING PERMIT APPLICATION (§10 . 2)
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant:
Address:QL> ` -Telephone:
2. Owner of Property, C
Address: '�K �rc N-Nva _ N""' Telephone: 5 ��
3. Status of Applicant: Owner Contract P\u-rchaser Lessee
Other(explain):
4. Job Location:
Parcel Id: Zoning Map# �1 Parcel# 61 District(s):
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/Property
6. De�scri tion of Proposed Us /V11oLk/Project/Occupation� Use additional sheets if necessa
i c <�i44 r�
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 # 7 C;
MAY 2 21991 455
'APPLICAN`T/(bNTACT PERSON:
ADDRESS/PHOTNE: 2d6j,,Lz ?ti- r7
PROPERTY OCATION:
MAP PARCEL: l�f ZONE
THIS SECTION FOR-OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM MLED OUT
Fee PAid
Riii1ding Permit Filled Out
AIZI
inn M
jM I
-3 Set, Of PlAns /Plat Plan
THE LOWING ACTION HAS BEEN TAKEN ON THIS AP ICATION-
Approved as presented/based 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 Conservation C mission
Signature of Building Insp Date
NOTE:Issuance of a zoning permit does not relieve an applioant's burden to comply with all
zoning requirements and obtain all required permits from the Board of Health, Conservation
Commission, Department of Publio Works and other applicable permit granting authoritles.
C 0 .
j Ort ampton REQUIRED INSPECTIONS
e 1. Footings and Walls
BUILDING DEPARTMENT 2. Structural Components in Place*
3. Complete Building*
NO. 453 Office of the Building Inspector
Zoning Form No. 962286 Date 6/2/97 Fee$40.00 Check# 2129
Page, 38 Parcel 61 ,Zone URB Section 127 ❑ Yes ® No
BUILDING r .,nRM I
* Plumbing and Electrical Inspections required
THIS CERTIFIES THAT Kevin C Netto Construction Inc before Building Inspections
has permission to Remodel 1st fl kitchen,2nd fl bath,replace interior Inspection on Site—Foundations
situated on 178 West St – Smith College--
doors,trim & windows 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 data: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 CONSPICUOUS PLACE ON PREMISES
Certificate of Occupancy _ -X5�
Building Inspector
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City p O or mini t n REQUMD INSPECTIONS
! e 1. Footings and Walls
a BUILDING DEPARTMENT 2. Structural Components in Place*
3. Complete Building*
NO. 453 Office of the Building Inspector
Zoning Fonn No. 962286 Date 6/2/97 Fee$40.00 (heck# 2129
Page, 38 Parcel 61 ,Zone uRB Section 127 ❑ Yes ® No
BU11LD1NGP, ERM1r-1
*Plumbing and Electrical Inspections required
THIS CERTIFIES THAT Kevin C Netto Construction Inc before Building Inspections
has permission to Remodel 1st fl kitchen,2nd fl bath,reploice interior Inspection on Site—Foundations
doors,trim & windows Inspection of Plumbing—Rough
situated on 178 West St - Smith College
provided that the person accepting this permit shall in every spect Inspection of Plumbing—Finish
conform to the terms of the application on this office,an o the Gas Inspection
provisions of the Statutes and the Ordin s relatin theCons u 'on, Inspection of Wiring—Rough
Maintenance and Inspection of Buil ' gs in the Ci of North n.
Any violation of any of the terns abov noted is an' ate revoca on Inspection of Wiring—Finish
of this permit.Expires six months f date iss ifnotsh Building Inspection—Rough
Note:A certificate of occupancy will is ed by this o ce upon re Insulation Inspection
of this card signed by the Plumbing,W' g and Buil ' Inspectors.
Building Inspection—Finish
Smoke Detectors(Fire Department)
Other
THIS CARD MUST BE DISPLAYED IN A CONSPICUOUS PLACE ON PREMISES
f
Certificate of Occupancy
Building Inspector
t ww^r
A
City of Northampton
BUILDING INSPECTION LABEL
APPROVEp
—��
inspector r
!s.9S 5 v?eP.c P4.17—
Date - % p
?` 'oy / ' Utamptoti REQUIRED INSPECTIONS
A
g 1. Footings and Walls
BUILDINGDEPARTMENT 2. Structural Components in Place
3. Complete Building*
Office of the Building Inspector
NO. 453
962286 / Date 6/2/97 Fee$40.00 Check# 2129
Zoning Form No. ejPID � .
Page, 38 Parcel 61 Zone URB ` Section 127 ❑ Yes ® No
]JUILDINGPERM11
* Plumbing and Electrical Inspections required
THIS CERTIFIES THAT Kevin C Netto Construction Inc before Building Inspections
has permission to Remodel 1st fl kitchen,2nd fl bath,repLace interior Inspection on Site—Foundations
doors,trim & windows
situated on 178 West St - Smith Collec�e _ Inspection of Plumbing—Rough
provided that the person accepting this permit shall in every respect Inspection of Plumbing—Finish �y
conform to the terms of the application on file in this office, and to the Gas Inspection Qa7
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 thispermit.Expires six months from date of is nuance,if not started. Building Inspection—Rough -6-14-
Note:
6-f4Note: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 c:-A-- �j-�Z-9
Smoke Detectors (Fire Department)
Other
THIS CARD MUST BE DISPLAY IN A CONSPICUOUS PLACE ON TtW PREMISES
Certificate of Occupancy _
Building Inspector