24A-010 (3) ASO City of Northampton REQUIRED INSPECTIONS
e1. Footings and Walls
BUILDING DEPARTMENT 2. Structural Components in Place*
3. Complete Building*
No. 917 Office of the Building Inspector
Zoning Form No. 962826 Date 9/25/97 Fee $120.00Cb k# 1014
Page, 24A parcel 10 ,Zone URB Section 127 ❑ Yes ® No
BUI]LDINGPERMIT
* Plumbing and Electrical Inspections required
THIS CERTIFIES THAT Henry Clement __- _ _____ before Building Inspecu--::-
has permission to finish attic space(creating(bedroom,bath;&family room) Inspection on Site—Foundations
situated on 130 Prospect Ave - Gary/Michelle Kaskey 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 temps 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 CONSPICUOUS PLACE ON RE ISES
Certificate of Occupancy
uilding Inspector
9
FILE #
SSP25M,
APPLICANT/CONTACT PE N: 02-
ADDRESS/PHONE: 163 —S
PROPERTY LOCATION: d
MAP PARCEL: ,/ ZO
THIS SECTION FOR OFFICIAL USE ONLY:
PERNIIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FIT.I.ED OUT
Fee Paid
IRnilding Permit Filled nift
�/ GZ
r
THE LLOWING ACTION HAS BEEN TAKEN N 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 Appro -Bd of Health Well Water Potability-Bd Health
!Permit from Conservatio mmission
Signature of Building Insp Date
NOTE: Issuanoa of a zoning permit does not relieve an appiioant's burden to comply with all
zoning requirements and obtain all required permits from the Board of Health, Conservation
Commission, Department of Public Works and other applioable permit granting authorities.
Y
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' SEP 2 5 � t Fi 1 e No.
ZONING PERMIT APPLICATION (§10 . 2)
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant:
Address: Telephone:
2. Owner of Property:_ C�n i1�f n^�c►+E«E KAS Kry
Address: 1 3 c PQ(jS C i AUC Ac•=?rlk M?-t 0 i /Telephone:
3. Status of Applicant: Owner - Contract Purchaser Lessee
Other(explain): 130%L OL,
4. Job Location: 130 ''r// C-CT AU- nn
Parcel Id: Zoning Map# 7� Parcel# J District(s):
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/Property ---
6. Description of Proposed Use/VVork/Project/Occupation: (Use additional sheets if necessary):
C'G7'C ` c �iTtiiSrl/tif C;t"F Ti/C UPsint✓: S -IT7ict S140.9c:r . iL/c /JAW i20"-%&
ej,CL /4CL-r1A T-Ar-'1L, IZ
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/Vadance/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)
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 DQE TO
LACK OF INFORMATION.
This colamn to be filled in
by the Building Department
(Required
Existing Proposed By Zoning
Lot size 141
Frontage
/l, G / Gc
Setbacks - frnnt (_ + 64
- side L: 4 c R: C, L: a R: ¢L
- rear
'3c�
Building height
Bldg Square footage
4G
%Open Space:
(Lot area minus bldg
&paved parking;
f -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: 4_7 7 APPLICANT's SIGNATURE 4 .
NOTE: Isauanoe of a zoning permit does not relieve an appl' ants burden to oomply wittvgkll
zoning requirements and obtain all required permits from Mie Board of Health. Conservation
iCommisalon. Department of Publio Works and other applioable permit granting authorities.
FILE #
04'T11A1'tP�O
9 �ZQZ ��11t�7IIltf T-)
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OLP 2 5199,
DEPARTMENT OF BUILDrNG INSPECTIONS
212 Main Street ' Municipal Building
Northampton, Muss. 01060
WORKER'S COMPENSATION INSURANCE AFFIDAVIT
GicenseeJPermi >
with a principal place of business/residence at: 7
V, (phone#) 467 316 Z
( city/stat.e/ p)
do hereby certify, under the pains and penalties of erjury, that.
I
( ) I am an employer providing the following wo er's compensation coverage for my
employees working on this job:
(Insurance Company) (Policy umber) (Expiration Date)
( ) I am a sole proprietor, general contractor or h meowner (circle one) and have hired
the contractors listed below who have the followin worker's compensation policies:
(Name of Contractor) (Insurance Company/P licy Number) (Ex
cation Date)
(Name of Contractor) (Insurance Companyip licy Number) (Expiration Date)
(Name of Contractor) (Insuran(m— CompanyiP licy Number) (Expiration Date)
(Name of Contractor) (Insurance Comparry/P 1icy Number) (Expiration Date)
(attach additional shod if nec tnxry to rochrde information pertLunng to all n)
(tJ�I am a sole proprietor and have no one worldn for me.
t�OM!'�'+CnclRl. JhlS�:224rJCE {'+HUL'TI
( ) I am a home owner performing all the work m self. CB j-e" 474-2Z f
NOTE:please be aware that vehUo homeowners who employ pazom to dolmaintmanc c comuuc6onor repair work on a dwelling of
not more thin throe units in wtrich the homeowner resides or oo the ground, tbarcto arc not generally oocsukrcd to be
employers under tbo vmrlca`s compeas4on Act(GL152,m 1(5)),application a homeowner for a ticense or permit may evidence the
legal stat as of an employer under the Woricoea compemation Act.
I undastind that a copy of this ctmtemeat may be forwarded to tbo DW tr c of Industrial Arci&n&Of500 of Insutloca for the
coverage venfim ioa and that failure to see=covcrago under section 23A of MGL 152 can lead to the iatposihoa of criminal Pcna cs
consisting of a fine of up to S 1,500.00 and/or imprisonment of up to one year and civil peaattim in the form of a Stop Work Ordrr and a
firm of 5100.00 1 day agarol mc.
Signed this J+_day of 1997 For dgWUn=]W Use co►y
Permit Number
Az' Map# Lot#
Signature icensee/Permittm
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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations
NORTHAMPTON, MASS. 19 Additions
APPLICATION FOR PERMIT TO ALTER Repair
a
Garage
1. Location 12P 0 ?a o—z r c-c-r AU= Lot No.
i3C
2. Owner's name c.!f 2 m tC NE qtr f( .tc. Address 20,r-c-e i five=
3. Builder's name l%cart C LEmttii' Address 54 Pt-- eX S-. C42AV:3,/ vim. , �.rC
Mass.Construction Supervisor's License No. 021G61 Expiration Date `► J 4 rr'f
4. Addition —
S. Alteration F 4Trl( 4'pCATi"wf iJa JJE+J Ari) t-An,tL� eZoz.
6. New Porch
7. Is existing building to be demolished? r-J C
8. Repair after the fire
i
9. Garage I No.of cars Size
10. Method of heating n5 al.' R r
11. Distance to lot lines 14- '1
12. Type of roof AWN A Q-rz 6 -t S S Y;-)r.a C vt
13. Siding house U w '+
14. Estimated cost-
etocaO Go
The undersigned certifies that the above statements are true to the best of his, her
knowledge and belief.
Signature of responsible app icant
Remarks
� w
OWNER ftMLXXKKXKXtl7 Gary/Miczelle Kassk, SHEET LOT
ADDRESS 130 Prospect Ave. 24a 10
APPLICANT same TEL. ZONE
ADDRESS DATE OF APPLICATION
ZONING APPLICATION APP. DATE FEE PLAN
I
BUILDING PERMIT ISSUED DATE FEE PLAN
490 2/28/90 Alteration dining room, converting porch area fee $44.00
#916 - 10/7/97 - Construct 2 car detached garage$64 �,,.,, ,� ,,,,
4917 - 9/25/97 - Finish attic space creating bedroom,bath,& family room$120 �F
CITY OF NORTHAMPTON FINAL APPROVAL BY DATE
BUILDING INSPECTORS
#1183 - Remodel existing bedroom into MaStE r bedroom & remodel kitchen$200
#BP-00-263 - 9/9/99 - Shingle roof over exi ting layer$25
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