24A-010 (4) City of Northampton REQUIRED INSPECTIONS
and Walls
BUILDING DEPARTMENT 2. Sm�cttural Components in Place*
3. Complete Building*
No.
1183 Office of the Building Inspector
Zoning Form No. 963113 Date 12/19/97 Fee$200.00 Check# 1105
Page, 24A Parcel 10 ,Zone URB Section 127 ❑ Yes No
BUI]LDINGPERNHI
*Plumbing and Electrical Inspections required
THIS CERTIFIES THAT Henry Clement before Building Inspections
as permission o _r el int ng be�r°au' _kltsher'._ _ . -Inspeetion--on-lylt 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 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 CONSPICUUO MISES
Certificate of Occupancy
Building Inspector
FILE #
y
APPLICANT/CONTACT PERSON: X41/1 Z ,7
ADDRESS/PHONE:
PROPERTY LOC_ TION: C)
p PARCEL: G' ZONE
THIS SECTION FOR-OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM M,T-ED 011T
Fee Pnid
Iguilding Pe it Filled nut
Fee Paid
r- '
TFOLLOWING ACTION HAS BEEN TAKEN ON THIS AP KATION: � <'
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: § wJ'ZOMNG 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 Commission
0,7-19 17
-
Signature of Building ector V Date
NOTE:Issuance of a zoning permit does not relieve an applicant's burden to comply with all
zoning requirements and obtain all require¢ permits from the Board of Health, Conservation
Commission, Department of Public Worcs Ond other applicable permit granting authorities.
File NQ. 'Z'3/J3
ZONING PERMIT APPLICATION (§10 . 2)
PLEASE TYPE OR PRINT ALL INFORMATION .
1. Name of Applicant: �[C VP-y C Lem e7,107-
Address:
�Address: S4 S;- 6 nRa3 j r. f- G r G 3 5Telephone: 413 +C.-7, 3/L 2,
2. Owner of Property: ! -+,st<�
Address: i3y ?t CcS&:–e- A'JC X40 rHA,,wPTO'd r74• Telephone: 5-Ft-4j2F
3. Status of Applicant: Owner Contract Purchaser Lessee
Other(explain):_ i1/r�C
4. Job Location: _ i3o t 2cs�«� /9 QC- A4or-,T -ihnsr7T0,%1
Parcel Id: Zoning Map# Parcel# Z CI District(s):
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5, Existing Use of Structure/Property SIAJ4L� F*^10L
6. Description of Proposed Use/WorkJProject/Occupaation: (Use additional sheets if necessary):
h/G 2Ct'C; TO 'L L-e3E(- ""-L/[ !w'e Ck.,5i i,4 t eW d %-4125 �t-Gli:kS r•J'T d r9
soeT-E Anit) 'Ed 2e-n6e)EC 72'c' LrXrS7rNic /�rrCr/C�
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 ffom the Conservation Commission?
Needs to be obtained Obtained ,date issued:
(FORM CONTINUES ON OTHER SIDE)
1 D. 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 cola= to be filled in
by the Building 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
&peved par!=in91
# of Parking Spaces
fof Loading Docks
Fill:
(volume--& location)
13 . Certification: I hereby certify that the information contained herein
is true and accurate to the best of my knowledge.
DATE: ;Y '' APPLICANT's SIGNATURE
NOTE: lasuanoe of a zoning permit does not relieve an appliq#61rs 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 applloable permit granting authorities.
FILE #
�(ItAMp� 1 1 199�
=o qy
.-
• I =
m DEPARTMENT OF BUILDING INSPECTIONS
212 Main Stteet ' Municipal Building
NorthaTpton, Mass. 01060
WORKER'S COMPENSAITON INSURANCE AFI.'IDAVTT
(li�ense�l�rmi ct ee)
with a principal place of business/residenoe at-.
(phoney#) ¢F7- 3i( Z
(strcek/city/statrizi p)
do hereby certify, under the pains and peaalties of pequry, that:
O I am an employer providing the following workers compensation coverage for my
employees working on this job:
(Lan=ce Company) (Policy Number) (Expiration Daze)
( ) I am a sole proprietor, general contractor or homeowner (circle one) and have hued
the contractors listed below who have the following worker's compensation policies:
(Name of Contractor) (Insurancc;Compaiy/Policy Numbcr) (Expiration Date)
(Name of Contractor) (Insurance Compaay/Poticy Number) (Expiration Date)
(Name of Contractor) (lasurancz Comi=y/Pohcy Number) (Expiration Dale)
(Name of Contractor) (Insuring Comparry/Policy Number) (Expiration Date)
(attach additioml zbcct if noocu to inc}udc infwinafioo?,blurting well ooatrn.don)
(0/1, am a sole proprietor and have no one working for me.
( ) I am a home owner performing all the work myself.
NOTE:please be awa c th=t whilo hoox;owncn woo caVloy pcnom to do rn a on cousti oa or repair wudK on a dwelling of
not morn than throe units i a vAndi the homoowncr rc.idcs or too the grounch appurtcunnt:bucto arc not generaily oDandcrcd to be
eutployc m under tbo worir-t oc-p—ation Act(GLI 52,=1(5)),application by a homeowner for a license oc permit may cvidcaoc the
legal rtnhu of an omployoe undertho Workcez Compcoo t Ad
I undcrsund dirt a copy of this ctat=co1 may be forty u d,o4 to tho DcVwr of Dial Aocidm&0frioo of LaAw-000 for the
coverage vaificalioa and that failure to to r covcrngo md.cr soctioa 25A of MGL 152 can 1cad to tha in-cpoaition of criminsl pcmltics
consisting of a fuse of up to S1,500.00 asi&or i oa; isoom tof tip to one year and civil pcmltics in the form of a Stop Wort;Order and a
find of 5100.00 a day igitimttoe–
Signed this I6 rel day of 199-7 Focdcputrot"Ua000ly
Permit Number
Map# Tot# __
Si®aab= tt mseelPeribitiec
I
v b "'•
70
D m
a
o mm
cm Z
a � o
A
Zoning
Miscellaneous Additions,Repairs,Alterations,etc. tel.No. sa�6 6 i i� Alterations
40 NORTHAMPTON, MASS. r�c5c r 19 '17 Additions
APPLICATION FOR PERMIT TO ALTER Repair
Garage
1. Location 130 Lot No.
2. Owners name G-Aa.� ` �^"cWC"C-- KRSr,6 � Address r30 /�2uS(�cci �cac
3. Builder's name 6 (.,4sZ / e Leo-enl�� Address 5-4 i7-2 G C s O-z,,j A/ ;*r.n
Mass.Construction Supervisor's License No. 0.226( r Expiration Date `r z 4 r S`f 9
4. Addition
5. Alteration IZirnc-,�c'L- CXrs f447 8C1)Z06,-1 J041N,2¢eM /iw3 Ktrcwev
6. New Porch
7. Is existing building to be demolished? ���'Tt2Jo•� >)cri sr, t/
8. Repair after the fire
9. Garage No.of cars Size
10. Method of heating C )(i s Ti� j-/4;- /}rr2
11. Distance to lot lines ify, q
12. Type of roof ASi"rJAL1- SH.,vF.c
13. Siding house
14. Estimatedcost- '15-0,ceo c�
The undersigned certifies that the above statements are we to the best of his, her
knowledgF and belief.
Signature of responsible app,icant
Remarks