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23D-023 (11) PeAR00, t Cityof Northampton REQUIRED INSPECTIONS t;�t '�1►.. a a 1. Footings and Walls 1 "• BUILDING DEPARTMENT 2. Structural Components in Place* 3. Complete Building* No. 1389 Office of the Building Inspector Zoning Form No. 963333 Date 3/28/98 Fee $20.00 Check# 15971 Page, 23D Parcel 23 ,Zone URB Section 127 ❑ Yes © No BUILDING PERMIT * Plumbing and Electrical Inspections required THIS CERTIFIES THAT B & R Siding Spec Inc before Building Inspections has permission to install vinyl siding Inspection on Site—Foundations situated on 496 Elm ST - Ange Gillman 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 ** Install per Manufacturer's information: windows, vinyl siding,roofs and woodstoves Smoke Detectors(Fire Department) Other THIS CARD MUST BE DISPLAYED IN A CONSPICUOU E MISES Certificate of Occupancy ` FILE # 9G 3 ,`33 '3 09 MAR 2 6 ;998 _ APPLICANT/CONTACT PERSON. � E� 4 (44 A2?/../X.,,C 1 "''''ADDRESS/PHONE: 7 PROPERTY LOCATION: -/94 :. P � e „At �¢i"- MAP ,,23 .� PARCEL: 0?`3 .i ZONELM7— THIS SECTION FOR_OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FIT I NT) OUT Fee Paid Rnilding Permit Filled mit �----- Fee Paid M-91/ , o — t-----' Type of Construction• Now Construction Remodeling Interior __ _7-,3""4 Addition to Evicting Accessory Structure Evading Plane Included Owner/Occupant Statement r irencg Qa6�l L.-- 3 Sets of Plans /Plot Plan - TEE.'0([LOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION: !//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 . Sepf�i<''e4pp:roval-Bd of Health Well Water Potability-Bd Health Permit from Conservatio ommission 22/9l'5 Signature of Building pector Date NOTE:issuanoe of a zoning permit does not relieve art applioant's burden to oomply with all zoning requirements and obtain all required permits from the Board of Health, Conservation Commission, Department of Publio Works and other applioable permit granting authorities. File No. % 3 '33 ZONING PERMIT APPLICATION (§10 . 2) PLEASE TYPE OR PRINT ALL INFORMATION 1. Name of Applicant: " ' ' si 7 1t1 S/-w 2 vc y IieW "J L g3 C'96J Address: '7 ( 164v I z �o4o ,f116R 7 `dlephone: r! Z//( 7 2. Owner of Property: AO 2< -7-7 LI'! Address: Hill 5 r A/on 1177u ri Telephone: g ` & ° 3. Status of Applicant: Owner Contract Purchaser 1/ Lessee Other(explain): 4. Job Location: -T 9 7 ( Parcel Id: Zoning Map# Parcel# oa 3 District(s): „ze4. (TO BE FILLED IN BY THE BUILDING DEPARTMENT) 5. Existing Use of Structure/Property '/ �� 'tO1je 6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary): • VI A)'1 Sic 1 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 PermitNariance/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 DUE TO LACK OF INFORMATION. This column 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 &paved parking) # of Parking Spaces # of Loading Docks Fill: volume -& location) 13 . Certification: I hereby certify that the information contained herein G is true and accurate to the best of my knowledge. DATE: hrcu i Sj APPLICANT's SIGNATURES /i�c . NOTE: Issuanoe of a zoning permit does not relieve an applioant's burden comply with ail zoning requirements and obtain all required permits from the Board of Health, Conservation Commission, Department of Publio Works and other applioable permit granting authorities. FILE # Oct f Pi._ 10 °8 GZ� l 1 N 'tI&ntp±U11 *_h B mist_____ _....------ ; ifi If;`B4 blassacgnsctts :" . ..,::. �4 '� DEPARTMENT OF BUILDING INSPECTIONS _?-�i- �_ = 1 • 212 Main Street Municipal Building ,F. Northampton, Mass. 01060 " r". WORKER'S COMPENSATION INSUL A_NCJ AFFIDAVIT I, &cv/2 sic)A) C S -2•U C. (licenseelpermittee) with a principal place of business/residence at: r�?/ 8 E; , /1/61? v1,-y7 T6& 7 4 (phone#) J--$�-2/1e (atUeet/ stair rip) do hereby certify, under the pains and penalties of perjury, that- ( I am an employer providing the follosvin worker's cons ensation coverage for g P $ my employees working on this job: >c�6-(At/, -�N5 C6 loo n a (9. 50 A— 06- -/S-- 7g/ ce Co ) (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 Company/Policy Number) (Expiration Date) i (Name of Contractor) (Insurance Company/Policy Number) (Expiration Dale) (Name of Contractor) (Insurance Company/Policy Number) (Expiration Date) (attach additional shed ifne-,-,,.ry to include information pertaining to all contractors) ( ) 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 aware that while honseowners who employ persons to do ma%nrena ,construction or repair work on a dwelling of not rmro than tree twits in which the hotpoowvcr resides cc oo taro grounds appurtenant thereto arc not generally aoosidcrcd to be employerrt under the workcr'a` That ion Act(GL152,ss 1(5)),application by a homeowner for a license or permit may evidence the legal atatua of an employer under the Worlccla Compmsalion Ad I understand that a copy of thu uatcroem may be forwarded to the Departmm2 of Industrial Accidead'Ofoo of Insurance for the coverage verification and that failure to secure coverage under section 23 A of MOL 152 can lead to the imposition of criminal penalties consisting of a fnc of up to S 1,500.00 and/or imprisonment of up to one year and civil penalties in the form of a Stop Work Order and a fino 0(5100.00 a day against tnc. For departmental uao only sh Permit Number _ i.%r�/�� [d %14 v4! 9'r Iv ap# _Lot# II*: , Signature of Liocnsee/Permitt Date • . z .:i < n. T A C ''t7 3' -o xl = m 70 a 3 © � m c - C rR- y-.ty _. ` Ew y cr. = . ..t cn z v5 O -i ^' m a 1 U Zoning Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. `S S4-/lG 7 Alterations ilk%r NORTHAMPTON, MASS. 4 " l ^ Q 19 �j Additions t._}` :,q Repair r q APPLICATION FOR PERMIT TO ALTER /(� / 14 Garage 1. Location 41 9,6 gbn J /" 1 Z"''A frI I 0 Lot No. / 2. Owner's name 400 L- �- /Jh 1�!A) a Address ' U C��! ST AIO/f�!1.9 T b rJ )i 4 3. Builder's name �j qkI2 s irJ' U 1� C Address 'JS/ l3, , -�LA Aloe r1,4 rn .Iv iv Pt 4--- Mass.Construction Supervisor's License No. en- h 4'6 Expiration Date 61 a7" a 00 0 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 )/ 10 I S/b i Cr c 14. Estimated cost:- , 003 Df The undersigned certifies that the above statements are true to the best of his, her knowledge and belief. Signature of r{Spons,ble app,icont Remarks