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23D-107 (36) 0 o� City of Northampton REQUIRED INSPECTIONS A At�, '�'Y"1 a 1. Footings and Walls • Ore '"� BULDING DEPARTMENT 2. Structural Components in Place* 3. Complete Building* No, 1663 Office of the Building Inspector Zoning Form No. 963626 Date 6/4/98 Fee$40.00 Check# Money Order Page, 23D Parcel 107 ,Zone URB Section 127 ❑ Yes 0 No BUILDING PERMIT * Plumbing and Electrical Inspections required THIS CERTIFIES THAT John Smith before Building Inspections has permission to construct att 16' X 26' pavillion Inspection on Site—Foundations situated on 548 Elm St - Mediplex Inspection of Plumbing—Rough provided that the person accepting this permit shall in every respect Inspection of Plumbing—Finish conform to the terms of the application on file in this office, and to the Gas Inspection provisions of the Statutes and the Ordinances relating to the Construction, Inspection of Wiring—Rough Maintenance and Inspection of Buildings in the City of Northampton. Any violation of any of the terms above noted is an immediate revocation Inspection of Wiring—Finish of this permit.Expires six months from date of issuance,if not started. Building Inspection—Rough Note:A certificate of occupancy will be issued by this office upon return Insulation Inspection of this card signed by the Plumbing,Wiring and Building Inspectors. Building Inspection—Finish ** Install per Manufacturer's information: windows, vinyl siding,roofs Smoke Detectors and woodstoves (Fire Department) • Other • THIS CARD MUST BE DISPLAYED IN A CONSPICUOUS PLACE 07 PRE ISES Certificate of Occupancy Building Inspector ` iS .J vi�� u,� .. __� . . _ FILE I GG3626 )6'� 3 1° JU IN4 i999 1 APPLICANT/CONTACT PERSO : 51 - 03 DEFT\ADDRZES$/PHONE: 5/ '5 • PROPERTY LOCATION: �7,ef61 t— -� MAP p PARCEL: /e ZO THIS SECTION FOR-OFFICIAL USE ONLY: PERMIT APPLICATION CH ii;CKLIST ENCLOSED REQUIRED DATE ZONTNCT FORM FIT J.FT) OTTT ✓ Fee Paid Building Permit Filled nut Fee Paid /226 y K:I- L/ Type of Cnnctr ietinn• 'New Cnnctriirtinn / - / 076 m Rendeling Interim- a&. r/jt/_ge Additinn hi Existing Arreccnry Structure Building Plane Tnrluded• Owner/Orrupant Statement .ir Te nce 0r),.n/ ✓✓ 3 Sets of la c)/6tP lan T FOLLOWING 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 ' ► ,Axpirta� �of HeaiY i ` '' Well Water Potability-Bd Health s s _ Permit from Conservatio mmission (4/ Signature of Building for Date / NOTE:Issuenoe of a zoning permit does not relieve en epplioant'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 applioable permit granting authorities. , . • • • - •• • • a i J1JrJUN 41998 DOI File No. • - '�(Z- I N. ZONING PERMIT APPLICATION (§10 . 2) PLEASE TYPE OR PRINT ALL INFORMATION 1. Name of Applicant: �e-p`,,,c\_ A T vv•\\C \,- _ Address: S ( L-t LL- / S Telephone: S-2 6 — 4-5O 3 2. Owner of Property: Ke... ,,\IR\.,.=, O v 0 `G.vv-\- \\7? Address:cc -(Z EL-vA_ ( 3 Telephone: •S 2 6 - 3 l 5 b 3. Status of Applicant: Owner Contract Purchaser Lessee Other(explain): k_DO A4._ c &\-\-ae 4. Job Location: 54-2 E\W\__ 5 \--- . Parcel Id: Zoning Map# .-2"5D Parcel# ) ` District(s): __,l-'1,1--.-b— (TO BE FILLED INBY THE�B^UILDING DEPARTMENT) 5. Existing Use of Structure/Property jic.A.e__ ____ N Qc .v S . C A__ ..t..\'- C21\-er-' 6. Deis Pti oop4sed lL�ea�r\ otect Occupa : ( aditio I sheets i necessy)� ��T ��c� 2( Sc:, ' (--.r.._,s ,,,a,„.\c-s- ,,, v.0\7- \r‘0,- .3-e____ --\ ..; ..m ..\--* ,._ ‘...-- 7. Attached Plans: Sketch Plan X 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 x YES_ IF YES: enter Book Page and/or Document# 9. Does the site contain a broody 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 E1wL IF YES,describe size,type and location: I 31 y Li_ r en �4._ �e,X S\ vt e. p - H p E�c i<� 5� Are there any proposed changes to or additions of signs intended for the property?YES NO _A__ 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 I IRequired I Existing Proposed By Zoning Lot size 4e Frontage , 0 Setbacks - front Lf- 1 ,j p7 C - side L: 20 R:2O.13 L: 15tr R: 17 - rear 0 Building height 1 4-i 3 ,` Bldg Square footage ` ' 17 l 22. 2 z IS 3 c, %Open Space: C� (Lot area minus bldg A-) ' &paved parking; 1 9 4_9 'J/ -S 1 pf Parking Spaces fo#' f Loading Docks / Fill: -(volume-& location) O O 10 13 . Certification: I hereby certify that the information contained herein c is true and accurate to the best of my knowledge. DATE: APPLICANT'S- SIGNATURE NOTE: Issu no'Va zoning permit does not relieve an applioant's u en 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 authorities. FILE # Th . _ _ - WEST ELEVATION '4� J ______ __.__.___ ._ ______._..________ . . .... . . _ . . . ___„. --- - FT- ___ _,,,.. ..- r = t- !\...) r yj‘,......—:, .....14 _ __.._.... _, ,,,• • ... .. . i ____ . _ , /...i...L. , .. .• .,!._ . . ..._,, , . •,• .„ , , _.. ,,,,, , , _ ,-„, � . .- ..... .1, N I '(NFL. - �^ 1!-h+.., , w W _ f 1„r...‘. ,-,__ /__ .r 1i9. -'.. :iI _ _ _ t NAB / - _ - -4---- ` J _T 1 L .Y Ut11T/2 � ( ,..._...1) 1; \0)9 2i (l8 ('i L J_ < < / r—i ---..,, , , , i,—AY_� -_ #n 1 - . . , ___,..i. ` 11 ---. I i, ,„, , I-- s, ,. i ,6 ' ._____J____t___77,:. J i . I ;,I ' ,, 866; V t 111 L;----- 51 0 1 q� x t }r OS i i _ \....1. _ . . . . WEST ELEVATIO \ ( +) ....___ _" . ,_ , ,„:.„:„--f---,-__ _. _.. r�.Jr ,-,? r__,,, . . ,, ,. , f, „ ,,,) ,! , _,, , , t E___ __, .. its, - LI, '-1• ..,• .4 ./. .•:•, : Ti-1.. ;; j — ,-------- - • 1 , 1., 1 + F i1!� If' : illii;i (t1j� i�;l.!,�,:nll'I j - ui4 I ._�,• - {11� uI! ,t • �}J}, ,,4.I, ; . _ ( 1�ri#11±,}; ��111►;i�i ,► rl.� Ititit; li1 WA LA.�H l - � 7, Irs_,. 7 - _____I ;7:--'7-' i Uri 1 fl:1 <--- ---> . ' / tii . (1) I.. 02 ..._,... c ..) _ y 1 :,, . I iii [<- I. 1 phi i`iE fit I HT---' __-- ._: L = __� -� I 1 I - i ,R • i 5. le&I - 0 - t tt I "- I \ • . i ^ () ,' TIRIIIIIIl!11lUIIIIII).11!llrll!!Plgpll, -7, I t • ' - �-`-=--+:--_ _ -e _� ^'!'.,�„ .:_'---�. %,.�-- -= .: -�„�; ,...ti".a f, _.cap_ • 40. i -(c...) • z - • r c • A I I _ -- -- o,rra " _ I �- A l l r 1__ i :t _ - - - __________ F- - - _ f--j-----i _ _- .- ` - A i _ — _ 1 ...,___,,s_____ : - • - .r IC � / ► Louv0 s � i Z� • ! �)` ri�N. r 'ize. • I I Corc_f�c . co\J"AS • - -- --1-1- -- ks�\ > 4„-C N/J f Pi. �- l J ! w Boo °� [ �Z7I1x � 71C�JtITT 1 =>t*_h t W ei° `�s t998 x5sxcansata1. _' = • *1` eft'mF DEPARTMENT OP BUILDING INSPECTIONS 4 II!-ice 212 Main Street ' Municipal Building Northampton, Mass. 01060 ttt•'a'� WORKER'S COMPENSATION INSURA.NC:Jr AFFIDA.VTI I, George Mercier, Administrator, Mediplex of Northampton (licenseeipermlttee) with a principal place of business/residence at: 548 Elm Street, Northampton, MA . 01060 (phone#) 413-586-3150 (sti ct/city/staIc/rip) do hereby certify, under the pains and penalties of perjury, that: (x) I am an employer providing the following worker's compensation coverage for my employees working on this job: ` CNA Risk Management WC 1 88900132 01/01/99 (Insurance 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) (Insuranc Company/Policy Number) (Expiration Date) (Name of Contractor) (Insurance Company/Policy Number) (Expiration Date) (Name of Contractor) (Insurance Com-paay/Policy Number) (Expiration Date) (Name of Contractor) (Insurance Company/Policy Number) (Expiration Date) (attach additional Meet if necxaary to inchidc information pertaining to all 000froC on) ( ) 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 bocecowncn who employ pawns to do mai.,tr,tarre.coauvaioa:or rtsrtirwork on a dhvclling of not nor o than throe trait'in Which the boccoowna maiden or co rho ground'appurtenant thereto are not generally oomidcred to be emptoy'aa under tbo worker's cocap,rsxiica Act(GL152,s l(5)),application by a homeowner fora Name or permit may evidence the legal rtatua of an employor under tho Workeet Coo pmnation Act I under-rtand that a copy of this rt.t t may be forwarded to tiro Dcpartancot of Ind.ulrial Accidcrstze Offioo of Inrarraoco for the coverage vcrifieatioo and that failure to ecatrc coverngo maker section 23A of MOL 152 cask lead w the inztfXditiou of aimmal penaltin . ,. 000iis;ixtg of a fine of up to 51,.500.00 andtor impruonmcat of tip to one ycor and civil penalties in the form of a Stop W ork Order and a find of 5100.00 a day against nit. • For dcpatnoohl tato only Permit Number ,. N 1t- i..f, 15 ` 11._ _ riot t _ -_. y=' �. » LiocnsceIpermittce / a < et sv r v -v o• m z a 3 0 o cn rn S J ,a4. z ni A et . -2-. ..° n # ... e Zoning Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. 6-3 15 Q Alterations f: irr-71:„st- NORTHAMPTON, MASS. A(( 19 Additions X 4 APPLICATION FOR PERMIT TO ALTER Repair =ram' Garage 1. Location g i- E1 VNA SA- nC'MCC.W\ \- Lot No. 2. Owner's name t"\ \R\--€_, , p !)y • P Address .7 1O F( vv., . 3. Builder's name --S-7p\✓` -a - __ -'Nn.v V L Address 5 ( L(LLB c-C.O Mass.Construction Supervisor's License No. (© 2 3 Z 3 I, Expiration Date I /l e//?-Q00 4. Addition ?ek.).)\`���v- 16�R�C .-e.E�. Acce S ,r E rM3 CJ . 5. Alteration ✓\) l 6. New Porch (A 7. Is existing building to be demolished? Ai in 8. Repair after the fire ►'V ! .A 9. Garage .) Cn No.of cars Size 10. Method of heating II //4 \ f� 11. Distance to lot lines ZS cc.a� • I 5 Zt` �-Py� • (� l �1 1�1w\ s 4 -e- v 12. Type of roof -----VC\J 5---3-5---3— atns — _.5L �-2— 13. Siding house V 14. Estimated cost:- 4 C-2©0 The undersigned certifies that the above statements are true to the best of his, her knowledge and belief. Signature of responsible applicant Remarks