32C-017 (5) ?O 0 (Nay of Northampton REQUIRED INSPECTIONS
p "K'r
1. Footings and Walls
BUILDING DEPARTMENT2. Structural Components in Place*
WaOt
Office
Complete Building*
No. 1112 of the Building Inspector
Zoning Form No. 963038 Date 11/20/97 Fee$40.00 Check#12452
Page, 32C parcel 17 Zone CB Section 127 ❑ Yes ® No
BuILDING PERmiT
* Plumbing and Electrical Inspections required
THIS CERTIFIES THAT Kohl Construction before Building Inspections
has permission to 4th fl renovation,partitioning,add 2 windows,firecode Inspection on Site—Foundations
situated on 78 Main Street - Trident Realty 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 J
provisions of the Statutes and the Ordinances relating to the Construction, Insp`:,ction of Wiring—Rough A.rF .2 ///9'
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 �/11 f y//W9er".
of this permit.Expires six months from date of issuance,if not started. Building Inspection—Rough ( fr. -/ -'q
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 0 K H-11,-q F.
Smoke Detectors(Fire Department)
Other
THIS CARD MUST BE DISPLAYgO IN A CONSPICUOUS PLACE ON TINPRE i ISES
Certificate of Occupancy ���� +' 2-° 4r '/
Building Inspector
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FILE # t�3
NW 1 9 Ne7
1_.APPLICANT/CANT CT PERSON: AL-Me �5��G'3o-�
D ,: - tfir I J ek: /
PROPERTY LOCATION: 711r
MAP ,j/C21 P• • EL: /7 ZONE f3
THIS SECTION FOR-OFFICIAL USE ONLY:
PERMIT APPLICATION C H H CKLIST
ENCLOSED REQUIRED DALE;
7flNTNG FORM FTT,T,FT) ()TTT t�
Fee Paid
Building Permit Filled nut 1�
Fee Paid Y �/ 2
Type of Cnnctrisctinn•
New Construction 1/‘4 02°'
ad-
Remodelin Interior -krGi��� �' �'—
C Artij9 e►Zf. o Q
Arreccnry Structure //11-44J' Gc 47
Ruilding Planc Tnrliuded•
Owner/flcri jant Statement nr 416111p )9: 7o I/
3 Setc nffnS>/ Plot Plan
THVOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION:
E 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 mmission
/7
/./ to
Signature :. ! . "ar,,,or Date
NOTE:Issuenoo of zoning permit does not relieve en applloant's burden to oompty with all
_ zoning requirements and obtain all required permits from the Board of Health, Conservation
Commission, Department of Public) Works and other applioabie permit granting authorities.
� f
1 91991 1 1
- � � Fi 1 e No�
63v32 t
EPT OF BUILD!
ZONING PERMIT APPLICATION (§10 . 2)
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant: KOH 1_ CONSTncmcThi ZNC
Address: 3 i C A im POs PLA?A_____E. fiAA Telephone: g�6 O3a.I
2. Owner of Property: )R,i DEntr Rr.A>-y
Address: l'S BkEtx)STE2 0
- CT NogriAM(MAI Telephone: 58R.- 97'1
/
3. Status of Applicant: v Owner Contract Purchaser Lessee
Other(explain):
4. Job Location: 78 mpo0 St LP" 0_ IvnIZTHAMPTOi•/
Parcel Id: Zoning Map# �a� Parcel# /7 District(s): (.,3
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/Property TAILS *cE. C-Rcom\ Kt,Oo4. 0F.PIC'' OA/ Zn�
Rl
34 ANt, 'INN I-I-00 R_
6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary): •
TNTE►2.toie.. RENr714inoN5 ID ISTI►v6 6 I✓tGE PACE ou Jh fL cot. REMNE i),201/
CF/uWtS/NMN S1,aCTU1211L PAPImoNs, AM Z /VIA I hOtag 1AI 1 4So ii/. INS1ALL ,? LAVERS
OC YSp ikECLIkt ON CE1 Lmiczi COA/STlet}% NNEuJ LJ 1.k AND /A'.c7 1.L ,D nO,?S
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?
INO 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 I/ 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: !Sf/wc SI aws ,AG/A.'c mA/A/
Are there any proposed changes to or additions of signs intended for the property?YES — NO i/
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 conta ed herein
a
is true and accurate to the best of my knowledge.
DATE: // - 18- 77 APPLICANT's SIGNATURE C
NOTE: lssuanoe of a zoning permit does not relieve en appli ant's burden to mpty with all
zoning requirements and obtain all required permits from the Board of Health, Conservation
Commission, Department of Publio Works end other applioable permit granting authorities.
FILE #
C.J U L; a L i.5
Q-Ttt pi,
b t1 git U NOV 191997
(Sib/ of Northampton 1
a t%•itili B "6 ftiasaaclinsctls
i': '� DEPT OF SUILD!'
w . PdOI T' nEPA R.TMENT OF BUILDING INSPECTIONS 1.11
ain Street ' Municipal Building 'a
Northampton, Mass. 01060 ' mes's
WORKER'S COMPENSATION INSURANCE AFFIDAVIT
I, Kotit- CoNSTRuci l Qnl l MC
(licenseeipermittee)
with a principal place of business/residence at:
31 CAMi,,us ?t-Az.n Rts HMu i MA Ol03' . (phone#) I- IPS-02)6-030V
(s t i eet/ci ty/stateizi p)
do hereby certify, under the pains and penalties of perjury, that:
N I am an employer providing the following worker's compensation coverage for my
employees working on this job:
A I U /Ns . Co. WC 582 -65" - '74 2.. - 10 18
(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) (Insurance Company/Policy Number) (Expiration Date)
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(attach additional sheet if n' '.ry to include information pertaining to all coatractors)
( ) 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 homeowners wno employ persons to do ERA ntm.n- construction or repair work on a dwelling of
not more than throe units in which the homeowner resides or on the grounds appurtenant thereto art not generally considered to be
employers under the worker's coo-qv-me ion Act(GL152,ss 1(5)),application by a homeowner for a license or permit may evidence the
legal statue of an employer under the Worker's Compensation Act
I understand that a Dopy of this etatem:Ed may be forwarded to the Department of Industrial Aocideaa Of oe of Imtuanoe for the
coverage verification and that failure to secure coverage under section 25A of MGL 152 can lead to the imposition of criminal penalties
consisting of a fine of up to S 1,500.00 and/or impr-isonnxat of up to one year and civil penalties in the form of a Stop Worst Order and a
fine of S 100.00 a day against ma.
Signed this I$ day of N , 1997 For departmental use only
aPermit Number _
Map#_ Lot#
Signature Licensee/Permitiee
z
nt a:
ti = rn
g i i70
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Zoning /
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. 2'Sb- 03d I Alterations
:_ NORTHAMPTON, MASS. 11 - 19 - 199� Additions
,-}= ;`;A' APPLICATION FOR PERMIT TO ALTER Repair
Garage
1. Location 178 MAini 57" N0t?iNAMt oN MA Lot No.
2. Owner's name-Tt 1 t cE rr REAL-T`/ Address 15 si .E.(.0 TER I o0 -1- NORTH AMP l ON
3. Builder's name KoH1— CONSTR.)ccIbN kNc Address I CAMPO. PLAZA ka HA1Jl..Ey MA 01035
Mass.Construction Supervisor's License No. 0 C/b/ 0 g Expiration Date 3/31/ g8
4. Addition
5. Alteration}Z1;piIn,IE 1\11o'P c E.iLi n1f N01,1 STRUCTu 3 _ W Al-LS, 1NS1"A6.1- a f &YELLS 54"1,1RECot EL11-1A4.)
6. New Porch CONS-Tie—QC-I" I,PLi.) wiaLs, Atr 2 WINLows IN MIt, oiR.y PEk ENGD'J EJZED DR.Aw1ncS
7. Is existing building to be demolished? NO
8. Repair after the fire ND
9. Garage N No.of cars Size
10. Method of heating Ol L STEAm H&ET
11. Distance to lot lines
12. Type of roof ii-A-r 12-Cty- ASPHALT
13. Siding house
14. Estimated cost:-1 61 000
The undersigned certifies that the above statements are true to the best of his, her
knowledge and belief.
Signature of responsible appican!
Remarks
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PROJECT NO. w-024MA
KOHL CONSTRUCTION REV.
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CAMPUS DRIVE, HADLEY, MA I P.0.13ox 8131, Wendell, MA 01.5/9 9/8/544-13000 1
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PROJECT NO. w-024MA
KOHL CONSTRUCTION REV. w/FLOOR 1/5/98
DWG. NO. S-1
CAMPUS DRIVE, HADLEY, MA
P.O.Box 881, Wendell, MA 01379 978/544-8000
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