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18D-004 (44) :+ . : . :4 M_ : 4 • Git- of goifi . .. ' ' _ :'�' . ' , 0 \ 99 DE PARTMENT OP BUILDDIG INSPECTIONS • A a =;_ 1_ 2 — _ , . 212• Main Street • Municipal •Building 14. Northampton, Macs. 01060 �` ',. WORKER'S COMPENSATION INSURANCE A. '? A,Vt 1 , 540 C--- :' l (licensocipermittce) with a principal place of business/residence at: 1 7 1V)cv, /k ?..Q 6t11 • once- . (phone #) Y 13) Q CpZ'W5S - (strm t/ci ty /staithi p) do hereby certify, under the pains and penalties of perjury, that: ( ) 1 am an employer providing the following worker's compensation coverage for my employees working on this job: (Insurance Company) (Policy Number) (Expiration Date) (4am a sole proprietor, 6neral co 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 ahoct ifneoea.ary to iaelude iofocaaatioa pct .iolog to all oodrndon) (am a sole proprietor and have no one working for me. ( ) X am a home owner performing all the work myself. NOTE please be aware that whilo bomcowocra wbo employ pcaom to do T•ir+ , west uctioo•or repair work oa & dwcfing of not morn than throe was is wtioch the bomoowacr residca or oo rho proua6 appartcaud thereto arc cot gcocrally ooasidcred to be cmploym undo the vpodus x oompea anion Act (GL152, to 1(S)). apptiatioa by a bomcawoir for a Haase ac permit may cvidcnoe the legal swim of ao employer uodeettse Wocicala Coaopemdaoa Ad. I uodentaad that a copy ordain etatemeed may be foewaedad to the Deputrocot ofl oduataial Accidea ti Offio. of Iovunooe foe the . coverage vcrificatiee sod that failure to secure cane rago under section 2SA of Ma . 152 cu Icad to the' impositi0a aerial' kulpl cs • ; ; oo misri Gra one nfttp to S1,950.00 and'or imptvoaro me at of tip to e yaw and civil praaltin in roan the fo of a Stop Work Order and a five of5100 00 a Asy spiracle: • / Map# . ,Lot # Foc depatdeotal cue ooty / P erm it N umber .-44.:-. i �J`�' ` . �Y �� . . — I • • - -- - ` . . S' • ol; ocsssoelpet s►ittx . . f •%1 > 1:1 ° 70 'U < rn n� CI b ow o 77 D m t` ` = l z co, -1 ° R i 8 C; = i a: 70 o -I c., Z f _ . I m U - 1 Zoning Miscellaneous Additions, Repairs, Alterations, etc. Tel. No. Alterations %r.� NORTHAMPTON, MASS. q Additions " r 1 APPLICATION FOR PERMIT TO AL Repair '' n r�'� Garage 1. Location ! 0 CS p&fh i 4 IC (0 cd' — lh f /fT .. -1 Lot No. 2. Owner's name tn.... dray -) "e. c, r Address / " /Db 1 k AO 3. Builder's name ] �l /? al �� 1 ��! � i ' Address J 8 i'>i CJ G f I , ilk.- Mass. Construction Supervisor's License No. C i) C) 6 3 y Expiration Date t / /lF/ .t it•C) 4. Addition /Ya'''m Y1- 5. Alteration l ; ' ' ° i-• J 6. New Porch 7. Is existing building to be demolished? I!,© 8. Repair after the fire AiC) 9. Garage /1.1 () No. of cars Size 10. Method of heating 11. Distance to lot lines 12. Type of roof /75 'Aitilf 13. Siding house //iv'. E j c 14. Estimated cost e The undersigned certifies that the above statements are true to the best of his . knowled: di lie �, ignature of responsible app. icont 2P Qctr ;, C Pk. Remarks 1111114LItilili f I CJ( op �° � , ,. 1 G I. -NOTE- • THIS PLAT IS COMPILED FROM DEEDS, PLANS AND OTHER SOURCES AND IS NOT TO BE CONSTRUED AS AN ACCURATE , ' SURVEY AND IS NOT TO BE RECORDED. PLAN BOOK 83, PAGE 12 ; PARCEL #3 1 \ 455.92' r -4 ' 4 . self stora.e buildin. n 4' ,7, +P \ self storage barn tb q.. buildin• O 4, si S .. p . ,/.. sporti w • ._ ?' i v) , _ - tore good , AP S toAre J p. z4 �� L -1 DAMON \ 79.71 ` RO AD • . TO: THE HERITAGE-BANK FOR SAVINGS & THE FIRST AMERICAN TITLE INSURANCE COMPANY I HEREBY REPORT THAT I HAVE EXAMINED THE PREMISES AND BASED ON EXISTING MONUMENTAT1ON ALL EASEMENTS, ENCROACHMENTS AND BUILDINGS ARE LOCATED ON THE GROUND AS SHOWN AND THAT THE BUILDINGS ARE ENTIRELY WITHIN THE LOT LINES, EXCEPT AS NOTED. I FURTHER REPORT THAT THE PROPERTY IS NOT LOCATED WITHIN A FLOOD PRONE AREA AS SHOWN ON FEDERAL FLOOD INSURANCE MAPS FOR COMMUNITY # 250167 ' SURVEYOR • • l�^ —NOTE— THIS PLAT FOR MORTGAGE LOAN PURPOSES ONLY AND DOES NOT CONSTITUTE A PROPERTY SURVEY Q. 1 f * \ — MORTGAGE LOAN INSPECTION PLAT — :� NORTHAMPTON, MASSACHUSETTS / E. PREPARED FOR tZER ! WILLIAM B. & EVELYN F. MOCK • . 035032 '. 4 1 SCALE: 1 " =80' • JULY 2, 1990 1 DmOw HAROLD L. EATON AND ASSOCIATES, INC. REGISTERED PROFESSIONAL LAND SURVEYORS 1 901 0. l /' .1 - r n1 Ir.frrl 1 r1"nr'rT 1 1 4 ' � - ,•._: S 1 t r.f. A "1 11 1Cr-'"T^ 10. Do any signs exist on the property? YES X NO • IF YES, describe size, type and location: S T R U c T u R f t ! l LLV /11 / t A - n0 til /0 X I o Are there any proposed changes to or additions of signs intended for the property? YES NO X 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 $ /2 0 st'i Frontage /74 sg.1 Setbacks - frnnt 7/ s r - side L: 26, R: /S L: R: - rear 3© Building height 2.3 Bldg Square footage 4, 2°0 %Open Space: (Lot area minus bldg &paved parking) 11 o/ O # of Parking Spaces it of Loading Docks N/p Fill: (vol -ume - -& location) iv 13. Certification: I hereby certify that the inrr; at' on 1, tai d herein is true and accurate to the best of my kno -•• DATE: Q' d-- j % APPLICANT'S SIGNATURE ' /. �jydti /� j� NOTE: Issuanoe of a zoning permit does not relieve an - • plioanrs burden o comply with .ail zoning requirements and obtain all required permits from the Board of Health, Conservation Commission, Department of Public Works and other applicable permit granting authorities. FILE # 8/9 ci p ��� 2 0 ■∎999 File No APeo/Y ZONING PERMIT APPLICATION ( §10.2) PLEASE TYPE OR PRINT ALL INFORMATION 1. Name of Applicant: W , / / //Rni i E u EL yiv DLK Address: 106, D f } mon/ cJ - No hw p I bR) Telephone: J 810- L) (18 7 2. Owner of Property: Vol t /lI f r� E i ELY N\ c k Address: inn R S A 1301IE Telephone: Z A M E 3. Status of Applicant: )( _Owner Contract Purchaser Lessee Other (explain): 4. Job Location: /0 4 D Amcpj . - A/0/2+11/911 pTO/tl 11 Parcel Id: Zoning Map# 18,1) Parcel# "1 District(s): (TO BE FILLED IN BY THE BUILDING DEPARTMENT) ` 5. Existing Use of Structure /Property C 1Y] E�',CIA L /QES l DFNT//9 (iPt/c 6. Description of Proposed Use/Work/Project/Occupa i ✓t4e additional sheets if necessary): q t1-ice-t- bl1 t %rzC/ it /=rim ro 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 X IF YES, date issued: 96 V- IF YES: Was the permit recorded at the Registry of Deeds? NO DON'T KNOW YES X 9oz 3591 56 = 006 IF YES: enter BoolVA : 34 9 Pagela = 00 and /or Document # 9. Does the site contain a brook, body of water or wetlands? NO >K 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) File # BP- 2000 -0189 APPLICANT /CONTACT PERSON STEPHEN SMITH ADDRESS/PHONE CALDWELL RD PROPERTY LOCATION 104 DAMON RD MAP 18D PARCEL 004 ZONE GI THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out Fee Paid /7 '\S Tvpeof Construction: REPLACE VINYL SIDING & RAISE FRONT FACIA ON BUILDING 18" New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/ Statement or License 068354 3 sets of Plans / Plot Plan THE Ff KLOWING 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 Septic Approval Board of Health Well Water Potability Board of Health Permit from Conservation I • ission Signatur-u uilding 1 fficial Date Note: Issuance of a Zoning permit does not relieve a applicant's burden to comply with all zoning requirements and obtain all required permits from Board of Health, Conservation Commission, Department of public works and other applicable permit granting authorities. 104 DAMON RD BP- 2000 -0189 GIS #: COMMONWEALTH OF MASSACHUSETTS Map:Block: 18D - 004 CITY OF NORTHAMPTON Lot: -001 Permit: Building Category: vinyl siding BUILDING PERMIT Permit # BP-2000-01 89 Project # JS- 2000 -0309 Est. Cost: $500.00 Fee: $50.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: STEPHEN SMITH 068354 Lot Size(sq. ft.): 87120.00 Owner: MOCK WILLIAM D & EVELYN F Zoning: GI Applicant : , STEPHEN SMITH AT: 104 DAMON RD Applicant Address: Phone: Insurance: CALDWELL RD NORTHFIELD 01360 ISSUED ON:8/27/1999 0:00:00 TO PERFORM THE FOLLOWING WORK: REPLACE VINYL SIDING & RAISE FRONT FACIA ON BUILDING 18" POST THIS CARD SO IT IS VISIBLE FROM THE STREET Inspector of Plumbing Inspector of Wiring D.P.W. Inspector of Buildings Underground: Service: Meter: Footings: Rough: Rough: House # Foundation: Final: Final: Rough Frame: ■ Gas Fire Department Fireplace /Chimney: Rough: Oil: Insulation: Final: Smoke: Final: THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Certificate of Occupancy Signature: Fee Type: Receipt No: Date Paid: Check No: Amount: Building 8/27/1999 0:00:00 $50.00 212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272 Building Commissioner - Anthony Patillo