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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. , (2�'tI Alterations
NORTHAMPTON, MASS. jU 19 ° Additions
_APPLICATION FOR PERMIT TO ALTER Repair
�C — )-7 L, Garage
1. Location uN T (l—t-4 0—T S-) C-At zus V%,.,r Ir Lot No.
2. Owner's name �O Q r H' � r� � Address 3 �V�,`:)e.& S-1 -l" 3
3. Builder's name vans+,..] Address 3 C S0Q-V1<1= cl k
Mass.Construction Supervisor's License No. L[cv"�- Expiration Date o 0
4. Addition
5. Alteration 2 `�� 0 LZ "N'D d 00 E"q4-
6. New Porch
7. Is existing building to be demolished? N U
8. Repair after the fire
9. Garage No.of cars Size
10. Method of heating rcc-- C C&,,\
11. Distance to lot lines
12. Type of roof
13. Siding house
14. Estimated cost:-
�J 000
The undersigned certifies that the above statements are true to the best of his, her
knowledge and belief.
Signature of responsible app.icant
Remarks
O
ti
g 1998 °, zf� of 'Wart4allipton
JLL
' � � „� �asst:chnsrtta
0. 8b DEPARTMENT OF BUILDITjG INSPECTIONS
212 Main Street ' Municipal Building '
Northampton, Mass. 01060
WORKER'S COMPENSATION INSURANCE AFFIDAVIT
(license&PernI ttee)
with a principal place of business/residence at:
3 hone#) 'T t" (22-x-1
(strcWcity/sta&2jP)
do hereby certify, under the pains and penalties of perjury, that:
,P I am an employer providing the following worker's compensation coverage for my
employees woring on this job:
UANr`�SPN l Sl 9 - oo —C)91 k'9 / -.'y 2 - r 9 9 9
(Insurance Company) (Policy Number) (Expiration Daze)
( ) 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 Com)any/Policy Number) (Expiration Date)
(attach additioml shed ifneccnary to inc}ude information pertaining to all 000tmetors)
( ) 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 dmt while homeowners who employ persons to do m mtc ,-,. onstruetion or rc*r work on a dwelling of
not morn than throe units in which the homeowner rides or on the groun6 appurtenant thereto are not generally oo=dcfed to be
employers udder the workeez compensation Act(GL152,ss 1(5)),application by a homeowner for a license or permit may evideam the
legal etatw of an employer under the Worker's Compensation Act
I undmund that a copy of this traiment may be farwrucled to the Depwuncna of Ixkntrial Axida ats'Ot$oo of Insurance for the
ooverago verification and that failure to axon coverago under section 25A of MGL 152 can lead to the imposition of criminal Penalties
eomisting of a fide of up to$1,500.00 andtor imprbonincrit of up to one year and civil penalties in the form of a Stop Work Order and a
firm of S100.00 a day agaitsst toe.
For dq=tm=W use aaly
g— Permit Number Lot#
_ Signature of Licensee/Permittee
[ N_5T
l ENTRY
/ 9
DEPT Of —
J BOOKSHELVES (BY OWNER)
rr
OVERHEAD SOFFITT 30" W x 6" TALL
FURR cur AND DRYWALL DINING f�i00M
ENTIRE WALT.
CAN
1 6 �
GLUE-DOWN
1 -_.---- NARbWCX7D
BELOW-GRADE
SLIDING PANELS ON TRACK FLOOSPFLOOR FULL EXTENSION APPROX, 8'-0"
I � �
t ��� BuTCNErz- I
BLOCK
ISLAND TOP
-� ARBLE STEEL REStA
LAS I 6NELVIN3 UN
��s I
KITCHEN r-ERAMIC-r LE
----— FLOOR
I '3
t
�e Dort
ry - Dw v I I CLOSET
BOX OUT AROUND
GAS PIPES
F ROF�06M KITCHEN LAYOUT 1/411 2 11-aI!
ENTRY
JUL 911998 _ _
Qf�PT OF BU
/ - - BOOKSHELVES (BY CU)NM'
OVERHEAD SCFFITT 30" w x 6" TALL
- - - - - - -- - -- - - - -- - - - - - -
FURR CUT AND DRYIUAL _ DINING ROOM
{ ETIT'IRE WALL — ---- - - --- —_ _
CAN
tsLUE-DOWiJ �.
SLIDING PANELS ON TRACK FLOOR BELOW-GRADE SPEC.
FULL EXTENSION APPROX, 8'-O"
I
L� BUTCHER-
, BLOCK
ISLAND TOP
- i--- ARBLE \_- --_ I - 8TM RESTA
I LAB I
SHELVING UN'
1 I — J I
KITCHEN CERAMIC TfLE
----- FLOOR
I 3
� h
I
I -
REM. oorl
- L ow I CLOSET
BOX OUT AROUND
GAS PIPES
PROf:!'OSW KITCHEN LAYOUT 114" = I'-0"
10. Do any signs exist on the property? YES NO C
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 Col— to be filled in
by the Balding Department
I 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)
# pf Parking Spaces
j %f Loading Docks
Fill:
4vol-1 me--& location)
13 . Certification: I hereby certify that the information contained herein
is true and accurate to the best of my knowledge.
.1_
D2ffE: _�( -1( Q APPLICANT's SIGNATURE
}" NOTE: Issunnoe of a zoning permit does not relieve an a iioanta burden to oom wit
PP P.IY h�...at
zoning requirements and obtain all required permits from the Board of Health, Conservtatic
Commission, Department of Publio Works and other applionble permit granting authorities.
FILE #
D Y'
JUL 9 W
}
File NO A
DEFT OF c3!_'_ 1?d�PECTIONS
z-.-,
IBC?,,,.
ZONING PERMIT APPLICATION (§10 . 2)
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant: Q d Q P CC-'X
Address: `3 (" Z C-KIP Telephone: 'S `y /2`2y
2. Owner of Property: 9—&d 4` G
Address: ��C'�<tc S Telephone:
3. Status of Applicant: Owner Contract Purchaser Lessee
Other(explain,): } �"
4. Job Location: 26 l.C�� .�wo c� /,(/A
iu:t Ozrss
Parcel Id: Zoning Map# Jj C Parcel# Cv District(s):
(TO BE FILLED IN BY THE BUILDING DEPARTMENT
5. Existing Use of Structure/Property 44 uo cMct4t'
6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary):
P- + btu{ - ' GS •�'Q61f�
111k� cal-4 ter S if-4C 15O-or.^La..y ��c �- �, `i1h'►�I'r
''ilk 'i b (I C Ra \ C,00-A ,ry
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 KNOIV___�6 _ YES IF YES,date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO DON'T KNOW Y 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)
Department: Reference No: BP-1999-0043
...................................
Building, Electrical & Mechanical Permits
.........................................................................................
Fee Type: Receipt No:
Non structural interior renovations REC-1999-000054
........................................................................................
......................................
Paid By: Paid in Full On:
Robert Reckman Fri Jul 10,1998
.........................................................................................
......................................
Received By: Check No:
Linda Lapointe 8068
......................................................................................... ......................................
DEPARTMENT'S COPY Amount: $140.00
.....................
DEPARTMEN'I' FILE ("OPY 80 WILLIAMS ST
CITY OF NORTHAMPTON
BUILDING PERMIT
Owner's pulling their own pen-nits or dealing with unregistered contractors for applicable work do
not have access to Guaranty Fund(MGL 142A)
Issued: Permit No: Inspector: Tracking No.: Fee:
BP-1999-0043 $140.00
GIS Map Block: Lot: Address: Zoning: Use Group: Lot Size:
10792 32C 276 001 80 WILLIAMS ST URC
Contractor: License Type: Insurance:
Robert Reckman CSL Workers Compensation
Address: License No.: Insurance No.:
36 Service Center 009498 151800097491
Li!y-i State: Zip Code: Phone:
NORTHAMPTON MA 01060 (413) 524-1224
Proiect No: Category of Work: Const. Class: Cost Estimate:
JS-1999-0056 Non structural interior renovati $35,000.00
Description of Work:
add kitchen/dining in storage area to convert to two units
GeoTMS@ 1997 Des Lauriers&Associates,Inc. Signature:
File#BP-1999-0043
APPLICANT/CONTACT PERSON Robert Reckman
ADDRESS/PHONE 36 Service Center (413)524-1224
PROPERTY LOCATION 80 WILLIAMS ST
MAP 32C PARCEL 276 ZONE URC
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT ✓
Fee Paid
Building Permit Filled out
Fee Paid ZO&
Type of Construction:
New C
on Structural interior renova i
Addition to Existing
Accessory Structure
Building Plans Included•
Owner/Occupant Statement or License#
3 sets of Plans/Plot Plan
THE LLOWING 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
t - -1A6rowra s�Board of Health Well Water Potability Board of Health
Permit from Conservation ission
Signature of Building icial 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.