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32C-349 C7 "p Z C"1 X c v Z > Zoning- -_ Miscellaneous Additions,Repairs, Alterauons,etc. Tel.No Alterations NORTHAMPTON, MASS. Additions— ---- ' APPLICATION FOR PERMIT TO AL TER Repair -- ,i Garage 1. Location—n l P � F A,'S'A V-r. ,T-r -/L 1�� � ' 0�� __--- _ � Lot No.------ --— 2. Owne.:s name L" Y — r4 °�_P. �1v ...—Address 1 Z G'�2' L7 vim- Z f l ��✓ i ll1 . Build tr'sn2r,^.e ---- . / Address) Mass. Construcion Sup er,,isor's License No. —y--/—�._Lxpirati;on Date 4. Addition -- 5. Alteration ^� �� GL�1�r� �� �,��r d��/�S✓�.�d�� 5. New Porch is exisung building to be demolished? Nl)" 8. Repair after the fire A))? _-- 9. Garage —" No.of cars Size IQ Method of heating ---- 11. Distance to lot lines 12. Type of roof -------------- —_- I3. Siding house—_ _- 14. Estimated cost lrf k The undersigned certifies that the above statements are true to the best of his. knowledge and belief. n tur of responsible app,icani Remarks •` •-- O �� o ? nPR 1 Q 2000 Crrf of 'No t11alllpfoil ppF E eN 6 yli76 ACh t16Cl(a _ DEPARTMENT OF BUILDrNC INSPE-CTIO14S 212 Alain Street ' Municipal Building Northampton, Mass- 01060 WORICER'S CONITENSATION INSURANCE A { <IDAVIT II-Ah — OJAZIzf'z 1 ---— — (li ccnscrJpermi tt�) with a principal place of business/residence at: __(phone,'=) `�'`C� (snit/ci r/stalc�z�P) do hereby certify, under the pains and penalties of perjury, :hat. ( ) I am an employer providing the following wori;cr's comnens ljon covem-C for Iny employees working on Otis job. (Lnsl_anc:� CompaL- ) (PoVC:Nufubcr) Date) ( ) I aul a sole prounetoi, general conriactor or homeovrner (circle one) and have hiiea the contractors listed below who have the folloVY Q workef's coEDoensation aolicies: (Name of Con!. cofl ) Gnstinnc Date) (Name of ConLrac�,oi) (Insurance Compaayi?olicy (Expiration Date) (Name of Coturactor) (I>uulanc Compare}vPol,c} -pinuon Date) (Name of Contractor) Gaauanc�-_ CompaETy/Poticy Number) (Expiration Date) (attach:A i a octal Sheet if noecur-y to arch iaf«-.a"oo per's w all 04-I am a sole propnetor and have no one working for me. ( ) I am a home owner performing all the work myself. NOTE:plcsc be awzm th:t wino hoa,cown wbo c=ploy pcioln co do m�anri,rx r,ccr_—,=on or repair work on s d. _Lhng of oo(mocc than throo u=tl in ts-ffieS the hoIDOD-r-rcmdo or oa the p-ouzid3 app Am—n:l thcceo me oo(wally cocsidcrtd to be cmployrr3 under the wvckrr'a oempc="1ioa Act(GL152 z 1(5)�appticabon try a homcoa-zjcr far e liccme cc permit n:t y�16mec the legal ctanrc of en ampioyx under th.o WorkCe,Coazpcmat-ioa ArL [undcrstxnd dLd a oopy of this rt rc.*c=miy ba forwn led to tbo Dcpxi tai of indii tri cl/,=&a(Y Offio of lrauznoc fof the oovcrx va-16cfat�ioo aad that f_dL'm to aeau-c cov':ng under zoction 25A of 1.(GL 152 cin lmd to the i Vosto.of mminal pcn.iltia coau5tmg of a 111)c of UP to S 1.500.00 andlor cnpruoanxal of up to one year and civil pcnahia in dx form of a Slap Work Order and a f1m of 5100-00 i d.y aping me For dq:irunctY.al ux only permlt Number �✓ — ivt tp 0 Lot S i gua lure of L c ruyi tScce ---- 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 —.I== to be filled in by the Haildiag Depar®eat Required Existing Proposed By Zoning Lot size Frontage Setbacks - side L: R: L: R: - rear Building height Bldg Square footage %Open Space: (Lot area minus bldg &pai,ed parking) # of Parking Spaces t of Loading Docks Fill: vol-ume--& location) 13 . Certification: I hereby certify that the information contained herein is true and accurate to the best of my knowledge. DATE: J6 l_d APPLICANT's SIGNATURE NOTE: l" anoe of a zoning permit does not relieve an appiioant's b e to comply wp"-all zoning requirements and obtain all required permits from the Board of. ealth. Conservation Commission. Department of Publio Works and other applioable permit granting authorities. FILE # a MOM r. Ei1e No. A-O ZONING PERMIT APPLICATION (§10 . 2) PLEASE TYPE OR PRINT ALL INFORMATION 1. Name of Applicant: 6-'-10 t N I Ll)"q!ty / L c--:- Address: / 0-177t7Cr- ST Telephone: / 3 Z 7 —0 2. Owner of Property: Address:-2 pl- 'g� S7 Telephone: 3. Status of Applicant: X Owner Contract Purchaser Lessee Other(explain): 4. Job Location: �LSi S Parcel Id: Zoning Map# Parcel Z* District(s): (TO BE FILLED INBY--THE BUILDING DEPARTMENT) 5. Existing Us f Structure/Property T 6. D"ion of Proposed Us(/Wo roject/Occupation: (Use additional sheets if necessary): 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/Vadance/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? NQ—z— 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-2000-0869 APPLICANT/CONTACT PERSON William Mazuch ADDRESS/PHONE 1411 Westhampton Rd (413)586-8749 PROPERTY LOCATION 71 PLEASANT ST MAP 32C PARCEL 349 ZONE CB THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out Fee Paid Typeof Construction: INSTALL WALL&2ND DOOR FOR AIR LOCK New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/Statement or License 010936 3 sets of Plans/Plot Plan THF, 3L�LOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION: �� Approved as presentedibased 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 Commission Permit from CB Architecture Committee � -1D -po Signature of Building ficial �a AV 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. 71 PLEASANT ST BP-2000-0869 G1S#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 32C-349 CITY OF NORTHAMPTON Lot:-001 Permit: Building Category'Non structural interior renovations BUILDING PERMIT Permit# BP-2000-0869 Project# JS-2000-1620 Est.Cost: $600.00 Fee: $50.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: William Mazuch 010936 Lot Size(sa.ft.): 2874.96 Owner: CHAMPAGNE GARY R Zoning:CB Applicant: William Mazuch AT. 71 PLEASANT ST Applicant Address: Phone: Insurance: 1411 Westhampton Rd (413) 586-8749 FLORENCEMA01062-9751 ISSUED ON:4110100 0:00:00 TO PERFORM THE FOLLOWING WORK.-INSTALL WALL & 2ND DOOR FOR AIR LOCK 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: OW Building 4/10/00 0:00:00 1296 $50.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo