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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