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(/ Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. 5 '7i Alterations
NORTHAMPTON, MASS. `� / T_19 Additions
APPLICa ATION FOR PERMIT TO ALTER Repair
Garage
1. Location rZ-3 CA"i t--a K t 1`'LELA C'E' Lot No.
2. Owners name ;'dy L- a Address 2-3 C�i ta; i.t tLR—y0� U
3. Builder's name l�Z�-� �l H,&L z-- Address 101
Mass.Construction Supervisor's License No. 0 J 2-t* Expiration Date_ f Z f
4. Addition t2 ��-ACS- x 1 s-► N y ZAP ca j
k�o .c'.
5. Alteration
6. New Porch
7. Is existing building to be demolished?
8. Repair after the fire
9. Garage No.of cars Size
10. Method of heating
11. Distance to lot lines
12. Type of roof
13. Siding house
14. Estimated cost 5 OZ7
The undersigned certifies that the above s tements are we to the best of his, her
knowledge and bel ef.
Signature of respo Bible app icant Q
Remarks
1�� i J l )1 Iti�T Old to i
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•�� °0� Gz of 'Wart 1999 t
�RSaRCIIaSCtta
DEPARTMENT OF BUILDING INSPECTIONS
212 Main Street • Municipal Building
Northampton, Mass. 01060
WORKER'S COMPENSATION MSY7RANCE 'MAVIT
(li censcc/permi tt ee)
with a principal place of business/residence at:
laS U• Gt�ST�u i Ntt,t✓ V-o . Y'A-f,rNyou honett) W-) 0'51`7
(st =V6ty/statrJzip) 01-N5 i
do hereby certify, under the pains and penalties of perl.lry, that:
( ) I am an employer providing the following worker's compensation coverage for my
employees working on this job:
(Insuzance 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) (Insurancc Corapany/Policy Number) (E)piration Date)
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(Name of Contractor) (lnsuran� compauy/policy Number) (Expiration Date)
(Name of Contractor) (Insurance Compauy/Policy Number) (Expiration Date)
(attach aclditioml t}uci ifaec�suy to wchuic informaIIoo pertaiaing W all 000iradorz)
I am a sole proprietor and have no one worming for me..
( ) X am a home owner performing all the work myself.
NOTE:pteaae be awarc that whilo hococoA m Ntio carplay pc",u=t.o do r iirrtmmcc comtuction or rcp work oo a dwelling of
not morn than throe units is wfncfr the homoo,vN r resides or oa the grounds zpp1rtcn1ai ibacfo arc oot grne<ally ooaridcrrd to be
employers ands the wotkct's.won Act(GL152,n 1(5))�application try R homcowar for a license or permit may evidcaoe the
IeS4 dahu of an oasployer under tha Wockoes Compamaiioa Ad
I undcrAA.d diA a copy of thin ctatcmart may be fomwizied to the Dtpnrtmmt of Industrial Aoadco&O$oo of Iawcwoe for d-
eovaxge vcriScziion and that Estrum to eoatrc covaxgo trader section 25 A of MGL 152 rya lad to the imposition of criminal paialtics
ootnistatg of a'fine of up to S 1,500.00 aadlof of tip to one year and Civil pcnsl6C$is the form of a Stag Work Order sad a
fin*of 5100.00 R day agsinst me.
For d +l tuo oaly
t, pmmit Ntunbes
Si Lia;nscc/PcrmitLcc
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 coluum 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:
(Lotarea minus bldg
&Pac,ed parking)
# of -Parking Spaces
# fpf Loading Docks
Fill:
-(volume--& location)
13 . Certification: I hereby certify that the information contained herein
is true and accurate to the best of my knowledge.
_.DATE: `�' APPLICANT's SGNATURE
I
NOTE: Issuanoa of a zoning permit does not relieve an app ioant's rden to oonn Lservation oil
zoning requirements and obtain all required permits from the B rd f Health. C
Commission. Department of Publio Works and other applloable it granting authorities.
FILE #
5 1999 ,
File No. ,gr
ZONING PERMIT APPLICATION (§10 . 2)
PLEASE TYPE OR PRINT ALL .INFORMATION
1. Name of Applicant: Z)
Address: ICJ 1 U, Ct4ESi,,j0T M uL, rLD Telephone:
2. Owner of Property: AL .t_ TACK
Address: 2-3 GHQ " 1,u L 1j8 T &F-9-Ac- Telephone: It 3
3. Status of Applicant: ` Owner '. Contractf4preheeer Lessee
Other(explain):
4. Job Location: 23 CAW\ t,,i—A+��
Parcel Id: Zoning Map# �? Parcel# District(s):
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/Property j 7--am.I C-y L-
1
6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary):
o S T p_..0 cx u u op >c i tL C✓�k A U
7. Attached Plans: Sketch Plan Site Plan Engineered/Surveyed Plans
Answers to the following 2 questions m ."ildina Dept or Planning Department Files.
8. Has a Special Permit/Varia
NO DO - - YES,date issued:
IF YES: Was the permit i t
NO DC p
IF YES: enter Booi lent#
9, Does the site contain a brooK, Douy VT 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)
4 04
23 CAHILLANE TERR BP-1999-0818
GIs#: COMMONWEALTH OF MASSACHUSETTS
Ma,o:Block: 35- 109 CITY OF NORTHAMPTON
Lot:-001
Permit: Building
Category:windows replaced BUILDING PERMIT
Permit# BP-1999-0818
Project# JS-1999-1453
Est. Cost:$500.00
Fee: $20.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Groun: DOUGLAS DONNELL 115275
Lot Size sg.ft.): 10541.52 Owner: JACOBS PAUL D
Zoning: SR Applicant., DOUGLAS DONNELL
A_ T: 2.3 CAHILLANE TERR
Applicant Address: Phone: Insurance:
109 W CHESTNUT HILL RD (413) 367-0377
MONTAGUE 01351 ISSUED ON:41611999 0:00:00
TO PERFORM THE FOLLOWING WORK.-REPLACE BAY WINDOW
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 4/6/1999 0:00:00 $20.00
212 Main Street,Phone(413)587-1240,Fax:(413)587-1272
Building Commissioner-Anthony Patillo