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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. J�y� Z Alterations
NORTHAMPTON, MASS. 4-4'111 S F 1 Additions
APPLICATION FOR PERMIT TO ALTER Repair
Garage
1. Location <A.�,tC Lot No.
2. Owner's name V-- i'1/ Address es +L
3. Builder's name Address Z
Mass.Construction Supervisor's License No. pn cl qy Expiration Date 6( a (el
4. Addition 12- L it *t7
5. Alteration b
6. New Porch 1,s J
7. Is existing building to be demolished?
8. Repair after the fire A
9. Garage No.of cars Size
10. Method of heating
11. Distance to lot lines
12. Type of roof
13. Siding house
14. Estimated cosL-
�b
The undersigned certifies that the above statements are true to the best of his, her
knowledge and belief.
Signature of responsible app scant
Remarks
0 ,O NOV V €3 ij'j i Crzt� of 'Norf4alllpt"
Bf�asar:chusctia
DEPARTMENT OF BUILDING INSPECTIONS
212 Main Street ' Municipal Building '
Northampton, Mass. 01060
WORKER'S COMPENSA'T'ION INSURANCE AFFIDAVIT
(licensee/pezmittee)
with a principal place of business/residence ax:
3 '� 72-Y
(strc:et/ci ty/stafr/rip)
do hereby certify, under the pains and penalties of perjury, that.
( ) I am an employer providing the following worker's compensation coverage for my
employees working on this job:
,;mac.,sr ,,_
(Insurance 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) (Insurance Company/Policy Number) (Expiration Date)
(Name of Contractor) (Insurance Compauy/Pokcy Number) (Expiration Date)
(Name of Contractor) (Insurance Compauy/Pohcy Number) (Expiration Daze)
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(attach additioml&beet ifnocciury to include informalioa pertnimng to all coatr d m)
( ) 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 that wbiro homcownccs wbo employ pa son:to do coasuvetioa or repair work on a dwelling of
not more than throe units in which the homoowocr sides or oa the grounds appurtenant tb=W arc not gaxr ity w—de ed to be
employes under tbo workeez compeuseioa Act(GL152_s 1(5)),application by a homeowner fora liaax or permd tnay cvi�the
legal statue of an amployer undor thn Wockees Compomalion AcL
I understand that a copy of this dalcmcal may ba forwarded to tho Depar w..d of Inds el Acd&c&Offioo of Inwrwoe for the
coverage vaific aftoa sad that failure to secure coverage under section ZA of MOL 152 can lead to tbd imposition of criminal pcnaltics
consisting of a fmc of up to S1,500.00 amdlor imprison of rip to one year sad civil pcml6cs in the form of a Stop Work Order and a
find of 5100.00 a day against me.
Signed this day of dUZ 199-7 For dcgrctmr3alrueoatY
Permit Number
map# Lot#
Signature ofLi=r-,ee/Permittee
ROBERT
Robert Reckman, General Contractor
Construction Supvr. Lic. #009498
August 3, 1998
AUG 5 1998
Mr. Tony Patillo
Northampton Building Inspector
Puchalski Memorial Office Building
Main St.
Northampton, MA
01060
Dear Tony;
This letter is simply to ask you formally what I asked you on the phone last week. In the
fall of 1997 1 applied for a building permit at 21 Longview Drive. Because the client was in
a hurry, I poured the foundation before we had the permit. It then turned out that the
property needed a decision by the ZBA to allow the addition where we ha(+poured the
foundation. The foundation was backfilled and has sat there ever since. When this
happened, I wrote to you and said that if there was a long term problem I would have the
foundation removed. Since that time the homeowner, Mr. Kevin Keilty, has had a heart
attack and has not applied for the ZBA decision. I now need a decision from you about
what I should do about the foundation. It seems silly to remove it if he still intends to apply
for the decision, which he says he does. However, since nothing has happened for at least
8 months I wonder whether he will make the application. In addition, of course, there is no
way for us to know what the ZBA will decide. Please let me know what you would like
done.
Sincerely yours;
Bob Reckman
cc Mr. Kevin Keilty
36 SERVICE CENTER, NORTHAMPTON, MASSACHUSETTS 01060 413/584-1224 QUALITY DESIGN &CONSTRUCTION
10. Do any signs exist on the property? YES NO k
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 cola= to be filled in
by the Building Dcpartmeent
(Required
Existing Proposed By Zoning
I Lot size
Frontage 15� '5
Setbacks 3 - 3
- side L. R: qb L.-_42V R:
- rear c
Building height u
Bldg Square footage
%Open Space:
(Lot area minus bldg QQ Q "
&paged parking) C� �S�J° 3 �`.
# of -Parking spaces Z
# of Loading Docks
Fill:
-(volume -& location)
13 . Certification: I hereby certify that the information contained herein
G is true and accurate to the best of my knowledge.
DATE: APPLICANT's SIGNATURE
NOTE: lneunnoe of a zoning permit does not relieve an applioant's burden to oomply with'all
zoning requirements and obtain all required permits from the Board of Health, Conservation
Commission, Department of Publio Works and other applioable permit granting authorities.
FILE #
I ;
Nov 1 91997 No
File . ✓`�
DEK OF SUILD�
�1cT4 3`Cu KING PERMIT APPLICATION (§10 . 2)
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant:
Telephone:C' `t r .Z
2. Owner of Property: kti
Address: -"2--1 L-o,,s C,v 6�-z Telephone:
3. Status of Applicant: Owner _Contract Purchaser Lessee
Other(explain): 70'rrZKI�
4. Job Location: _ �'�' C
L �
Parcel Id: Zoning Map# Parcel# t District(s):
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5, Existing Use of Structure/Property 5 IH C L LL- k'P�( .v (?trC, :nj Z,,
6. Description of Proposed UseNllork/Project/Occupabon: (Use additional sheets if necessary):
A n a (L t k 2 4 ` jl�, � _,\� .4-0;)t �
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 KN^:A: k' YES IF YES,date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO DON'T KNOW k 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)
FILE # Jr s J3J
APPLICANT/CONTACT PERSON: -
ADDRESS/PHONE:
PROPERTY LOCATION:
MAPS PARCEL: ZONE - C
THIS SECTION FOR-OFFICIAL USE ONLY:
PER UT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FH,T.FT) OITT
Fee P"lid
Build Permit Filled not
Fee Pflif]
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS AP ICATION:
d 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-Bd of Health ell Water Potability-Bd Health
Permit m e ion
"5::7 -/Z7
Signature of uilding Inspector to
NOTE:Issuanoo of a zoning permit does not relieve an appllonnt's burden to comply with all
zoning requirements and obtain ell required permits from the Board of Health, Conservation
Commission, Department of Publio Works and other applioable permit granting authoritles.