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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations
NORTHAMPTON, MASS. 19 Additions
Repair
APPLICATION FOR PERMIT TO ALTER
J� Garage
1. Location 4 r w- *1� w Lot No.
2. Owners name Address
3. Builders name Address
Mass.Constructio Supervisors License No. L Expiration Date Q C�
4. Addition
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
e
12. Type of roof '
13. Siding house
1 14. Estimated cost-
The undersigned certifies that the above statcmcnts are true to the best of
r knowledge and belief.
/f
Signature of responsible appicant
Remarks -
t
O O,y
e Grif� of 'Ward ampton 4
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DEPARTMENT OF BUILDWG INSPECTIONS
212 Main Street ' Municipal Building 'a
Northampton, Mass. 01060
WORICER'S COMPENSATION INSURANCE AFFIDAVIT
j I, -
(li permittee)
with a principal place of usiness/resid nce at:
(phone#)
(M=t/city/state2ip)
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:
(Insumance 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) ansurance Company/Policy Number) (Expiration Daze)
(Name of Contractor) (Insurance Company/Policy Number) (E)piration Date)
(attach additioml shod ifneoesury to iacksde infaansuon pertaining to all cootractots)
K'i am a sole proprietor and have no one working for me.
( ) I am a home owner performing all the work myself.
NOTE:pieaae be aware dud while homeowners who empicy persons to do mai d==ce,o= nrctionor repair work on a dwelling of
not more than throe units in which the boni owner resides or as the g wn&appurtenant tbardo=not gc orally coandeted to be
employers under the worker's compensation Act(GL152,ss l(5))�application by a homeowner for a Gore or permit may-id—the
legal ctatua of an employ«under the Workees Compensation Act.
I understand that a copy of this sutcmeat may be forwarded to the Depa u=d of Industrial Axideesd Oflioe of tnummWe for the
coverage verification and that failure to aoarre covemp under section 25A of MGL 152 can lead to tbd imposition of miminal penalties
comistiag of a fine of up to$1,500.00 andlex imprisoemart of up to one yt a and civil penalties is the foam of a Stop Work Order and a
fine of$100.00 a day against sac.
For dq„ta=Sl use only
Permit Number
Lot#
Si of Licensee/Permittee
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 —1— to be filled in
by the Building Department
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
&paved parking)
# of -Parking spaces
#' of Loading Docks
Fill:
4vo1-ume-& location)
13 . Certification: I hereby certify that the information contained herein
is true and accurate to the best of my knowledge.
DA E: 146 `� APPLICANT's SIGNATURE
NOTE: Issuanoe at as zoning permit does not relieve an pplioanta burden to oomply wRhl +all
zoning requirements and obtain all required permits i m the Board of Health, Conservation
Commission, Department of Publio Works and other a linable permit granting authorities.
FILE #
Lj OCT 1 81999
Fi l e No. -00
ZONING PERMIT APPLICATION (§10 . 2)
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant:
Address: Telephone: �7 -,7 —
2. Owner of Property: - >
Address: :Kt:f Telephone:
3. Status of Applicant: Owner Contract Purchaser C--tessee
Other(explain):
4. Job Location:
Parcel Id: Zoning Map# �O Parcel# 021e;� District(s):
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/Property
L_ 6. Description of Proposed Use/Work/Project/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? 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)
42-44 WALNUT ST BP-2000-0433
G1S#: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 25C-218 CITY OF NORTHAMPTON
Lot:-001
Permit: Buildina
Category:roofing BUILDING PERMIT
Permit# BP-2000-0433
Project# JS-2000-0747
Est.Cost:$9000.00
Fee: $25.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: James Roberts 117154
Lot Size(sq ft.): 9278.2B Owner: KNAPP KARL E&KAM S
Zoning:URC Applicant: James Roberts
AT• 42 - 44 WALNUT ST
Applicant Address: Phone: Insurance:
30 Edwards Rd (413) 527-6078
WESTHAMPTON 01027 ISSUED ON.1012111999 0:00:00
TO PERFORM THE FOLLOWING WORK.-STRIP & SHINGLE ROOF
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 Sip-nature:
Fee Type: Receipt No: Date Paid: Check No: Amount:
Building 10/21/1999 0:00:00 $25.00
212 Main Street,Phone(413)587-1240,Fax:(413)587-1272
Building Commissioner-Anthony Patillo