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Zoning
N.tscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations_
NORTHAMPTON, MASS. A ,/-74� 19U Additions
APPLICATION FOR PERMIT TO ALTER Repair
�� ��� � ���� Garage
1. Location �/^ Lot No.
2. Owner's name 62-an _ - Address �GS^ �'7 G-t
3. Builder's name LA t"I 1-e� �C/`"fJ�i Address P
Mass.Construction Supervisor's License No. � "I �3 Expiration Date G O
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
12. Type of roof 4,41 �
J
13. Siding house
14. Estimated cost-
The undersigned certifies that the above statements are true to the best of his, her
knowledge and/belief.
Signature ojresponsible app icant
Remarks
O O
A �xf of wart 1jatltptoT1 .
• AUG 2 5 1,99l csfnct]nsr(lc
3 =
DEPARTMENT OP BUILDDZC INSPECTIONS
212 Main Street ' Municipal Building
Northampton, Mass. 01060
WORXCER'S COMTENSATION INSURANCE AF t AVrr
Tc r17
(ti��c:J pc rmi l tG;
with a principal place of btlsiness/residence at:
a— PX 4�" oC/�? �Q (phone, ) S�yc��y�/
do hereby certitj1, under the puns and peaal6cs of perjury, Thai:
( ) I am an employer providing the followMg compcnsauon covc:-aoc for my
employees worming on this)ob.
(Lnsulance Cody) (Policy Number) (Expiration Date)
( I am 4 le propri r, general contractor or homeowner (circle one) and have hired
the contractors listed below who have the following worker's compeasation policies:
0
(Name of Contractor) Qmsur n� Compauy/Policf Nwnbcr) (Expiration Date)
(Name of Contractor) (Insuranczz Conipulyi?olicy Number) (Exoiranoa Dalc)
(Name of Contractor) (1asu=c-- Come/Polio Nu bzr) (F-�piradoo Da1c)
(Name of Conractor) (Lnalimcc Coalpany/PoLcy Numbccr) (L xpiradoo DaLc)
(ctlic+�a.Ciiboml z+�.-.0 if�ccciiry to ixw�iaformuca p:^_icint�to.11 ctidr-_Cori)
J. I am a sole proprietor and have no one worEng for me.
O I am a home owner perforrming all the work myself.
NOTE-plc?sc be cb-.1 whilo hc=owwc �tb cam*loy oC
¢ot meet th_n Lb—traits is wtncb the F,ecvotvocr redo er co e!�-ffvuab:pp xi—H tba c- ere ooc w be
rmPloycrs undo Lb- (GL152y 1(5)�np?tic�Goa by�6omcowncr far a licYax cc perua �)r cvidc,oc the
legal rtat.of'as—Ploy-<under tho Wocirela Compca..i.ion Aet
I understand d-t a oopy of this" �my bo toemrci.«i to tho Dcga to ,r of ofs—of tour for th<
covaz&c Yaificiioo mad this ailucc to soc, ' covet ao uowt T scctioa 23A of MOL 152 cwa lctd to tbd imposi6—of crimmA Pm-iloes --
eoosi=zg or&five of up to S 1,500.00-nYcc impri3ocmcat oCuP Lo 0o yter ud avil pcmhicn in the focm oCa step WorkOrdcr and a
dw 0(S 100.00 achy Lp-ia .me
Signed this day of 1997 Fo<d��tm�..1u>ooary
Permit Number
Lot I
ig)aa of Lic�nsec/k'cimiticc
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 MIDST BE COMPLETED, or PERMIT CAN BE DENIED DUE TO
LACK OF INFORMATION.
Thin columm 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
' &pacled parking)
# of Parking spaces
f 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: APPLICANT's SIGNATURE r
r" NOTE: Issuance of a zoning permit does not relieve an lioanr burden t oom wit
PP Pty h,.•all.
zoning requirements and obtain all required permits from the Board of Health, Conservation
Commission, Department of Publio Works and other applicable permit granting authoritles:..
FILE #
AUG 2 51997
File No. i
ZONING PERMIT APPLI CATION (§10 . 2)
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant: d�
Address: �G� P ,�O 5 /a,,741�P Telephone:
2. Owner of Property: Ste /Lr/(
Address: ^ 7 Telephone:
3. Status of Applicant: Owner X Contract Purchaser Lessee
Other(explain): /
4. Job Location: v�/-t /�-, 5',r-
Parcel Id: Zoning Map#j,_-,� _ Parcel# _ District(s):
(T BE E FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/Property
i
6. Description of Proposed Use/Work/Project/Occupabon: (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 PermitNadance/Finding ever been issued for/on the site?
NO DON'T KN-,"A/___ C YES IF YES,date issued:_
IF YES: Was the permit recorded at the Registry of Deeds?
NO DON'T KNOW ,\!5�_ 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)
y; FILE # aJ - i u 3
AUG 2 51997
APPLICANT/CONTACT PERSON:
u}, ADDRESS/PHONE: 0p03 e-3� Q/061 �
PROPERTY LOCATION: ?
MAP- PARCEL:. ZONE I
THIS SECTION FOR-OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONIENG FORM EITLED OUT
Fee Paid
Rnilding Permit Filled nut
ll--*,'
_1RemndPlin2 Interior
AcressoryStriirtur; t/
T OLLOWING ACTION HAS BEEN TAKEN ON THIS APffICATION-
V.
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
L" ''Septic Approval-Bd of HealtfW Well Water Potability-Bd Health
Y rt r ry ' n Sion fly
Signature of Building 19pector Date
NOTE:Issuanoa of at zoning permit does not relieve an applioant's burden to comply with all
zoning requirements and obtain all required permits from the Board of Health, Conaervation
Commission, Department of Pubiio Works and other applicable permit granting authorities.
►w+
o�s��"•e City of Northampton REQUIRED INSPECTIONS
BUILDING DEPARTMENT 2. Strucntural Components in Place*
.3. ".ompiete Bunaing*
No. 808 Office of the Building Inspector
Zoning Form No. 962703 Date 8/27/97 Fee $20.00 Check# 162
Page, 12C Parcel 60 ,Zone URA/WSP Section 127 ❑ Yes ® No
BUI]LDINGPERMIT
* Plumbing and Electrical Inspections required
THIS CERTIFIES THAT Ronald Mistarka before Building Inspections
has permission to strip & reshingle roof Inspection on Site—Foundations
situated on 16 Cloverdale St - Sally Wild Inspection of Plumbing—Rough
provided that the person accepting this permit shall in every respect Inspection of Plumbing—Finish
conform to the terms of the application on file in this office, and to the Gas Inspection
provisions of the Statutes and the Ordinances relating to the Construction, Inspection of Wiring—Rough
Maintenance and Inspection of Buildings in the City of Northampton.
Any violation of any of the terms above noted is an immediate revocation Inspection of Wiring—Finish
of this permit.Expires six months from date of issuance,if not started. Building Inspection—Rough
Note:A certificate of occupancy will be issued by this office upon return Insulation Inspection
of this card signed by the Plumbing,Wiring and Building Inspectors.
Building Inspection—Finish
** Install per Manufacturer's information: windows,vinyl siding,roofs Smoke Detectors(Fire Department)
and woodstoves
Other
THIS CARD MUST BE DISPLAYED IN A CONSPICUOUS PLACE ON T REMISES
Certificate of Occupancy -
uilding Inspector