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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations
NORTHAMPTON, MASS. �-fU 19 `('*e Additions
APPLICATION FOR PERMIT TO ALTER Repair
a
Garage
1. Location /S ' � Lot No.
2. Owners name AO 4"'c 7"`""`' Address
3. Builder's name /&X 0-I't of Address "�� Nt''�'4 5 *' �G1
Mass.Construction Supervisor's License No. 06616- Expiration Date
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 .s--
13. Siding house
14. Estimated cosL- 7 d pd
The undersigned certifies that the above statements are we to the best of his,
knowledge and belief. / �✓
Signature of responsible app,icant
Remarks / `'0,.r4
ZL
Li
l NOV 2 21999
9 a DEPT OF BUILDING INSPECTIOFtiS aZ` of wart 4�Ilt� tan L
NORTHAMPTON,MA 016 60 f A:ssxchnsctls
m DEPARTMENT OF BUILDITjG INSPECTIONS
212 Main Street ' Municipal Building '
Northampton, Mass. 01060
WORKER'S—COMPENSATION INSURANCE 'MAVIT
with a principal place of business/res�idencee at:
7 —"66'
(sti--,, Ucity/statrhip)
do hereby certify, under the pains and penalties of pcoul-Y, that:
( ) I am an employer providing the follollving worker's compensation coverage For my
employees working on this job:
W C i /a -7/11 DPD
(Las=cc 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) (Lnsiu-nc: Company/Policy Number) (Expimtion Date)
(Name of Contractor) (Lasun�cc Compauy/Policy Number) (Expiration Date)
(Name of Contractor) Qnsurancz Company/Policy Number) (Expiration Dale)
(Name of Contractor) (Lnsulance Company/Policy Number) (Expiration Date)
(anarh add tieasl shed if.,.— .ry to iachsdc infvcrosti oa pertaining to all ooatrad4n)
( ) I ani a sole proprietor and have no one working for me.
( ) I am a home owner performing all the work myself.
NOTE:please be awatr that while homeown,rz who employ perro=to do �wu Xion:cr rzpair work on a dwelling of
not me o than thtro units in wbicb the hoMca, cr rc do a ca the groundr appurtenan!ihado arc Dot gaxrally comidard to be
cmployrta undo tba worker`s o=pcns4 a Act(GL152,xs 1(5)),applicz6on by a homcown r far a li-nsc cc permit may evidence the
le7pil ctnriir of an employer under tho Wotkces compmsaiiou Act
I understand tb,i a copy of thii may bo forwarded to the DV rtmcni of 1.&L-'tri al Ac6d--&Oleo of lunuwoe for the
oovcsage vcrifieatioa and that failtire to t==covcnrgo uadcr soeiioa 25A of MOL 152 can,lead to tbo'impo>itioa of ctic i pca'W"'
oanistiug 9 a•fie of up to 51,500.00 and/or impraoonscut of tip to.onc year and civil pcn Lw cs in the form of n Stop W ocic CWcr and a
firm of 5100.00 a dry agai[ss1 me
For dcp:rtm�
u,o only
Permit Ntltnber
_ --
Lot:#
Y Sim of Liocnsc cRcrmittcc
T5�
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10. Do any signs exist on the property? YES NO
IF YES,describe size,type and location:
i
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 colnm to be filled in
by the Building I.kpartme,t
Required I
Existing Proposed By Zoning
Lot size sc,
Frontage sv
Setbacks - frnnt
- side L: R: L: R:
- rear
Building height
Bldg Square footageC�;
%Open Space:
(Lot area minus bldg
&paved parking)
# of Parking Spaces
# of Loading Docks
Fill:
-(volume--& location)
13 . Certification: I hereby certify that the information contained herein
is true and accurate to the best of my knowl ge.
DATE: i/1/y F7 APPLICANT's SIGNATURE
NOTE: Issuanoe 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, Conservotion
Commission, Department of Publio Works and other applicable permit granting authorities.
FILE #
..� 9A9
tow 12) 21
File No.
DEPT OF 8llIL 4!�!1 fNl'tGT1�tyS
ii? ,,., NG PERMIT APPLICATION (§10 . 2)
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant:
Address: 07/ /� 'r Sf �''�` "'� Telephone:
2. Owner of Property:
Address: //S /r'1�G�2rst �2 Telephone: .,S k6
1 Status of Applicant: Owner L--- Contract Purchaser Lessee
Other(explain):
4. Job Location: //.f- h'
Parcel Id: Zoning Map# /V Parcel# OoZ District(s):_��/_
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
S. Existing Use of Structure/Property
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 PermitNadance/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)
File#BP-2000-0537
APPLICANT/CONTACT PERSON Roy Omasta
ADDRESS/PHONE 21 North St (413)247-5666
PROPERTY LOCATION 115 HILLCREST DR
MAP 17A PARCEL 302 ZONE URA
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: FINISH I/S OF BASEMENT
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/Statement or License 006763
3 sets of Plans/Plot Plan
T LOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION:
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 Board of Health Well Water Potability Board of Health
Permit from Conservation Commissio
a
Signature of wilding Offic' 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.
e
1
A
115 HILLCREST DR BP-2000-0537
COMMONWEALTH OF MASSACHUSETTS
Aap:Block: 17A-302 CITY OF NORTHAMPTON
Lot:-001
Permit: Building
Category:Non structural interior renovations BUILDING PERMIT
Permit# BP-2000-0537
Project# JS-2000-0934
Est.Cost:$7000.00
Fee:$50.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group_ Roy Omasta 006763
Lot Size(sq.ft.): 21867.12 Owner: TURNER DAVID S&MELODIE P
zoning:URA Applicant: Roy Omasta
AT: 115 HILLCREST DR
Applicant Address: Phone: Insurance:
21 North St (413) 247-5666 Workers Compensation
HATFIELD 01038 ISSUED ON.1211199 0:00:00
TO PERFORM THE FOLLOWING WORK:FINISH 1/ OF BASEMENT'
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 12/1/99 0:00:00 $50.00
212 Main Street,Phone(413)587-1240,Fax:(413)587-1272
Building Commissioner-Anthony Patillo
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115 HILLCRESTDR BP-2000-0537
GIs#: COMMONWEALTH OF MASSACHUSETTS
Map:Block:17A-302 CITY OF NORTHAMPTON
Lot:-001
Permit: Building
Category:Non structural interior renovations BUILDING PE R •I T
Permit# BP-2000-0537
Project# JS-2000-0934
Est.Cost:$7000.00
Fee:$50.00 PERMISSION IS HEREB Y GRANTED TO:
Const.Class: Contractor: License:
Use Group: Roy Omasta 006763
Lot Size(sq.ft.): 21867.12 Owner: TURNER DAVID S&MELODIE P
zoning:URA An�ticaht:`Roy OMasta
AT: 115 HILLCREST DR
ApplicantAddress: Phone: Insurance:
21 North St (413)247-5666 Workers Compensation
HATFIELD 01038 ISSUED ON.-1211199 0:00:00
TO PERFORM THE FOLLOWING WORK:FINISH 1/S OF BASEMENT
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:
Roughol Rough:� Q�'� House# Foundation:
FinalFinal:
7 0 a Rough Framei r/C l
o� 4 4 va�i
Gas Fire Department Fireplace/Chimney:
Rough: Oil: Insulation:
Final: Smoke: Final: O K• ?j-3D•co
THIS PERMIT MAY BE REVOKED BY THE CITY OF NO PTON UPON VIOLATION OF
ANY OF ITS RULES AND REGULATIONS. r s 5•
Certificate of Occupancy nature:
Fee Type: Receipt No: Date Paid: Check No: Amount:
Building 12/1/99 0:00:00 $50.00
212 Main Street,Phone(413)587-1240,Fax:(413)587-1272
Building Commissioner-Anthony Patillo