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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. 77L 677,5— Alterations
NORTHAMPTON, MASS. _ + � 19� Additions
Repair
APPLICATION FOR PERMIT TO ALT R
Garage
1. Location S =' Lot No.
2. Owner's name _ c l w
3. Builder's name c-) ; - Address p / h
- p/�t3
Mass.Construction Supervisor's License No. C'S h l% 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 _
--c
13. Siding house
o �^
14. Estimated cosL-
The undersigned ce ifies that the a v statements are true to the best of his, her
knowled ief.
Signature of responsible app,icant
Remarks
el Q-
4�ttAlrP� 'I i
t OCT 31997 l�,j Gxf� of 'War llttnYpfnn .
a � �+cssxcltnsctla
DEPT Of`c U1°Oi"dG bEPARTMENT OF BUILDDIC INSPECTIONS
212 Main Street ' Municipal Building
Northampton, Mass. 01060 '
'S CO NfP N VON INSURANCE AFFMAVIT
N�ns�/permitic:.)
with a principal place of b ess/residZatz ,el-- (� l ( '� r Ihone7t) 7'2 q- C/7 7j
(sTTr...t/cit}/stair�np) C�13 C'
do hereby certify, under the pains and penalties or perjury, than.
O T am an employer providing the following v,or'r er s compensation cove age for my
employees worling on this job:
an_s uance Company) (Policy Number) (Expiration Date)
( -:IaEi:;o oprietor eneral contractor or homeowner (circle one) and have hired contrted below who have the following worker's compensation policies:
(Name of Contractor) Qmsu ancz Company/Pobcy Number) (Expiration Date)
(Name of Contractor) (Lase any Compaay/?ohcy Number) (Ex-pLm6oa Date)
(Name of Contractor) (Ln_suranc-- Company/Pobcy Numb r) (Expimbo❑Date)
(Name of Contractor) (Losvran�Company/Poky Number) (E)piration Date)
(+n,.-h additicml nccct ifnco.—'y to mc:}vdc infixm C'patziaing to nil ooa:rndon)
XI am a sole proprietor and have no one worming for me.
( ) I am a-home owner performing all the work myself.
NOTE:plcasc be aw2ic tbat whilo bomcowocn wbo employ pczsom to do=x utcn ao o==Uc ioc or repair worst on a dwelling of
not moeo than throo traits in which the homeowncr rcadc3 oc ca the gou0j4s xppurtenaut the o art:oot gcnavlly coandcrcd to tx
employ—undo tbo wockcr`s.oCmpcosstioa Act(GL152-s l(5)�A-Wdcztioo lry a homcow=for a licca-c cc'Pa-ma may evidcooe the
legal rtzhu oCao caployx undectho Wortcela Compomaliou Ad:
I uodcrstand th■t x OOPY of thu elltcmcat may b*focwwdod to the Dipnrtmcnc of indurri I Aocid—&Otsoo of InvA- o0o for the
covcragc vaificstioa aid that failure to so=m covcn go undo section M cf MOL 152 cm to d to tbo'itapositioa of crimi W pwa16-
oomistnxg of a-fine of uQ to S 1,500.00 ss:Wor imptuoam of up to one year aid civil pcaanics is dx foem of a Stop W ork Order and a
firm of 5100.00 a day tcgninst tom. )!
Signed _day 9 G'% 1997 For dq=tMo0w oary f
Pcrmil Number
-zr Map;} Lot#
Signaturc . Li�PcMI-i e i
• t
M 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 columm to be filled in
by the Building Department
Required
Existing Proposed By Zoning
Lot size
Frontage
Setbacks - front
- side L• R: L: R:
- rear
Building height
Bldg Square footage
%Open Space:
(Lot area minus bldg
&paved parking)
.of Parking spaces
ht of Loading Docks
Fill:
A volume--& location)
13 . Certification: I hereby certify that the ,inform ion contai-W herein
is true and accurate to the best of my kno d
DATE: - APPLICANT's SIGNATURE
NOTE: lssuanoe of a in permit does not relieve an a lloanra bu'rd'en to oom ly wit
9 P P_ 111...$11
zoning requirarnents d obtain all required permits from the Board of Health, Conservtvtlon
Commission, Department of Publio Worker and other applioable permit granting authoritles.
FILE #
� B s
fx i
OCT 31991 4...
DEPTaFr3U1°4" ', `� s File No. '�7 1
ZONING PERMIT APPLICATION (§10 . 2)
PLEASE TYPE OR P T ALL INFO TION
1. Name of Applicant: '
`5 6 --6
'zzAddress: / /i'i1 ;�is� ___Telephone:
2. Owner of Property: z--
�" elephone:
re 0
Add —,
3. Status of Applicant: Owner Contract Purchaser Lessee
Other(explain):
4. Job Location:
Parcel Id: Zoning Map# //h, Parcel# District(s): ✓�. �2 U'—
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/Property
6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary):
G' 3
7. Attached Plans: Sketch Plan L 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 PermitA/ariance/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)
a FILE 1 9 � �
OCT 3 1997 `` ?
APPLICAND6NTACT PERSON:
DE FT —20/�
PROPERTY LOCATION: 1 �--
NIAp Z� PARCEL: 5 ZONE
THIS SECTION FOR-OFFICIAL USE ONLY:
PERNII'T APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM EMLED MIT
Fee Pnid
'Riii1din2 Permit Filled nvit
Accessory StriiChirl
�6 I p
THE LLOWING ACTION HAS BEEN TAKEN ON THIS AP ICATION:
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 App roval-Bd of Health Well Water Potability-Bd Health
Permit from Conserva ' Co n
`O
Signature of Building Wector Dat
NOTE:Issuance of a zoning permit does not relieve an applicant's burden to comply with all
zoning requirements and obtain all required permits from the Board of Health, Conservation
Commission, Department of Public Works and other applioable permit granting authoritles.
City of Northampton REQUIRED INSPECTIONS
.
BUILDING DEPARTMENT
I. S�atural Components in Place*
P
3. Complete Building*
No. 954 Office of the Building Inspector
Zoning Form No. 962854 Date 10/6/97 Fee $20.00 Cbeck# 5820
Page, 17A Parcel 53 ,Zone URB Section 127 ❑ Yes u No
BU-11-LDING PERMIT
* Plumbing and Electrical Inspections required
THIS CERTIFIES THAT Robert Thibodo before Building Inspections
has permission to install 1 ply rubber system over double coverage Inspection on Site—Foundations
(3) porches
situated on 157 Oak St - Jonathan/Theresa Toner 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 TFWPRE ISES
Certificate of Occupancy
Building Inspector