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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations
NORTHAMPTON, MASS. 19 Additions
• Repair
' APPLICATION FOR PERMIT TO ALTER
Garage
1. Location I 0 j *- 1 /7-4 44KF ST F-IOROA)&E Lot No.
2. Owner's name h c rej R_ A4 gy re) Address At hn F 1I c'An.1r�µ }��_jl/� t�UR ,
3. Builder's name kZ&,+n Z u r;t+ __ _ _ _ __ Address l'f/I "smy.4 n are!y !fin Floc aF-
Mass.Construction Supervisor's License No. 010 "M& Expiration Date
4. Addition A)d
5. Alteration Al F_ 4 L!5"I,D/N rw, ►N a o 6
6. New Porch Ard
7. Is existing building to be demolished? 10)
8. Repair after the fire IV&
9. Garage No No.of cars Size
10. Method of heating .4
11. Distance to la lines Nif�
T
12. Type of roof VIA,
13. Siding house A90D
14. Estimated cost:- 1 Qj oo d
The undersigned certifies that the above statements are true to the best of his
knowledge and belief.
Signature of responsible app,icant
Remarks
-
� amass:rqa:rtt. .
DEPT OF BULL ,`! .r, r I«
DE4RTMENT OF BUILDING INSPECTIONS
Street - Municipal•Building
Northampton, Macs. 01060
WOI2ICER'S COMPENSATION INSURANCE AFMA VIT
(d,T-V R purr
(liccn_uWlperm;aec)
with a principal place of buswess/residence at:
<f ht n& 161] [ PAx426 l n �:1���,�1'1S� � (phone#)
—� (str t city/s'ta&jzip)
do hereby certify, under the pains and penalties of perjury, that:
( ) I am an employer providing the following worker's compensation coverage for my
einployees working on this job:
ansusance,Cody) (Policy Number) (Fxpiration Date)
I am a sole proprietor, general contractor r homeowner circle one) and have hired
the contractors listed below who have the following wor er's compensation policies:
lVE legs -92W,1N�L GfQ7 �le 9
(Name of Contractor) (Insuranor Com}rarry/Policy Number) (Expimtioa Date)
(Name of contractor) Unsluancc Company/Policy Number) (Expiration Date)
(Name of Contractor) (Insurancc Company/Poficy Number) (a-pifation Date)
(Name of Contractor) (Insurance Compaay/Policy Number) (E)piration Dat--)
(anxh additionsl ahoct ifnoocnAry to iochsde iaSocmation pcnia;ag to ay oodrsaon)
( ) I ani a sole proprietor and have no one working for me.
( ) I am a home owner performing all the work myself.
NOTE:plcase be awarc that White b0abDOwacr7 Wbo cmplvy paw to do m kdca_•^^c.oocz:ruc oo•or tcpair work on a d vclliog of
not morn than thcco waits is which the homeowacr rrsido or oa the trou06 Wtrtcaaut thacto arc oa Co xedlly ooa:idc r to be
employ—uod-the%—*-c'z pompanutieu Act(GL152,=1(S)),aWUcsbon by a homcowncr for.I;ca=cc pa aid may evtdcaae the
kgzl stab"of as eWloyt t•uodw the Workoes CoaVa=Ation Act
I uodrrstaad that a copy of thra etacw4at may be food to cbe Doparmea>t ofIO&Arid Aocidm&Moe of twuraoea for dm
*Wemge vai6cxfwd aad that WIum to sown cov=p tinder soWaa 2SA ofUOL 152 as t c d to tbd impost laa of aimkd,pwdtia
ooim sdaig of t Six of tip to$1,560.00 sailor 6pris�of tip to ooe ytaraod tint pcoLWCS in the form of a Stop Wak order sad a •a
fim of 5100.00&day aghast taw ..
For dcpwbmedaluse ooly
Permit Number
3 4� Signature o�fLi maps Lot#
L •� .
r
10. Do any signs exist on the property? YES l� 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 wl=m to be filled im
by the Bcildiny 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:
(vo3-ume--& location)
13 . Certification: I hereby certify that the information contained herein
is true and accurate to the best of my knowledge.
D,-U'E: /j,,K,6— 9q APPLICANT's SIGNATUREyC
NOTE: Issuanoe ofd zoning permit does not relieve an sappiloanre(butcden to oomply wing ,an
zoning requirements and obtain all required permits from the Board of Health, Conservation
Commisslon, Department of Publio Works and other appiioable permit granting authorities.
FILE #
F�, A 2 71999
File No.
ZONlNG PERMIT AP P LICAT I O N (§10 .
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant: via-ralz C,4PUT0
AddressA #XOF_ )))/I L3FL4W,�U;i o !i(&l g Telephone:
2. Owner of Property: SAME.
Address: Telephone:
3. Status of Applicant: Owner Contract Purchaser Lessee
Other(explain):
4. Job Location: 10.1- 10 H L,4F, ST F1,3 erj&,g
Parcel Id: Zoning Map# 1V Parcel# -7 District(s):
(TO BE FILLED IN BY THE BUILDING DEPARTME
5. Existing Use of Structure/Property J f,4-M 11�
6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary):
�, ELV LJ117 HVC, &22,V 0,12 LJ`a
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 L/� 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)
102 LAKE ST BP-2000-0096
GIS#: COMMONWEALTH OF MASSACHUSETTS
Ma :Block: 17A-249 CITY OF NORTHAMPTON
Lot:-001
Permit: Building
Category:replacement windows/siding BUILDING PERMIT
Permit#_ BP-2000-0096
Project# JS-2000-0148
Est.Cost:$10000.00
Fee: $50.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Groin William Mazuch Q10936
Lot Size(sq.ft.): 17772 48 Owner: CAPUTO VICTOR F JR&DENISE M
Zoning:URB Applicant: William Mau h
AT.• 102 LAKE ST
Applicant Address: Phone: Insurance:
1411 Westhampton Rd (413) 586-8749
FLORENCE 01062-9751 ISSUED ON.•712711999 o.00.00
TO PERFORM THE FOLLOWING WORK.-INSTALL SIDING (SHAKES) & REPLACEMENT WINDOWS
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 Si nature
Fee Type: Receipt No: Date Paid: Check No: Amount
Building 7/27/1999 0:00:00 $50.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Building Commissioner-Anthony Patillo
,