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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. / T/el.No.s�y-S� {'� Alterations
NORTHAMPTON, MASS.—[" 19el-1) Additions
APPLICATION FOR PERMIT TO ALTER
Repair
_ Garage
1. Location s �C °�y 1 QW Lf ek Lot No.
2. Owner's name _:S;1 AN �> U L 6A,- Address 7W ) C�6
3. Builder's name V Lf c 1 a Address 11 f j
Mass.Construction Supervisor's License No. Q ZZ & Expiration Dater�r-
4. Addition
5. Alteration i+1 of +r ooY`S 6v\� o.�t.-1 e2 - hLUT W l u 6u,)S- VLC t o �� °�"- 1MV�Q__ tY7Y-S ( tM�
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
13. Siding house
14. Estimated cost:-
The undersigned certifies that the abov state are we to the best of his, her
knowledge and belief.
Signatur 0f responsible app scant
Remarks
0 ,
a GHfx of xaz#4ttntpturt
� u�� ' �sssA�yns�tls
rte, m DEPARTMENT OF BUILDING INSPECTIONS
OF BUFF r+ 212 Main Street Municipal Building 'a
sko
t r • Northampton, Mass. 01060
WORICER'S COMPENSATION INSURANCE t A.VTT
I,
(licenser/permittee)
with a principal place of bu'siness/—residence at:
(phone#)
(s trcet/city/statr/zi p)
do hereby certify, under the pains and penalties of pedu-ry, that:
( ) I am an employer providing the following worker's compensation coverage for my
employees working on this job:
(Insurance 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) (Insurance Company/Policy Number) (Expiration Date)
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(Name of Contractor) (Insurance Compmy/Policy Number) (Expiration Date)
(anach additional shzci ifn6ocnxry to mchsde info mrti on pertaining to a ooatraetors)
�) I am a sole proprietor and have no one working for me.
( ) I am a home owner performing all the work myself.
NOTE:please be aware that whilo homeowmc \Abo cmplcy paxaai to do m.mi .nm .r�:c on or repair work on a dwelling of
not morn than thtcc ufl is which the 6xnoowucr r=dn or on the groups appud msni tht, ere oot malty ooasidacd to be
employes under the twtkc oonTcas,ation Act application by a homcow=for a kca_-'e cc permit may evidence the
legal rutll of en employer under the Workcet Compensation A. L
I undcrstxnd that a oopy of thu a tcmmt m„y be forwarded to tho Dcpartmca2 of iedautrid Afladm&Ofrroo of Imursnoe for ttm
cova-uge verification and that fa urc to teatre covetngo under soction 25A of MOL 152 can lead to the'imposition of tximinA prnaltics
oomisting of a fine-of up to S 1,500.00 mdloc impziwamcut of tip to one ytar and civil pcaallia in the form of n stop W mk Ordcr and a
firm of SID0,00 a day
Foe,depatrxk l uao poly
Permit NtnMbex
�° Map# Lot#.
i of Li ermittee
10. Do any signs exist on the property? YES NO
V
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 c-1-- to be filled in
by the Building Department
I Required
Existing Proposed By Zoning
Lot size
Frontage
Setbacks - frnnt
- side L: R: L: R:
- rear
Building height
Bldg Square footage
%Open Space:
(Lot area minus bldg
&paced parking)
# of -Parking Spaces
ht of Loading Docks
Fill:
_(volume -& location)
13 . Certification: I hereby certify that the information contained herein
G is true and accurate to the best of my knowledg
DATE: APPLICANT's SIGNATU�
NOTE: Issuano4e of a zorilng permit does not relieve `
I�eve an pia cant's urden to 0o ply With all
Czoning requirements and obtain all required permits m the Board of Health, Conservation
ommission, Department of Publio Works and other applicable permit granting authorities.
FILE #
L�,
I �
6 File No 1c.
0EFT of BU! Ir�s��cT' �'EONING PERMIT APPLICATION (§10 . 2)
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant:
Address: iI �oe ( Telephone:
2. Owner of Property:
Address: I ) I (�C� ��� Telephone:
3. Status of Applicant: Owner Contract Purchaser Lessee
Other(explain):
4. Job Location: I I 1
Parcel Id: Zoning Map#____I.r7 Parcel# _� District(s):,,,60
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/Property
6. De�criptio ofr r posed Use/Work/Project/Occupati n: (Use additional heets if necessary):
M S c l V L Q C (J— C aoLtLs
VIA Uwe_ r a�- Jet-&?,
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/Findin 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-1999-0759
APPLICANT/CONTACT PERSON Kim Rescia
ADDRESS/PHONE 311 Locust St (413)584-5816
PROPERTY LOCATION 111 OAK ST
MAP 17A PARCEL 257 ZONE URB
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: INSTALL NEW GARAGE DOORS REPLACEMENT WINDOWS,MOVE INTERIOR
DOOR REPLACE TOILET
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/Statement or License 022464
3 sets of Plans/Plot Plan
THE�ULLOWING 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 C ssion
Signature of Building OfficiaT 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.
_ __ ____
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111 OAK ST BP-1999-0759
GIs#: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 17A-257 CITY OF NORTHAMPTON
Lot:-001
Permit: Building
Cate o :Non structural interior renovations BUILDING PERMIT
Permit# BP-1999-0759
Project# JS-1999-1390
Est.Cost:$2000.00
Fee:$40.00 PERMISSION IS HEREBY GRANTED TO
Const.Class: Contractor: License:
Use Group: Kim Rescia 022464
Lot Size(sa ft.)_ 11499.84 Owner: STENSON JAN
Zoning:URB APP can(;_Kim Rescia
AT: 111 OAK ST
Applicant Address. Phone: Insurance:
311 Locust St (413) 584-5816
FLORENCE 01062 ISSUED ON:311711999 0:00:00
TO PERFORM THE FOLLOWING WORK.-INSTALL NEW GARAGE DOORS,REPLACEMENT
WINDOWS,MOVE INTERIOR DOOR, REPLACE TOILET
POST THIS CARD SO IT IS VISIBLE FROM THE STREET
Inspector of Plumbing Inspector of Wiring D.P.W. Inspector of Buildings
. R .
Underground: Service: Meter:
Footings:
Rough: Rough:../ 4f-- y��/ 'House# Foundation:
Final: " Final: >
Rough-Frame: -j- qj _/I/."
t
Gas Fire Department Fireplace/Chimney:
Rough: Oil: Insulation:
Final: Smoke• Final:
THIS PERMIT MAY BE REVOKED BY THE CITY OF OR�TON UPON VIOLATION OF
ANY OF ITS RULES AND REGULATIONS.
Cert0ficate of igy a
Fee Type: Receipt No: Date Paid: Check No: Amount:
Building 3/17/1999 0:00:00 $40.00
212 Main Street,Phone(413)587-1240,Fax:(413)587-1272
Building Commissioner-Anthony Patillo