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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations
NORTHAMPTON, MASS. 19 Additions
APPLICATION FOR PERMIT TO ALTER Repair
a
Garage
1. Location ,7 9 1414 5osr;c ST Lot No.
2. Owner's name C`,?,S-7191111 Sfrt,.j c` 0Ali✓xe-,/, Address ' l.4sa;r
3. Builder's name � �6����-^r- —�n Address `rl A&W S�-
Mass.Construcdon Supervisor's License No. C/-5'C� 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
13. Siding house
14. Estimated cost- y37 -=
The undersigned certifies that the above statements are we to the best of his, her
knowledge and b 'ef.
Signature of responsible app,icant
Remarks /� -? ✓/n/cs K�.�/i4 Camftrl'T` �S i�l CL -S
O4C1WfP�O
afi �'e AUG 2 5 19")J` Crz� of �nx#llant�fnrl - a
B Q AX5 Kchtticllt
DEPARTMENT OF BUILDING INSPECTIONS
212 Main Street ' Municipal Building
Northampton, Mass. 01060
WORI ER'S COMPENSATION INSURANCE + t AVI-f
x-71- S tit
(Lion - feravttce)
with a principal place of buSmess/residence at:
q /� G� ST N ✓ �'!-�/� o/o oneff)_5��/157/
(str C),/statrJzi p)
do hereby cefafy, u-oder the pens and peiJallies of perjury, l�
( ) I am an employer providing the followulg :orr,ers cornpens uoD cove:-age for my
employees Wor'"dng on this)obi
(Lnsu_rance Compa.ay) (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 workel's compensation policies:
(Ncmc of Contractor) �Lasurinc�- Corupan),/Poky NumkT) (F-<piration Datc)
(Name of Contrzctor) (Insunnc:: CouzpauyiPo��cy (E),-piraaon D21c)
(NzrLe of Contractor) Com'-p2o)'/Potic N rn�'r) ( piraaon D 1c)
(Name of Contractor) (Insurance. Compisy/Pohcy Ntlzncr r) (E)cpiration Date)
(eriirS itie�.J c+a�c1
if.c ry to cxrbck iaroemi_i oa perr ng w.11 coa.7-11on�
(loam a sole proprietor and have no one working for me.
( ) I am a'home owner puforming all the work myself.
MOTE_plc 3e be aware chid vvhiJo bomcotiv-,r wbo employ persom w do ��cz oa Cr mpz work on L d-cUi g of
aot mock th=Lb Lmits is wbieh the bomoocvncr r-=do or oo the go,a zp:.rtcu tbacto u oct gc vlly ooandcrcd to be
cmPloycn under tba-v&cr4. dica Au(G Li52=1(5)�application by c bomrowncr for a licrmc oc perm may cvidcacc chc
legal elalua of an e=Ploy.<uod<r tho Wo i{—,,000�*.a oa Act'
I undQZtwd 11+ A oopy ac lbia rbl—d may bo forward-ed to rbo DcperEZ f o.Clnduxri al ilacidmtf of —of L xinoo fx d-
OOvcragc vcrificxtioo Arid that ailu c to ccau cow mbo uodcr sod oa 25A of MGL 152 caa t,-d t4 tbd imposiE—aCcrim nsl Pcaaltics `
00mistr0Z or a-fine bf UP to S 1,500.(o and/or imprizoamcat of uP to ooe year and civil pcmicic in the f«m of a Slop Wort order and a
fin oCS100.00&.&&y xpiast tnc
Signed this day of J ds ` 199 7 For dcP rt .J oary
Permit Number
2vfap4 Lot 9
Srg�aab=of I:iocnscCfPcrmittcc
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 MUST BE COMPLETED, or PERMIT CAN BE DENIED DUE TO'
LACK OF INFORMATION.
This col=m to be filled in
br the Building Depar at
Required
Existing Proposed By Zoning
I
Lot size
I
Frontage
Setbacks
- side L• R: L: R:
- rear
Building height
Bldg Square footage
%Open Space:
(Lot area minus bldg
' &paved parking)
# pf -Parking Spaces
# Hof Loading Docks
Fill:
4 volume--& location)
13 . Certification: I hereby certify that the information contained herein
is true and accurate to the best of my knowledge.
DA'L'E: APPLICANT's SIGNATURE 4::: t /J
NOTE: Issuanoa of a zoning
g permit does not ratieve an applicant's burden to comply wjtf),,4%11
zoning raquiremanta and obtain all required permits from the Board of Health, Consei vation
Commission, Department of Public Worka and other applionbte permit granting authorities.
FILE #
i`
y5y
k AUG - -
. _ Ei1e No.&V ! ��
ZONING PERMIT APPLICATION (§10 . 2
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant:
Address: `7 1�2Pecl ST- _Telephone:
2. Owner of Property: CAR+S-)�14 ti S c i eel G� �hU e
Address: Telephone:
3. Status of Applicant: Owner Contract Purchaser Lessee
Other(explain): /
4. Job Location:
1� t
Parcel Id: Zoning Map# �/.V Parcel# �o District(s): 1 .–k
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/Property
6. Description of Proposed UseM ork/Project/Occupabon: (Use additional sheets if necessary):
-Tk)s i t 2 1/i,v H l ✓�o�sr�� - l��✓c�uS
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 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 # 9G ' ��� 6
1 APPLICANT/CO' NTACT PERSON:
ADDRESS/I'HQNE:
PROPERTY LOCATION:
NIAP 3/P PARCEL: - ZONE ('
THIS SECTION FOR-OFFICIAL USE ONLY:
PERNIIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FH,T,FD OUT
13iii1ding Permit Filled plit
Fee Pnid o)-3 - We— ✓
NPw Cnnctrnrt
THE OLLOWING 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:
x•
Curb Cut from DPW Water Availability Sewer Availability
Septic Approval-Bd of Health Well Water Potability-Bd Health
it fro Con ry n ' sion
Signature of Building ector Date
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 applioabie permit granting autheritles.
�0AW"•� City Northampton TIof REQUIRED INSPECTIONS
. BUILDING DEPARTMENT 1. Footings and Walls
2. Structural Components in Place
3. Complete Building*
No. 804 Office of the Building Inspector
Zoning Form No. 962696 Date 8/27/97 Fee $20.00 Check# 2335
Page, 31D parcel 126 ,Zone CB Section 127 ❑ Yes ® No
BUI]LDING PERTVHT
* Plumbing and Electrical Inspections required
THIS CERTIFIES THAT Ed Corbett Jr before Building Inspections
has permission to install replacement windows Inspection on Site—Foundations
situated on 79 Masonic St - Christian Science Church 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
and woodstoves Smoke Detectors(Fire Department)
Other
THIS CARD MUST BE DISPLAYED IN A CONSPICUOUS PLACE ON THSPREMISES
Certificate of Occupancy _
wilding Inspector