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17C-282 (2) Electric,Run- if hlr� s i .> ,fir j,.•� y .�—_. .r"S F/ tiLo kt '41 j r� y ? . 4,14 ro " 4 L c i ' i 1� I r r J ! > o ' 3 0 0 cool tV � to O a- �' O -� _ '.� m _ _ h0.M ur �o v Zoning Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations NORTHAMPTON, MASS. 1 q Additions APPLICa ATION FOR PERMIT TO ALTER Repair Garage 1. Location 8 b y ft Lot No. 2. Owner's name -DA" a- L o lZ of A ht i L L RnI g Address L Au St 3. Builder's name M jX-1 )4 144 M oiq, ►! Address a n COns N,`ll /10. 144uDE.,IV, �lco Mass.Construction Supervisor's License No. 0 4,0 & r) Expiration Date 4. Addition 5. Alteration KFnr„uo?r �lfc{.P.N AtAj-rxv� - v ��f .4TNAtjfjm � AJ, iV L-ER/t bv7)r. 121'DA���� 6. New Porch 7. Is existing building to be demolished? kyt7 8. Repair after the fire —A A 9. Garage _/—V No.of cars Size 10. Method of heating ST�AM. 11. Distance to lot lines 12. Type of roof 13. Siding house 14. Estimated cosL- J� �vou The undersigned certifies that a above statements are we to the best of his, her knowled and belf. t' ce-- le apcaf Signature oresp pnt Remarks [ OrA/C� Ltij jA11iu/ve fir,A)Y&A-riAt eJ9J /Lc1 i!!L1'i'u 6 Dam �ll/G� ��L��/�Gl�r� � w�17 o��"AMM - $ S'EP 2 8 11998 �assarEjasrlla EPARTMENT OF BUILDING INSPECTIONS DEPT Of SUIL0ING 1NSPECTIONS NORTHAMPT01� MA 01060 12 Main Street ' Municipal Building Northampton, Mass. 01060 WORKER'S COMPENSATION INSURANCE Ali t AVIT censer/permiuee} with a principal place of busmess/residence at-. f / �i/)��'� 7 street/ci ty/stair/zip) do hereby certify, under the pains and penalties of pegu y, 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 workers compensation policies: (Name of Contractor) (Insurance Comparry/Polic Number) (Expiration Date) (Name of Contractor) (Insurance Como any/Po1ic-,,Number) (Expiration Date) (Name of Contractor) (Insurance Company/Policy Number) (Exp,ira,bon Date) (Name of Contractor) (Ins-trance Company/Policy Number) (Expiration Date) (attach addiitional ShCCt ifnC0=—ry m induae information penalising to all a�on� (� a sole proprietor and have no one working for me. ( ) I am a home owner performing all the work myself. NOTE:please be await tltai whilo homco"mcrz who cumplay perions to do maiatrnwce,coustrucuorl ar rtparr wow on a dwelling of not mots than throe units in which the homoowncr rxsidcn or oo the grounds appurtenant thcrct°are not Ecacraily coasidcrtd to be employ=un. a the workees.comper 4ca Act(GL152,a 1(5))�application by a homeowner for a Uccnx or Permit may evidcna tho legal etatua of an employer under tho Workeet Compmsaiion ALL I under i d that a copy of this rt3trmcn1 may be forvr-du to the Dqp tmc of Indutrw Accidea&Offioo of Iuuut<noo for the coverage unification and that failure to acxtut a vcrngo wodcr se ctioa 25A of MOL 152 can lard to tbo imposition of criminal penalties comist mg of a fine of up to S 1,500.00 and/or iutptiso�of up to orx yar and civil pmal6es in the form of a Stop W orit Order and a flan of 5100.00 a day agni-t mo. For dq=t=OU1—Only Permit Number .] I&P-H Lot# sale ofLi ermittee 10. Do any signs ebst 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 v IF YES,describe size,type and location: 11. ALL INFORMATION MIDST BE COMPLETED, or PERMIT CAN BE DENIED DUE TO LACK OF INFORMATION. This aolw= to be filled in -7 141% /zt/f ��/✓L � by the Building Depart= ent Required Existing Proposed By Zoning Lot size Frontage Setbacks - side L: R: L: R: - rear Building height '4Z A Bldg Square footage %Open Space: (Lot area minus bldg &payed parking) # of Parking Spaces Zy Z4 f of Loading Docks Fill: (vol-ume--& location) 13 . Certification: I hereby certify that the information contained herein is true and accurate to the best of my know edge DBE: 7� APPLICANT's SIGNATURE Ardern��to NOTE: Issuanoa of a zoning permit does not relieve a appiioant's b 00 wlt4 all zoning requirements and obtain all required permits from the Board of Health, onserva�tion Commission, Department of Publio Works and other applioable permit grants authorities. FILE # SEP 2 8198 File OEPT of $UILDlNG INSPECTIONS NORTHAMI'TOM MA 01060 ING PERMIT APPLICATION (§10 . 2) PLEASE TYPE OR PRINT ALL INFORMATION 1. Name of Applicant: 14/'71AI 6r/iS� -/y1/L�y Address:9 G r-ya, 8 // Telephone:c2 t,q' 12 Q 2. Owner of Property: /J f. �n,� �'0a; &0A)� Address: 1�3 l� � Telephone: 3. Status of Applicant: Owner Contract Purchaser Lessee Other(explain): 4. Job Location: z'$3 Parcel Id: Zoning Map# 47 Parcel# OVA District(s): (TO BE FILLED IN BY THE BUILDING DEPARTMENT) 5. Existing Use of Structure/Property /�LsI*�)'_'//LZ 6. Desffption of Propose Use/Work/Pro.ect/Occupation: (Use additionl sheets if necessary): l J.yu�s�3 ���� �� S '/ ✓L G' d , 14,1 �b 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 KN0A t/ 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-1999-0344 APPLICANT/CONTACT PERSON Martin Mahoney ADDRESS/PHONE 20 Fort Hill Rd (413)268-3296 PROPERTY LOCATION 18 LILLY ST MAP 17C PARCEL 282 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 5yV Sr Type of Construction: New Construction t Z1016711 1_'A�lw Non Structural interior renovations Addition to Existin . Accessory Structure Building Plans Included: Owner/Occupant Statement or License# 3 sets of Plans/Plot Plan ✓ THE F,flLLOWING 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 Commission -3- -� Signature of Building Official`/ 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. Reference No: BP-1999-0344 Department: ................................... Building, Electrical & Mechanical Permits ......................................................................................... Fee Type: Receipt No: New Wiring REC-1999-000905 .......................................................................... . .................................... Paid By: Paid in Full On: Martin Mahoney Fri Oct 02,1998 ........................................ .. ...... ...... By: .. . Received ........................................... .C. Check No ................... Linda Lapointe 584 ......................................................................................... ...................................... DEPARTMENT'S COPY Amount: $40.00 ........... ...............DEPARTMENT FILE COPY 18 LILLY ST CITY OF NORTHAMPTON BUILDING PERMIT Owner's pulling their own permits or dealing with unregistered contractors for applicable work do not have access to Guaranty Fund(MGL 142A) Issued: Permit No: Inspector: Tracking No.: Fee: BP-1999-0344 $40.00 GIS#: Map Block: Lot: Address: Zonine: Use Group: Lot Size: 1878 17C 282 001 18 LILLY ST URB 16857.72 Contractor: License Type: Insurance: Martin Mahoney CSL Address: License No.: Insurance No.: 20 Fort Hill Rd 040602 City: State: Zip Code: Phone: HAYDENVILLE MA 01039 (413) 268-3296 Proiect No: Category of Work: Const. Class: Cost Estimate: JS-1999-0712 Non structural interior renovati $4,000.00 Description of Work: ADD FULL BATH&REPAIR FOUNDATION& SILL GeoTMS@ 1997 Des Lauriers&Associates,Inc. Signature: