17D-048 (3) P,
,> c
F
— 70 m
3 o a
r Z
Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. 67- 73 F9 Alterations
NORTHAMPTON, MASS. A"a 19 Additions
APPLICa ATION FOR PERMIT TO ALTER Repair
�1 Garage
1. Location c�4►ia w /7 Lot No.
2. Owner's name 7'1_-ef yAct /Yl o .+.sin.^ Address .S AV,^.2
3. Builder's name A4yj 14 - —J—,,khJd,^ Address Y1M r.a,r ifa 1 jQ.4. C[,71iii^rbuea�l►9, �.1 X X90
Mass.Construction Supervisor's License No. d s"s-961 Expiration Date G .,29/!2r
4. Addition
5. Alteration T-^.s�2ll // yl M!d) Q-eg2jec a m-e,,+ U-r) ,�A 124?placa duis,dQ .9jiW
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- 6 .7,5'
The undersigned certifies that the above statements are true to the best of his, her
knowledge and belief. la
Sign re of responsible app.icanl
Remarks b-A-- ,e4 W1411 15.q_1 S g.v- e
R
Q S F-XL Lr,6— 1
S
s b-e & + wrote
� f3ofh .z. -i-r-e+adS
if wart11alliptOT1
B B
1997 Ax5s itch o'sctta
DEPARTMENT OF BUILDDIG INSPECTIONS
212 Main Street ' Municipal Building
Northampton, Mass. 01060
WORTCCIR`S COMPENSATION INSURANCE A 4 < AVIT
(L'cens�lpermi ttcc)
with a principal place of business/residence at:
<-{�{' Q�^&ei� {.�,%l IQt91• /.rlf/`rlaw,sb�va (phone�f)�e'.P'7�k'9
do hereby cer-ufy, under the pains and penalties of perjury, dial.
O I am an employer providing the following wor'�_ers compensation cove lge for my
employees worming on this job.
(Insurance Compz y) (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) i Qnsurauc-- Corupaay/Pobcy Number) (Expiration Date)
(Name of Contractor) 'I.nsurancz aarpany/PoUcy Number) (Expiration Date)
(Name of Contractor) (Insurance Compaoy/PoUcy Number) (F-., iraboo Date)
(Name of Contractor) (tnsu=--Company/Poucy Number) (Expiration Date)
(nria�additioaa1 dwc if ncocsr.ry to c>c}udc iafarmxa oo pert.ia w zll oodr-..inn)
I am a sole proprietor and have no one working for me.
( ) I am a-home owner performing all the work myself.
NOTL please be awzm chit whilo bomocwocra wbo cmploy persons to do :m•,,3ncc 00onructi00'or repair work w a 6-11 g of
not mom than tbroo uadi is which the bomoowocr rc=dc3 oc oa tbo gaaodr zppeuunsot tba-cto tie oot gaxr lly oo=kk-d to be
cmploym under tba woritcr's ooccp=u:tioa Act(G L152,=l(5)1 appliratioa by&bomcow=for a ticco�.e cc p=dd may cvjdm the
lcgi[ctshsa of as caployx uodcrthu Worlcola Compomatioa Ad'
I uaderztamd dxA x oopy of thu th#-t m.y be forwarded to Lb*Daparmxvt of lndu:j i d Aecdmt!Offioo of Imursooe for the
c ovcm&,:vcrifiestioa and that fOu c to&.=curt cov+aag=undo z=cdoa 25A of MOL 132 can lu d to tbd imposition of crimiasl penalties
oomismag of a Sac bf tW to s 1X00.00 anNor 6praoammd orup to on, yter and civil pcm26a is the form of Stop Work Order and a
Sao 0(3100.00&day apx.inA.tnc.
Signed this_� day of i t 1997 For dcQatma jd U—ody
Permit Number
ivfap; Lot{!
Signature of LiccascefPe
10. Do any signs exist on the property? YES NO G-'
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 —7— to be filled in
by the Banding Department
I 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
# fof Loading Docks
Fill:
_(vo3.-ume--& location)
13 . Certification: I hereby certify that the information contained herein
j is true and accurate to the best of my knowledge.
DATE: APPLICANT's SIGNATURE
NOTE: inauanoe of a zonin — _ a
g permit does neat relieve an applioanra bur—Wen to oompty U!K4 4111
zoning requirements and obtain all required permits from the Board of Health. Conservation
Commission, Department of Publio Works and other appiioable permit granting authorities.
FILE #
it •
,
AUG 1 1 1997
File No. SSW'
ZONING PERMIT APPLICATION (§10 . 2)
PLEASE TYPE OR PRINT ALL INFORMATION
1. NaMe of Applicant: avJ -De'losavo
�.Ra.i3ox 39p - -
Address: 11 Telephone: ace -2.3 R'9
2. Owner of Property: 7—'1'�'/b"o M a ►n s-r7-A
Address:—'--,2? v^a w /}-v-e Telephone: 5--Fc/ 70 1-10
3. Status of Applicant: Owner Contract Purchaser_jjV Lessee
Other(explain):
4. Job Location: :2 X_L Ernes j IdL4
Parcel Id: Zoning Map# Parcel# Gj District(s):
(T3 BD IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/Property
6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary): ,.
r�r1J-J�1) [/f K 41 /Q Q d�Q[ R iM�c'.n* LV r rnrAOwJ� Q✓V71�() C�X�Cv[Ov� GtI
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 I/ 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_4/" 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 '}# � �- ��.� ti.
+
199T 1 ,�
�p APPLICANT/,CTACT PERSON• ' J ���
PROPERTY LOCATION: 2
MAP 7 T� PARCEL: ZONE
THIS SECTION FOR-OFFICIAL USE ONLY:
PERK UT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Pnid
111nilding Permit Filled ntit
Rernndelin2 Interior'
off -
THE OLLOWING ACTION HAS BEEN TAKEN ON THIS AP ICATION-
Approved as presentedfbased 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/ZONI NG BOARD OF APPEALS
Received& Recorded at Registry of Deeds Proof Enclosed
Variance Required under: § w/ZONI NG BOARD OF APPEALS
Received&Recorded at Registry of Deeds Proof Enclosed
Other Permits Required:
Curb Cut from DPW Water Availability Sewer Availability
Septic Approval-Bd of Health Well Water Potability-Bd Health
Px.rmit from Couse on o Sion
Signature of Buildin ector Da e
NOTE: lasuanoe of at zoning permit does not relieve an applicant's burden to oomply with all
_ zoning requirements and obtain all required permits from the Board of Health, Conservation
Commission, Department of Publio Works and other applicable permit granting authorities.
�0 "• City of Northampton REQUIRED INSPECTIONS
} , BUILDING DEPARTMENT 2. Strucntural Components in Place*
e ,
3. Complete Building*
No. 752 Office of the Building Inspector
Zoning Form No. 962642 Date 8/11/97 Fee$20.00 Check# 156
Page, 17D Parcel 48 ,Zone URB Section 127 ❑ Yes 0 No
BUI]LDINGPERMIT
* Plumbing and Electrical Inspections required
THIS CERTIFIES THAT David Johnson before Building Inspections
has permission to install replacement windows & replace 1 step front & Inspection on Site—Foundations
rear
situated on 78 Straw Ave - Thelma Manson 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 T P ISES
Certificate of Occupancy �"c
Building Inspector
o�s��"• City of Northampton REQUIRED INSPECTIONS
BUILDING DEPARTMENT 1. Footings and Walls
2. Structural Components in Place*
3. Complete Building*
No. 752 Office of the Building Inspector
Zoning Form No. 962642 Date.8/11/97 Fee$20.00 Check# 156
Page, 17D Parcel 48 ,Zone URB Section 127 ❑ Yes 0 No
BU11`LD1NGPERj'NW
* Plumbing and Electrical Inspections required
THIS CERTIFIES THAT David Johnson before Building Inspections
has permission to install replacement windows & replace 1 step front & Inspection on Site—Foundations
rear
situated on 78 Straw Ave - Thelma Manson Inspecticn 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 Inspo tion 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. Ar
** Install per Manufacturer's information: windows,vinyl siding,roofs Building Inspection—Finish AFC•
and woodstoves Smoke Devxtors(Fire Department)
Other
THIS CARD MUST BE DISPLA CONSPICUOUS PLACE ON P ISES
Certificate of Occupancy
Building Inspector