30A-032 (84) r �
A City of Northampton REQUIRED INSPECTIONS
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e
BUILDING DEPARTMENT 2. Struccttugral Walls Components in Place*
3. Complete Building*
No. 471 Office of the Building Inspector
Zoning Form No. 962309 Date 6/3/97 Fee $40.00 Check# 2065
Page, 30A parcel 32 ,Zone GI/WP Section 127 ❑ Yes ® No
BU-.11LDING PERMIT
* Plumbing and Electrical Inspections required
THIS CERTIFIES THAT William Mazuch before Building Inspections
has permission to install partitioning ng for new off;cps Inspection on Site—Foundations
situated on 320 Riverside Dr - (rear of hui 1 di ng) - Cutlery 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
Smoke Detectors(Fire Department)
Other
THIS CARD MUST BE DISPLAYED IN A CONSPICUOUS PLACE ON P MISES
Certificate of Occupancy
Building Inspector
FILE # 962)300
APPLICANT/CONTACT PERSON:
ADDRESS/PHONE: /K// A) ' ZZ 2
PROPERTY LOCATION: 3
MAP �-;Y 4 PARCEL: 3 ZONE
THIS SECTION FOR-OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FULED MITc
Fee Pgifi
Rnildin2 Permit Filled mit
Type of Constnirtion
L
lmd
Accessary Strurtime
ACTION HAS BEEN TAKEN ON THIS AP ICATION:�FLOWING
ppoved 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-Bd of Health Well Water Potability-Bd Health
Permit from Conservatiop1tommission
Signature o Bui g or D e
NOTE:lssuanoe of a zoning permit does not relieve an applloant'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 authoritles.
File No.
ZONING PERMIT APPLICATION (§10 . 2)
PLEASE/TYPE OR PRINT ALL INFORMATION
1. Name of Applicant: f2) 4 /T/At"f �,z oe"y
Address:NL/ 1�fLS7-N,4f' 1'77N) t?d N175 _Telephone:
2. Owner of Property: t!a 17'C fQ
Address: " HA/N ST A)> TD A7 Telephone: � �G
3. Status of Applicant: Owner Contract Purchaser Lessee
X Other(explain): 0 4 AIT-1?44 6 7 6 R
4. Job Location:
0
Parcel Id: Zoning Map# d- Parcel# ✓ District(s):
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/Property f aerilll R C!f!1
6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary):
P F-
7.
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 PermitNariance/Finding ever been issued for/on the site?
NO DON'T KNOW 7S YES IF YES,date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO DONT 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 L 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)
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 DQE TO
LACK OF INFORMATION.
This co7u to be filled in
by the Building Department
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
&paved parking)
of -Parking Spaces
of Loading Docks
Fill:
(volume--& location)
13 . Certification: I hereby certify that the information contained herein
is true and accurate to the best of my knowledge.
DAVE: - C APPLICANT's SIGNATURE /
NOTE: lunuanoe of m zoning permit does not relieve an applioant's b en o oomply wit4 all
zoning requirements and obtain all required permits from the Board of Kealth, Conservation
Commission, Department of Publio Worku and other applicable permit granting authorities.
FILE #
i
_ 4
4(1tAM P�.
B o o o of &Nart4ailivfia 1
B B $lassachnsrtta
cm DEPARTMENT OF BUILDING INSPECTIONS
212 Main Street ' Municipal Building '
Northampton, Mass. 01060
WORKER'S COMPENSATION INSURANCE AFFIDAAVTr
(Iicense&permittee)
with a principal place of business/residence at:
1111 W EST&APP) ON R fi), 01D44 (phone#) SG—fl?At C,
(strmUci ty/state/rip)
do hereby certify, under the pains and penalties of perjury, that:
( ) I am an employer providing the following worker's compensation coverage for my
employees working on this job:
(Insurance Company) (Policy Number) (Expiration Daze)
(, 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:
A A
(Name of Contractor) (Insurance Company/Poticy Numbcr) (Expiration Date)
(Name of Contractor) (Iasurance Company/Policy Number) (Expiration Date)
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Dale)
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(attach ad&6oml shoe ifn«xvuy to include infw-marioa pataiuing to all ocaaacwm)
I am a sole proprietor and have no one working for me.
( ) I am a home owner performing all the work myself.
NOTE:picric be aware that whilo homeownaa who employ pazom to do maidenmc,construction or repair work on a dwelling of
not more than three units is which the bomeowncr asides or on the grounds appurtenAnt thereto arc cot gwera lly wandered to be
employrsa under the twxiceez compeas4on Art(GL152,ss 1(5)),application by a homeownir for a license or permit may evidence the
legal status of an employer under the Workeet Compensation AcL
I underhand that a copy of this statemem may be forwarded to the Deport,c of rodwbial A=dmN Offioc of Iaaa¢ance for the
coverage verification and that fadure to secure coverngo under section 25A of MOL 152 can lead to the imposition of mmmal penalties
const ing of a fine of up to$1,500.00 zn&or igriso�of up to one year and civil peualtia is the form of a stop Work otda and a
fim of S100.00 a¢ay agninsc M
Signed this _day of ) 199 7 For d1 tree only
Permit Number
Mao
#
Sit=Wre of Li
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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. ,8� Alterations
NORTHAMPTON, MASS. JYA I9n Additions
APPLICATION FOR PERMIT TO ALTER Repair
Garage
1. Location l YjF k S l D F Lot No.
2. Owner's name (,OT I E 1z)( 6111�icS t) Address C�-/i K J!U _701 o f Dt 0
3. Builder's name W)1 J/,A M �AZ wee j t Address
Mass.Construction Supervisor's License No. Expiration Date
4. Addition
5. Alteration ,1)�OP 0_,F,fjeVC - Pyr/ T"1 D/V 5_ D R �{ AFF! G� Es
6. New Porch
7. Is existing building to be demolished? /v d
8. Repair after the fire n)n
9. Garage No.of cars Size
10. Method of heating 9,467
11. Distance to lot lines
12. Type of roof FLAY - )—,4 R^
13. Siding house ] RIC X
14. Estimated cost:- p0-0--r,4
d>
The undersigned certifies that the above statements are true to the best of his, her
knowledge and belief.
Sign ure o responsible app ican!
Remarks OPEN 1S7-Q R k 6 ,F A R F-A r BE-11,065 6,rJ N6,, &111 F-0 A
Ado ' ' `k.✓Ity of Northampton REQUIRED INSPECTIONS
and Walls
BUILDING DEPARTMENT 2. Smactural Components in Place*
3. Complete Building*
No. 471 Office of the Building Inspector
Zoning Form No. 962309 Date 6/3/97 Fee $40.00 Check# 2065
Page, 30A parcel 32 ,Zone GI/WP Section 127 ❑ Yes ® No
BUI]LDINGPER,AM
*Plumbing and Electrical Inspections required
THIS CERTIFIES THAT William Mazuch before Building Inspections
has permission to install partitioning for new offices Inspection on Site—Foundations
situated on 320 Riverside Dr - (rear of building) - Cut 1 ery 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 Ordin,--.,nces 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 YT
of this permit.Expires six months frorn date of issuance,if not started. Building Inspection—Rough
Note:A certificate of occupancy will bf,issued by this office upon return Insulation Inspection
of this card signed by the Plumbing,Wiring and Building Inspectors.
Building Inspection—Finish
Smoke DE°tectors(Fire Department)
Other
THIS CARD MUST BE DISPLAM INA CONSPICUOUS PLACE ON It P MISES
Certificate of Occupancy
` Building Inspector