25C-251 (19) 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 cola= to be filled in
by the Building Department
Required
Existing Proposed By Zoning
Lot size
Frontage
Setbacks - front
- side L: R: L: R:
- rear
Building height
Bldg Square footage
%Open Space:
(Lot area minus bldg
} &paved parking)
# pf - Parking Spaces
i 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 knowledge.
DATE: /Q- -a .. - ?( APPLICANT's SIGNATURE �� CC
ti " NOTE: Issuance of a zoning permit does not relieve an rip ioant' urden to oomply
zoning requirements and obtain all required permits from the Board of Health. Conservation
Commission. Department of Publio Works and other applioable permit granting authorities: -
:,;, FILE #
•
File No.
ZONING PERMIT APPLICATION ( §10.2)
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant: i, , Air! ' .[S A. r •e> 1
Address: ,, S% Telephone: L C9V / 9;437
2. Owner of Property: _cam r<?
Address: Telephone:
3. Status of Applicant: ,,/ Owner Contract Purchaser Lessee
Other (explain): e/n,D /7
4. Job Location: � S% •• ° J!__ /r.AA ,K1c,4
Parcel Id: Zoning Map# c9 SC..- Parcel# r District(s): G�/L
(TO BE FILLED 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
/me- 9 re) r7A c,://i
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 # 9-51641
A
9
APPLICANT /CONTACT PERSON:
ADDRESS/PHONE: V 2 3 7
PROPERTY LOCATION:
MAP S C.a PARCEL: ZONE
THIS SECTION FOR - OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZQNTNTG FC)R M FIT .T.ET) MIT t. �'< 2
_Fep Paid
Rnilding Permit Filled not 1
Fee Paid C3f <
Tyre of Cnnctrnrtinn•
New Cnnctrnrtinn
Remndeling Tnterinr ms's /Lti
Arirlitinn to Fricting
Arreeenry Strnrtnre
Rnilding Plane Included•
C)wner /Orrurant Statement nr T.irence
3 Sete of Plane / Pint Plan
TBE.I�OLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION:
ice/ Approved as presented based on information presented
Denied as presented:
Special Permit and/or Site Nan 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
Per . rom Conservation mission
/0/20/
Signature of Building .l for 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 Publio Works and other applicable permit granting authorities.
°�""�'�o City of Northampton REQUIRED INSPECTIONS
_�,�,. "'t a 1. Footings and Walls
: » :-�
B UILDING DEPARTMENT 2. Structural Components in Place*
,i '� =• 3. Complete Building*
Office of the Building Inspector
No. 999
Zoning Form No. 961641 Date 10/28/96Fee $40.00 Check # 1532
Page, 25r Parcel 2c1 , Zone IRA Section 127 ❑ Yes ® No
BUILDING PERMIT .
* Plumbing and Electrical Inspections required
THIS CERTIFIES THAT Joe Jasinski before Building Inspections
has permission to repair rotted sills -- Polish Kitchen Inspection on Site — Foundations
situated on Three County Fair - Fair St 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 -/'1 / e') 7 0 - 6 .-i
Smoke Detectors (Fire Department)
Other
THIS CARD MUST BE DISPLA IN ) CONSPICUOUS PLACE ON P' '► ISES
Certificate of Occupancy ��'
Building Inspector
(,op / 21111 Si1OPI I
, ,
.., › ,
. ,.
,
'° `Y �'!
< 7,'
T w
r
-ti „ a
=j 3 o zn
_ %17 o n Z
Z
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a
1
n
Zoning them
Miscellaneous Additions, Repairs, Alterations, etc. Tel. No. S/ 3 7 Alterations
: NORTHAMPTON, MASS. /G' rs(vZ 1 9 Additions
APPLICATION Repair e l.( �,JS i
;447 FOR PERMIT TO ALTER
Garage
1. Location `,Cr?,(1:,r:1jjD ' le &(4 /'/:-.�eeAJ Lot No.
2. Owner's name i d,f't A,o/nrDe t) [i�,/u, /r.J Address /-70 ;/.1 .s
3. Builder's name 4!' /c,✓i'fi'/:�1 LeCre 4 Address Sam
Mass. Construction Supervisor's License No. /0 75 .;' ?� Expiration Date ✓ G - - :7 /
4. Addition ./// //S
5. Alteration M %eC ''tC r';n> S;a:S
6. New Porch ,I.// '
7. Is existing building to be demolished? 4;4'
8. Repair after the fire 7)-j/l, ..
9. Garage jVen No. of cars Size
10. Method of heating , /t'
11. Distance to lot lines /1 /`,
12. Type of roof �0
13. Siding house . ,'1/ /
14. Estimated cost: -
The undersigned certifies that the above statements are true to the best of his, her
knowledge and belief.
. 4s
Signature of responsible app,icane
Remarks