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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. ,77y- /77 Alterations
NORTHAMPTON, MASS. `� 19,,� Additions
APPLICATION FOR PERMIT TO ALTER Repair
Garage
1. Location —P loj Lot No. , l
2. Owners name fE L Address 0 -e- iazt;I J /'!�►
3. Builder's name Address J'{�� Q 2 v�o[no
Mass.Construction Supervisor's License No. C-5- 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 A .
13. Siding house
14. Estimated cost:- o
The undersigne p ie that the a v st tements are true to the best of his, her
knowledge d beli
Signature ojresponsible app lcant
j
Remarks
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L
f
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.
T2as colw= to be ffl 77 In
by the Baildzng 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 . Certif "cation: I hereby certify that the info t ' con fined herein
is t and accurate to the best of my kn ed
DATE: �I ( APPLICANT's SIGNATU
NOTE: Issuanoe of a zo ing permit does not relieve an a lioant's burden to oomply with all
zoning requirements a d obtain all required permits from the Board of Health, Conservation _
Commission, Department of Publio Works an dr other applicable permit granting authorities.
FILE #
Fi 1 e No.
ZONING PERMIT APPLICATION (§10 . 2)
PLEASE =E OR T ALL INFORMATION
1. - Name of Applicant:
Address: XVe 'done: 72�/— Y2 7 5—
2. Owner of Property: S- ,/
Address: ��U �1 I Telephone: L7 d't —
3. Status of Applicant: Owner —?45--Contract Purchaser Lessee {
Other(expl in)'
4. Street Address; p
Parcel Id: Zoning Map# Parcel# District(s): i-
(TO FILLED IN BY THE 13UILDING DEPARTMENT)
5. Existing Use of Structure/Property -�
6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary):
oZ' I 1 v ut� o o/
7. Attached Plans: Sketch Plan Site Plan Engineered/Surve d 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 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 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)
4 -
FILE #
ANO'LiCANTICONTACT PERSON:
ADDRESS/PHONE:
PROPERTY LOCATION:
MAP L7 5 PARCEL: ZONE
THIS SECTION FOR-OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONTNG FORM FH.T,FD OUT
Fet, Paid
Ilididing Permit Felled ovit
f r 2
t E' Z
4 �.
T2OLLOWING 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-Bd of Health Well Water Potability-Bd Health
Permit fr Cons ry C on
Signature of Building Wpector Dat
NOTE: lasuanoa of at zoning permit does not relieve an applicant's burden to oomply with all
zoning requirements and obtain ali required permits from the Board of Health, Conservation
Commission, Departmant of Publio Works and other applioable permit granting authorities. —
City of Northam ton RQUIRD INSPECTIONS
1. Footings and Walls
BUILDING DEPARTMENT
2. Structural Components in Place*
3. Complete Building*
No. 902 Office of the Building Inspector
Zoning Form No. 961544 Date 10/1/96 Fe&20.00 Check#5519
Page, 17B Parcel 4 , Zone RR Section 127 ❑ Yes ® No
BUI]LDINGPERMIT
* Plumbing and Electrical Inspections required
THIS CERTIFIES THAT Bob Thibodo before Building Inspections
has permission to install 1 ply system to dormer over 1 layer roll roof inihspection on Site—Foundations
portion of house)
situated on 500 Bridge Rd - Eva Berlin 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 CON$PJCJOUS PLACE ON E P MISES
Certificate of Occupancy
Building Inspector