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17B-004 (8) � � z T Z pm r� ^^ 'Z Z �. v m a 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 ` 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