17C-047 Oil
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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations
NORTHAMPTON, MASS.- 19 Additions
APPLICATION FOR PERMIT TO ALTER Repair
Garage
1. Location Lot No.
2. Owner's name t,/, Address -31
3. Builder's name Address
Mass.Construction Supervisor's License No. 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
13. Siding house
14. Estimated cost-
The undersigned certifies that the above statements are true to the best of his, her
knowledge and belief.
Signature of responsible app,icant
Remarks
10. Do any signs exist on the property? YES NO i/
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 wlamm to be filled in
by the Banding, Depa=ewant
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)
;p*f Parking spaces
i rof Loading Docks
Fill:
'4vo1-ume--& location)
'13 . Certification: I hereby certify that the information contained herein
_ is true and accurate to the best of my knowledge.
a
DA'Z'E: APPLICANT's SIGNATURE
NOTE: Issuanoe of of zoning permit does not relieve an a
zoning pplioant's bia en to comply with api�l...�:,
g requirements and obtain all required permits from the Board of Health, Conservation
Commission, Department of Publio Works and other applioable permit granting authorRies:
�,i; FILE #
Fi 1 e No. 92
ZONING PERMIT APPLICATION (§10 . 2)
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant:
Address: Telephone:
2. Owner of Property:
Address: f' Telephone:
3. Status of Applicant: Owner /Contract Purchaser Lessee
Other(explain):
4. Job Location:
Parcel Id: Zoning Map# )7C- Parcel# '41r7 District(s):
(TO BE FILLED IN BY THE BUILDING DEPARTMENT) r5. Existing Use of Structure/Property (o-6 /
6. Description of Proposed UseNVork/Project/Occupation: (Use additional sheets if necessary):
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 be n 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 L,-" 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)
r FILE # , 0 ,
APPLIANT/CONTACT PERSON:
ADDRESS/PHONE:
PROPERTY LOCATION: Cs e >1
C. '7
MAP PARCEL:
THIS SECTION FOR-OFFICIAL USE ONLY:
PERAUT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
MNING FORM FELLED 0111
Fee PAid
Rt-mndelin2 Interior
1P t.i'
TEE,ALLOWING ACTION HAS BEEN TAKEN ON THIS AP ICATION-
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
I/
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 Conservation Co ion
Signature of Building Inspector Date
NOTE:Issuanoe of as 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 Public Works and other applicable permit granting authorities.
City of Northampton RE
$ e QUIRED INSPECTIONS
BUILDING DEPARTMENT 1. Footings and Walls
e ,
2. Structural Components in Place*
3. Complete Building*
No. 835
Office of the Building Inspector
Zoning Form No. 961462 Date-9/17/96 Fe620.00 Check#197
Page, 17C Parcel 47 , Zone URA Section 127 ❑ Yes No
BUI]LDINGPERMIT
* Plumbing and Electrical Inspections required
THIS CERTIFIES THAT Larry Yentsch before Building Inspections
has permission to reshingle house over 1 laver Inspection on Site—Foundations
situated on 81 Fox Farms Rd - John Emerson 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$PJCVOUS PLACE ON HE PREMISES
Certificate of Occupancy
N wilding Inspector _
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