17A-083 (4) a � Z
•� o
'v
70 'C
T ^►
z
a
w 3 c Zp�
> _ = O
x, m
"1 m
A
I
I
Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No :;�K(f /1'2 733 Alterations
NORTHAMPTON, MASS. lo ]9 Additions
APPLICa ATION FOR PERMIT TO ALTER Repair
Garage
1. Location Lot No.
2. Owner's name Address � 2
3. Builder's name V` c�� Address era <:tn�. Ai-t!T46�:Z
Mass.Construction Supervisor's License No. Expiration Date -7
4. Addition
5. Alteration _y r �t Ot t — /I�CC L rrr)-+r/ � clue
6. New Porch
7. Is existing building to be demolished? + 4
8. Repair after the fire
9. Garage No.of cars / Size
10. Method of heating {/� = c�•�
11. Distance to lot lines
J n sr
12. Type of roof . UA
13. Siding house +. -
14. Estimated osc-
r �
J '' r The undersigned certifies that the above statements are true to the best of his, her
"7 knowledge and lief.
i
signature ofiesponsible app ica
try
Remarks i/
i
,.
��
� ��y �
� c
f
� �
�. _ —�.
� �. - _ �—
l �
� . � � -
i -
r�. ,. ___ _.___._ r
__ _ __-----_-T
_ 1.
i I �. _ i
I _ .� � �
� �
I �
R
+;
_. ___ ,,
_.__�.
� �_.._.
i
��
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 coluM to be filled in
by the Ekd1diny Department
Required
CE Proposed By Zoning
Lot size
Frontage
Setbacks
- side L: R: L: R:
- rear
Building height 1
Bldg Square footage
%Open Space:
(Lot area minus bldg
&paved parking) 'S b
.pf. -Parking Spaces
of Loading Docks
Fill:
-(vol-time--& location) r ,�
r
13 . Certification: I hereby certify that the information contained herein
is truelanq accurate to the best of my knowledge.
1 D / .
DAVE: APPLICANT's SIGNATURE
7
�/i r_
T" NOTE: Issuanoe of a zoning permit does not relieve an appl cant's burden to comply
zoning requirements and obtain all required permits from the Board of HaaHh. Conoei=vation..
Commission. Department of Publio Works and other applicable permit granting authorities::-
,,: FILE #
File No. n
_ 4
ZONING PERMIT APPLICATION (§10 . 2
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant:
I - _
Address: . Telephone:
2. Owner of Property: n+
Address: Telephone:
3. Status of Applicant: Owner Contract Purchaser Lessee
Other(explain):
4. Job Location: K.�1� AeL�.
Parcel Id: Zoning Map# Parcel# `> District(s):
(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):
7. Attached Plans: i/ 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
APPLICANT/CONTACT PERSON: 6, ' r�l � � �� /"
ADDRESS/PHONE: / Z U _
PROPERTY LOCATION: '"i y2�.
MAP--42 4- PARCEL: ZONE S
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DA
ZONING FORM FH,Y,Fl) OUT
Fee pnod
Ep�;Paid
Irlyided-
C r
0111,5Y cr
THE
,/FOLLOWING 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
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 Conservatio ommission
Signature of Building or Date
NOTE:Issuanoe of a zoning permit does not relieve an applloant'a burden to oomply with all
zoning requiremanta and obtain all required permits from the Board of Health, Conservation
Commission, Department of Publio Works and other applioable permit granting authorities.
City of Northampton REQUIRED INSPECTIONS
goo � tie
BUILDING DEPARTMENT 2. Footings Components in Place*
3. Complete Building*
Office of the Building Inspector
No. 921
Zoning Form No. 961557 Date10 8 96 Fee 40.00 C heck#999
Page, 17A parcel 83 ,Zone URA/WSP Section 127 ❑ Yes ❑ No
BUI]LDINGPERM] f
*Plumbing and Electrical Inspections required
THIS CERTIFIES THAT Edwin F-vprett before Building Inspections
has permission to install bath dormer rear of holinP Inspection on Site�—Foundations
situated on I() Carol= St - TPrP7 Wai deck 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
x THIS CARD MUST BE DISPLAYED IN A CONSPICUOUS PLACE ON ISES
Certificate of Occupancy
Bt lding Inspector ,n✓—_------ -