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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No � � � Alterations
NORTHAMPTON, MASS. ° 19 Additions
APPLICATION FOR PERMIT TO ALTER Repair
r1 A Garage
1. Location /L 1 11 tt�'' a ill �I c,-s—p�,i Le, Lot No.
2. Owner's name&-I t ,'�G��^G, (1�5 N t ltl7._�� Address g 4 OM R i r"e' A y e n uJ
3. Builder's name Dk��
Address-30 ��1?1 itC��� ��. V-Ly °(( L
Mass.Construction Supervisor's License No. C),3 9.- L Expiration Date �i — 5
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
6DType of roof S\N\ c�eS
13. Siding house
Estimated cost- _ o G)
The undersigned certifies that the above mcnts are true to the best of his, her
knowledge and belief.
Signature of responsible app icant
emarks)�- ��is;� uc �>��ttt��i= �f' �'�'
10. Do any signs ebst 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 C07— to be filled ;n
by the Building 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 . Certification: I hereby certify that the information contained herein
is true and accurate to the best of my knowledge.
APPLICANT's SIGNATURE-
NOTE: Issunnoe of a zoning permit does not relieve an ajal lioant's burden to comply with all
zoning requiraments and obtain all required permits from the Board of Health, Conservation .
Commission, Department of Publio Works and other applioable permit granting authorities.
FILE #
Fi 1 e No.
ZONING PERMIT APPLICATION (§10
P41�t i f�`�iera��,,; �a
PT,F.'A E TYPE OR PRINT ALL =ORMATION ?;�� {j
y 'erylcd,5�a'`l�
1. Name of Applicant=.- rnL51)2`(2�c)
Address:,,_o B;cnebi i Lk Telephone: ,`5 -CXQ 1 p
2. Owner of Property: C>rc, ,� .SSe"OY atz
Address: i �. G.i t, Telephone: J I - 03(0' 1
3. Status of Applicant: Owner Contract Purchaser Lessee #
Other(explain):
4. Street Address: 1
Parcel Id: Zoning Map# /Im Parcel# /�'�� District(s):_
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/P rope rtyY�
6. Descrip'on of Proposed Use/Wor roject/Occupation: (Use additional sheets if necessary):
5 li+llG,l 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 Fifes_
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 SIDE7_.
FILE # 960276
APPLICANT/CONTACT PERSON:
ADDRESS/PHONE: �3&
PROPERTY L ATION: �c'-C�1�
MAP/,Z PARCEL: / ZONE
THIS SECTION FOR�OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
7.ONTNr-FORM FYI.T.FD OUT
Ownt-r/nervilinnt Statement n4irt-nse if L7
THE LLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION:
Approved as presente&%ased 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
!P it from Wnsery 'on Commission
tgnature of g Inspector Date
NOTE:Issuanoe 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 Public Works and other applicable permit granting authorities.
City of Northampton REQUIRED INSPECTIONS
$ f 1. Footings and Walls
BUILDING DEPARTMENT 2. Structural Components in Place*
3. Complete Building*
No. 828 Office of the Building Inspector
Zoning Form No. 960276 Date 9/27/95 Fee$20 Check#2278
Page, 17A Parcel 115 Zone URA/WSP Section 127 ❑ Yes ®No
BUI]LDINGPERMIT
* Plumbing and Electrical Inspections required
THIS CERTIFIES THAT Thomas Dolan before Building Inspections
has permission to reshingle roof. Inspection on Site—Foundations
situated on 14 Claire Ave. - Florence - George Hassenfratz Inspection of Plumbing—Rough
provided that the person accepting this permit shall in every respect Inspection of Plumbing—Finish
conform to the terms of the application on file in this office, and to the Gas Inspection
provisions of the Statutes and the Ordinances relating to the Construction, Inspection of Wiring—Rough
Maintenance and Inspection of Buildings in the City of Northampton.
Any violation of any of the terms above noted is an immediate revocation Inspection of Wiring—Finish
of this permit.Expires six months from date of issuance,if not started. Building Inspection—Rough
Note:A certificate of occupancy will be issued by this office upon return Insulation Inspection
of this card signed by the Plumbing,Wiring and Building Inspectors.
Building Inspection—Finish
** Install per Manufacturer's information: windows, vinyl siding,roofs Smoke Detectors (Fire Department)
and woodstoves
Other
THIS CARD MUST BE DISPLAYED IN A CON$PJC J S LAC N HE PREMISES
Certificate of Occupancy
Building Inspector