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17A-174 r� r� 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 N0 IF YES,describe size,type and location: 11. ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE DENIED DUE TO LACK OF INFORMATION. This ccly W be filled in by the 8nilding Department Required Existing Proposed By Zoning Lot size g S s. Frontage Setbacks - side L: R: L: R: - rear v Building height Bldg Square footage �d %Open Space: Lot area minus bldg �Z} &Paved parking! # of -Parking spaces f of Loading Docks Fill: {vol-ume--& location) 13 . Certification: I hereby certify that the information contained herein is true and accurate to the best of my kno edge. DATE: APPLICANT's SIGNATURE l �> NOTE: Issuan a of a zoning permit does not relieve an appli ant's burden to oomply wit4-all zoning requirements and obtain all required permits from the Board of Health. Conservation Commission. Department of Publio Works and other applloable permit granting authorities. FILE # AU G - ? "Col File No. moo DEPT OF BUILDING IN N PERMIT APPLICATION (§10 . 2) TypE OR PRINT ALL INFORMATION 1. Name of licant: AAP q Address: G G Telephone: / 73 2. Owner of Property: C 9 C Z' (C Address: 7 AV f Telephone: 3. Status of Applicant: Owner Zcontract Purchaser Lessee Other explain): f (� 4. Job Location: Q ���� ( �^� 1 ►—lL�' 7 l�.S 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: Sketch Plan Site Plan Engineered/Surveyed Plans Answers to the following 2 questions may be obtained by checking wi the Building Dept or Planning Department Files. 8. Has a Special Permit/Variance/Finding ever be issued for/on the site? NO DON'T KNOWS YES IF YES,date issued: IF YES: Was the permit recorded at the Registf Deeds? NO DON'T KNOW­L_ YES IF YES: enter Book Page and D ument# 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) 08/07/01 3:23:36 PM RESIDENTIAL PROPERTY RECORD CARD CITY OF NORTHAMPTON, MASSACHUSETTS EFFECTIVE DATE OF VALUE: J Y 1, 1998 PARCEL ID: 17A-174-001 KIMBALL ST PLOT: LIVING UNITS: 0 CLASS: R - 130 CARD #: 1 OF 1 CURRENT OWNER/ADDRESS ZONING: URB NEIGHBORHOOD ID: 5.00 FINAL VALUE FLAG: COST VALUE KIREJCZYK JOSEPH C & MADALYN J LAND DATA 173 NORTH MAPLE ST TYPE SIZE INFLUENCE FACTORS LAND VALUE ASSESSMENT INFORMATION - FLORENCE MA 01062 SECONDARY 7668 -50 9,780 PRIOR COST CURRENT LAND 9,800 9,800 BLDG DEED BOOK: 1518 TOTAL 9,800 9,800 9,80C DEED PAGE: 604 SALES INFORMATION DEED DATE: TOTAL ACREAGE: 0.176 TOTAL LAND VALUE: 9,800 LAST UPDATE/COST: 8291997 DATE TYPE PRICE VALIDITY LAST UPDATE/COST: 8291997 ADDITION DATA X DATE: DATA COLLECTION INFORMATION Lower Level First Floor Second Floor Third Floor Area A ENTRANCE CODE: EXTRY & SIGN B INFORMATION SOURCE: C DATA COLLECTOR: D DATE: E F DWELLING INFORMATION G - H �. STYLE: YEAR BUILT: J O STORY HEIGHT: ATTIC: af Basement: { TOTAL ROOMS: p z TOTAL BEDROOMS: o z n V FULL BATHS: ADDITIONAL DWELLING INFORMATION B Half Baths: BASEMENT GARAGE(#CARS) ADDITIONAL FIXTURES: o a EXTERIOR WALLS: BRICK TRIM: X � UNFINISHED AREA: STONE TRIM: X rn Q GROUND FLOOR AREA: Z TOTAL LIVING AREA: REMODELING DATA FINISHED BASEMENT LIVING AREA: X � BASEMENT RECREATION AREA: X YEAR REMODELED: MASONARY FIREPLACE STACKS/OPENINGS: / METAL FIREPLACES: KITCHEN REMOD(Y/N) HEAT/CENTRAL A/C: BATH REMODEL (Y/N) HEATING SYSTEM: FUEL TYPE: QUALITY GRADE: PHYSICAL CONDITION COND/DESIRABILITY/UTILITY INTERIOR/EXTERIOR OUTBUILDINGS & YARD ITEMS PERMIT DATA ?' ' TYPE QTY YR SIZEl SIZE2 GRD COND DATE PURPOSE PRICE Ti 1 NOTES: File#MP-2002-0019 APPLICANT/CONTACT PERSON David McCutcheon ADDRESS/PHONE P O BOX 43 (413)529-9973 PRO THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE C=:FO ILLED O T Building Permit Filled out Fee Paid Typeof Construction: LEGAL BUILDING LOT New Construction I � Non Structural interior renovations r Addition to Existing; Accessory Structure1 � , `! Building Plans Included: ., LJi Owner/Statement or License 3 sets of Plans/Plot Plan t4j ' THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICA INFORMATION PRESENTED: � 1 Approved Denied PLANNING BOARD PERMIT REQUIRED UNDER: § ,, ,t ;j��� � ;�1;•� Intermediate Project: Site Plan OR Special Permit a Major Project: Site Plan OR Special Permit ar ZONING BOARD PERMIT REQUIRED UNDER: § Find 9i Vari Proo 1(415 ov ty cr G11 — to 1oi-J5 Sa (gotS 11 Wate C I _ Permi Signature of Note: Issuance of a Zoning permit does not relieve a applicant's burden to comply with all zoning requirements and obtain all required permits from Board of Health,Conservation Commission,Department of public works and other applicable permit granting authorities. *Variances are granted only to those applicants who meet the strict standards of MGL 40A. Contact the Office of Planning&Development for more information.