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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations
NORTHAMPTON, MASS. i�C 19 ? Additions
APPLICATION FOR PERMIT TO ALTER Repair
Garage
1. Location 1 - Lot No.
2. Owners name mot//vr Address c!5�24
3. Builder's name Address
Mass.Construction Supervisor's License 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 cosh,
The undersigned ifies that the above state ents are true to the best of his, her
knowled d be,. f.
c
Signature of responsible app,icant
o
Remarks z
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 colrmm to be fi ll ea in
by the Bni.Sdfng Department
Required
Existing Proposed By Zoning
Lot size
Frontage
Setbacks - frnnt
- side L: R: L: R:
- rear
Building height
Bldg Square footage
%Open Space:
(Lotarea minus bldg
&paved parking)
# of Parking Spaces
# of Loading Docks
Fill:
(volume & location)
13 . Certification: I hereby certify that the information contai d herein
is true and accurate to the best of my kno
DAT ' : APPLICANT's SIGNATU
NOTE: v unnoe'of'm zo Ing permit does not relieve an a lionnto bur en to oomply with ali
e
zoning rquirements a d obtain all required permits f the Board of Health. Conservation
Commission, Department of Publio Works and other al6plioable permit granting authorities.
FILE #
5 ,..��. File No. (+11 cp
ZONING PERMIT APPLICATION (§10 . 2)
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant: �l J
Address:
Teleph n
2. Owner of Property:
vw�o
Address. ���-f r Telephone: f— ��3 `��� —
3. Status of Applicant: Owner Contract Purchaser Lessee
Other(explain): ,,((����
4. Street Address: ���TC �� /`�
Parcel Id: Zoning Map# Parcel# District(s):_,,&fA--
(TO 9E ILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/Property
6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary):
-'��� � ,rY GE'�G✓ G
7. Attached Plans: Sketch Plan Site Plan Engineered/Surveyed PI
Answers to the following 2 questions may be obtained by checking with the Building Dept or Planning Department Files.
8. Has a Special PermitNariance/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:
ADDRESS/PHONE: J i J Ce
A
PROPERTY L CATION:
MAP PARCEL: 1 G C.% ZONE U:=
THIS SECTION FOR-OFFICIAL USE ONLY:
PERNUT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
70NING FORM MLED 0111
Fee Pnid
'Rnildin2 Per
U�
THE FeLLOWING ACTION HAS BEEN TAKEN ON THIS AP ICATIOM <
Approved as presentedfbased 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
.4,
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 mmission /
Signature of Building Inspp4or Date
NOTE:Issuanoe of as zoning permit does not relieve an applioant's burden to oomply with ali
_ zoning requirements and obtain ail required permits from the Board of Health. Conservation
Commission. Department of Publio Works and other applionbie permit granting authorities. —
City of Northampton REQUIRED INSPECTIONS
} " 1. Footings and Walls
BUILDING DEPARTMENT
f 2. Structural Components in Place*
3. Complete Building*
No. 789 Office of the Building Inspector
Zoning Form No. 961418 Date 9/5/96 Fee $20.00 Check# 5531
Page, 17A parcel 160 ,Zone URA Section 127 ❑ Yes ® No
BUILDINGPERINM
* Plumbing and Electrical Inspections required
THIS CERTIFIES THAT Bob Thibodo before Building Inspections
has permission to strip & reroof house Inspection on Site—Foundations
situated on 35 Fox Farms Rd — Alfred Lewonis 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 CONSPICUOUS PLACE N SES I t Certificate of Occupancy
Building Inspector