17A-244 (9) PERMIT APPLICATION CHECK LIST
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�`��/ ZONE L/�'j� �°�- `�'- e° <='`�, YES NO HATE
1 ,
ZONING FORM APPLICATION
2 .
PERMIT APPLICATION
3 .
OWNER OCCUPANT IE NOT
4 .
SETS OF S PLAN
5 .
NEW CONSTRUCTION
6 .
CURB CUT
7
WATER V S
8 .
REMODELING
9 ,
ADDITION
10 ,
ACCESSORY U
11 .
SIGN Z AWNING
12 .
PERMIT FE E - - MONEY 0 E
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13 ,
SPECIAL PERMIT REQUIRED WIIH DEED IF APPLICABLE
14 .
UNDER SECTION 27 - C R 780
15 .
FORM A
16 .
FILL
COMMENTS :
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LAKE S-rrE"C'-7"
John M. Demitiski, mc.
-Builder & Cocard ^!
P.O.Box 602418
MA O14
JOHN H. ZIEMINSKI, INC.
CARPENTER-BUILDER & CONTRACTOR
P.O. BOX
NORTHAMPTON, MA 01060-
413-584-4002
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Zoning 'T& e'
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. S `��' ` Alterations
NORTHAMPTON, MASS. -! t 19 �a Additions
I Repair
APPLICATION FOR PERMIT TO ALTER
Garage
1. Location
' Lot No /7
,/V�"2a/.' ..j Y!/Y7T}rJ�-- /1/�-y�2— /(� Lr/�T-�:rJL•GC� J'E=`7-'/=1-i-tr_.
2. Owner's name i�/J6 r17r�iLC7/— — 4-A,,,"z- Address_ A/ a1resJ
3. Builder's name Address,P,4� ���Liar G :;? YX
Mass.Construction Supervisor's License No. r-1,11-1 Sly i _-�Expiration Date �r
4. Addition °x
5. Alteration s(-:7 j
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
knowled c and belief.
Sigma)re of responsible app,ican!
7
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Remarks
r., � � 0 01 5 J ��
Date Filed File No.
ZONING PERMIT APPLICATION (§10 . 2)
I. Name of Applicant:
Address :_ cj. . c,K spa y� Telephone:
/✓,i,4277147-?�
2 . owner of Property: �gY
Address : S;� �, s, Telephone :_ 1 y 3,J>
3 . Status of Applicant: Owner Contract Purchaser
Lessee Other (explain:
4 . Parcel Identification: Zoning Map Sheet#v Parcel# 2�1� ,
Zoning District(s) (include o 1 s t4,21�
Street Address Q1a IL--.
Required
5 . Existinq Proposed by Zoning
Use of Structure/Property v
(if project is only interior work, skip to #6)
Building height /Dire✓ , s;vv i �,a
%B1dg. Coverage (Footprint)
Setbacks - front 3,y -311
- side L: R: /4, L:_(_R:
- rear "Sa ;'Vc
Lot size
Frontages s ,
Floor Area Ratio
tOpen Space (Lot area minus
building and parking)
Parking Spaces
Loading
Signs
Fill (volume & location)
6 . Narrative Description of Proposed Work/Project: (Use additional sheets
if necessary) l�rii�,
t �l c �✓ ` /L` ' Q?.1�G> C onJ c! � fvt7 ! LO r 1 ufC 7- 7,L)
7 . Attached Plans : Sketch Plan A Site Plan
8 . Certification : I hereby certify that the information contained herein
is true and accurate to the best of my knowledge.
Date: g'YL�Li,3 Applicant's Signature :
� THIS SECTION FOR OFFICIAL USE NLY:
Approved as presented/based on information presented
Denied as presented--Reason:
cial' Per it and/or Site Plan Required :
i ing R re Variance Required:
gnat o ui or � at
NOTE: Issu zoning p�Idoa-�nlrcf ie ve an applicant's burden to comply willi 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.
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City of Northampton REQUIRED INSPECTIONS
BUILDING DEPARTMENT
I. Footings and Walls
2. Structural Components in Place
3. Complete Building*
No.
705 Office of the Building Inspector
Zoning Form No. 001550 Date 8/10/93 Fee $44 Check# 3656
Page, 17A Parcel 244 ,Zone URB Section 127 ❑ Yes No
BUI,LDINGPERMIT
* Plumbing and Electrical Inspections required
THIS CERTIFIES THAT J.H. z ieminski Inc. before Building Ins tins
has permission to Add a 8'x10' lst fl. bath & convert 2nd fl.1 closet to Inspection on Site—Foundations ' 2-
z bath
situated on 82 Lake street Inspection of Plumbing—Ro -� 3—
provided that the person accepting this permit shall in every respect
Inspection of Plumbing—FinishoH,q°f� ?
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 30/ (.�
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 �Pv
��
of this permit.Expires six months from date of issuance,if not started. Building Inspection—Rough v aO4
Note:A certificate of occupancy will be issued by this office upon return Insulation Inspection ^ t
of this card signed by the Plumbing,Wiring and Building Inspectors. Building Inspection—Finis�"���
Smoke Detectors(Fire Department)
Other
THIS CARD M S T BE I PLAYED IN A CONSPIC S CE ON THE PREMISES
Certificate of Occupancy
Building Inspector