17C-173 (3) . ` __ it t,7 �i o• �
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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations
NORTHAMPTON, MASS. �y1i`�-- 1> 1
-> 19 `I �, Additions
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% � Repair
APPLICATION FOR PERMIT TO ALTER
Garage
1. Locations r1jc`(Ur An''� �hre� i, - Lot No.
2. Owner's name S f � vz v ��« y- Address r T f r r <��� �j 0-e_
3. Builder's name Ct(v-SL.V` Address Q i Pa 1�,,� f�' (1 (Av�:141
o. j�/ c / b f S�`/ 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 e -! 5
13. Siding house
14. Estimated cost:-F ` 6C,c7
The undersigned certifies that the above statements are true to the best of his, her
knowledge and belief. '
Signature of responsible app icant
Remarks
l
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 X07— to be filled in
by than Building Department
Required
Existing Proposed By Zoning
Lot size
Frontage
Setbacks - front
- side L: R: L: R:
- rear
Building height
Bldg Square footage
%Open Space:
(Lot area minus bldg
&paved parking)
_pf -Parking spaces
f of Loading Docks
Fill:
'4vol-dme--& location)
13 . Certification: I hereby certify that the information contained herein
4a
is true and accurate to the best of my knowledge.
DA'j'E: ��r �� APPLICANT's SIGNATURE �l
NOTE: I uan a of a zoning permit does not relieve an appiioants burden to oompiy with all
zoning requirements and obtain all required permits from the Board of HaaH114 Conservation --
Commission, Department of Pubiio Works and other mpplioable permit granting authorities.
�!; FILE #
File No. Cc%
ZONING PERMIT APPLICATION (§I0 . 2)
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant: '-5/ / / DI
Address:—) 1 k✓ Telephone:
2. Owner of Property:
Address: ,�S ,Y ' _ Telephone: / y3
3. Status of Applicant: Owner Contract Purchaser Lessee
Other(explain):_____(?
4. Job Location: j k �� ' ,
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 with the Building Dept or Planning Department Files.
8. Has a Special Permit/Vadance/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_\Z/_ 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 # 9 U 1 1 U 15 060
O'"
2 519.0
APPLICANT/CONTACT PERSON:
ADDRESS/PHONE:
PROPERTY LOCATION:
MAP PARCEL: '' ZONE
THIS SECTION FOR-OFFICIAL USE ONLY:
PERK UT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
Byiildin2 Permit Filled njAk
THE OLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION,
Ll 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
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 Co mission
Signature of Bui1 g ec ate
NOTE:Issuanoa of to zoning permit does not relieve an applioant's burden to oompty with all
zoning requirements and obtain all required permits from the Board of Health, Conservation
Commission, Department of Publio Works and other applioable permit granting authorities. —
w
City of Northampton REQUIRED INSPECTIONS
i 1. Footings and Walls
BUILDING DEPARTMENT 2. Structural Components in Place*
3. Complete Building*
No. #561 Office of the Building Inspector
Zoning Form No. Date 6/26/96 Fee $20 Aleck# 2320
Page, 17c Parcel 173 ,Zone uRB Section 127 ❑ Yes ❑ No
BUI]LDING PERMIT --
* Plumbing and Electrical Inspections required
THIS CERTIFIES THAT Bill Dickenson before Building Inspections
has permission to repair slate , chimney Inspection on Site—Foundations
situated on 25 ve�1e 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 terns 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 ON TfO PREMISES
Certificate of Occupancy
Building Inspector