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Zoning
Miscellaneous Additions, Repairs, Alterations, etc. Tel. No. Alterations
t C %r NORTHAMPTON, MASS. 1 9 Additions
APPLICATION FOR PERMIT TO ALTER Repair
Garage
1. Location (o'a 3 f--- t oce; , z _. - Lot No.
2. Owner's name -- heti v\ Me + -` t A a Address (0 �- OC:e_.: v'1 C f' LC A 0
3. Builder's name 1 o YYl 00 Y1 Address
Mass. Construction Supervisor's License No. t) 3 cI Z B 1 Expiration Date
4. Addition
5. Alteration R €(OoC (S "1-h t p pp I(ej) i r , -)1,aC e U'i'1 E', 11 A (t)l4 )
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: -
$ 3 UCoc;> () C
The undersigned certifies that the above statements are true to the best of his, her
knowledge and belief.
i 1 0-_ 6 1 - 4 :'( �
A 4 _AF 1. .
Signature of responsible •rpicant
Remarks
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 column to be filled in
by the 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)
# of Parking Spaces
#` f o f Loading Docks
Fill:
( volume -& location)
13. Certification: I hereby certify that the information contained herein
G is true and accurate to the best of my knowledge.
DATE : L� \ (G APPLICANT 's SIGNATURE tdh G YYy l l `C � /j L L f � �
NOTE: I uanoe of a zoning permit does not relieve an applioant's burden to comply h 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.
FILE I
File No. 9
ZONING PERMIT APPLICATION ( §10.2 )
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant: IOM DC tI sn
Address: 1 30 (3 (l (C. (_( ��( �a 0 Telephone: bz j.. JC0 D-
2. Owner of Property: 5tlf1 rN m Lt (A
Address:4 (.0,) 3 TILveocc IZ_co\so Telephone: . 3 (C
3. Status of Applicant: Owner Contract Purchaser Lessee
Other (explain):
4. Job Location: (Q ).3 F (L , re 1 C 12 U r\
CTh
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): •
Rse roof (s tr; p ) 4 V 1(tC COrl F'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 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# nC_8O
APPLICANT /CONTACT PERSON: ? \"-Dr!)-1-/44,4 1�'�
ADDRESS/PHONE: 0 A C%! , A
PROPERTY LOCATION:
MAP 3 7 PARCEL: /() ZONE
THIS SECTION FOR - OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST •
ENCL9$ED REQUIRED DATE
ZONING- FORM FIT ,FT) OUT ,/
Fee Paid
Rttilding Permit Filled Ant
Fee Paid CA 9 ,65: G' 1 -
Type of Ct netrnetinn•
► . •• •I I , '1 1 ')./tv
ice)
_Remodeling Interior
Addition to Fi jet g "%rt., rz.
A rreeenry Strnetnre
Rttilding Plane Tnrinded• ✓� ) /
Owner /Orettpant Statement nr 77�� lrenee i C)`� Cd 2X /
3 Sete of Plane / Plot Plan
Tp IOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION:
Approved as presented/based 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
! Perm_ ,m Conservation ilemissio
Signature of Building Insp or Date
NOTE: Issuetnoe of a zoning permit does not relieve etn epplloants burden to comply 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.
°o �'" Cit y Northampton of REQUIRED INSPECTIONS
� = = ~~ '' I. Footings and Walls
• BUILDING DEPARTMENT
2. Structural Components in Place*
rz
3. Complete Building*
No. 663 Office of the Building Inspector
Zoning Fonn No. 961280 Date 7/25/96 Fee $20 .00 Check # 1054
Page, 37 parcel 10 , zone SR al No
Section 127 ❑ Yes
BUILDING PERMIT
* Plumbing and Electrical Inspections required
THIS CERTIFIES THAT Tom Dolan before Building Inspections
-
has permission to strip & reroof house & install replacement windows. Inspection on Site — Foundations
situated on 623 Florence Rd - Sharon Martula Inspection of Plumbing —Rough
provided that the person accepting this permit shall in every respect Inspect pn of Plumbing— Finish
conform to the terms of the application en file in this office, and to the Gas Inspection
provisions of the Statutes and the Ordinances relating to the Construction, Inspe :;lion 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. Buil :ling 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.
Bui'ding Inspection— Finish O6e-
** Install per Manufacturer's information windows, vinyl siding, roofs
and woodstoves Smoke Dei .tors (Fire Department)
• Other
THIS CARD MUST B L' ^ISL �f, CONSPICUOUS PLA ON T SES
s. Certificate of Occupancy
Building Inspector