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29-361 (5) 5 ��. .. _. r ,t_ � . Y } S t i S 7 � � t P 1 '�.� 3± d 5. wnr � � � Ai�i�,., �.,+ s i i 9 IS. R ^y,'I,r�.R t�+A a'�S sff - I:� ..:�y.. �b..9 e...}.' � r PERMIT APPLICATION CHECK LIST PA-GE PLOT 3 ZONE URf�/ WSI�:' ES NO DATE 1 . ZONING FORM APPLICATION a.:Z7 ,lac--cb-rco K Dri vc I-- 9- 1 1-9 2 2 . PERMIT APPLICATION 1/ 3 . OWNER OCCUPANT STATEMENT / LIC . IF NOT- 4 . l� 3 SETS OF PLANS /PLOT PLAN `� ICeTc h 1i 5 . NEW CONSTRUCTION 6 . CURB CUT 7 WATER AVAILABILITY FORMS S REMODELING INTERIOR 9 . ADDITION 10 ACCESSORY STRUCTURE 11 SIGN- / AWNING 12 PERMIT FEE - CHECK ONLY - MONEY ORDER 13 SPECIAL PERMIT REQUIRED WITH DEE[) IF APPLICABLE 14 . UNDER SECTION 127 - CMR 780 15 . FORM A 16 FILL COMMENTS : XTe'r"I o r' MORTGAGE LOAN INSPECTION S s o° SNEDS Sun BELT" To: _,:�F1sEnie:Nr tv W.M.,5. CA. t&F 7_17L se': 3k /*/ R%zz2 EASE�)tN)' 72, 1 Sty WIF I---I See 3k 1562T6 373 I I 1 /- C-RE:l3ROOK btvl I hereby report that the premises shown on this plan is not located within a Flood Hazard Area as shown on Department of H.U.D. Federal Insurance Administration Maps, Community N be 250167 0001A Identificati ate pr By: TO THE SPRINGFIELD INSTITUTION FOR SAVINGS OWNER, AID THE FIRST AMERICAN TITLE II:S. CO.-ONLY EDWARD F. & MAUREEN A. MIKUCKI LOCATION, To the best of my knowledge, informa- 227 ACREBROOK DRIVE FLORENCE tion and belief, I hereby repor": that I ALMER HUNTLE have examined the premises -and :hat this Y,JR.Ek ASSOCIATES, INC. inspection plat shows the improvement or SURVEYORS-ENGINEERS- LANDSCAPE ARCHITECTS improvements as located on the premises de- 30 INDUSTRIAL DRIVE EAST P.O. BOX 568 scribed, that the improvement o- improve- NORTHAMPTON,MASSACHUSETTS 01060 ments are entirely within lot lines, and that there are no encroachments upon the SCALE, premises described by the impro)ement or or improvements of any adjoining premises, ��N ' 30 except as indicated. I further report that etas DATE, -there are no easements of record affecting w.P" ZI 11�OAA i the tract shown hereon, except its noted. Na 28M Qcro acR 24(1989 rsrt way ia�o JOB NO., THIS PLAT IS FOR IDENTIFICATION PURPOSES ONLY AND DOES NOT CONSTITUTE A PROPERTY SURVEY i �,, �l� �� `�. r ...� ` .... _ 1'-..�f _.. Y � o C A• o ro o r a 0 � z 0 O Z ° t�7 tz O a > tr] .y Zoning Miscellaneous Additions,Repairs,Alterations,etc. Tel.No Alterations 1 Garage NORTHAMPTON, MASS. 19 Additions ' � a APPLICATION FOR PERMIT TO ALTER Repair 1. Location l �l.f' � `�u IC Y V, C I c,Cr n ,r°- , t"n A n f Lot No. 2. Owner's name (=, (,� �3 �� �t?l .(�. 1 i. f L)(l f.. Address 3. Builder's name Address Mass.Construction Supervisor's License No. Expiration Date 4. Addition 5. Alteration 6. New Porch 7. Is existing building to be demolished? n0- 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 knowledge and belief. Signature of responsible app,icant Remarks Grxf� of u8 Xaseacil Its etla a DEPARTMENT OF BUILDING INSPECTIONS INSPECTOR 212 Main Street ' Municipal Building - Northampton, Mass. 01060 HOMEOWNER LICENSE EXEMPTION _ (Pleae Print) DATE: ���/ /l p�f �1a s JOB LOCATION• I 3 G / (Map) (Parcel) ( Subdivision) HOMEOWNER: /{ (Name & Address ) (Home Phone) (Work Phone) The current exemption for "homeowners" was extended to include Owner-occupied Dwellings of six ( 6 ) units or less and to allow such homeowner to engage an individual for hire who does not possess a license', provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER: Person( s ) who own a parcel of land on which he/she resided or intends to reside, on which there is, or is intended to be, a one to six family dwelling, attached or detached structures accessory to such use and/or farm structures . A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner" shall submit to the Building Official, on a form acceptable to the Building Official, that he/she shall be responsible for all such work performed under the building permit. As acting Construction Supervisor your presence on the job site will be required from time to time , during and upon completion of the work for which this permit is issued. Also be advised that with reference to Chapter 152 (Workers ' Compensation) and Chapter 153 (Liability of Employers to Employees for injuries not resulting in Death ) of the Massachusetts General Laws Annotated, you may be liable for person( s ) you hire to perform work for you under this permit. The undersigned "homeowner" certifies and assumes responsibility for compliance with the State Building Code, City of Northampton Ordinances, State and Local Zoning Laws, and State of Massachusetts General Laws Annotated. HOMEOWNER SIGNATURE BUILDING PERMIT # atnr rr �.wgirs•� , •+ n Date Filed 9- 11- 9 Q, File No. Q- ?- 3 G ZONING PERMIT APPLICATION (§10.2) ct F? W5' P 1. Name of Applicant: &O&J Ord /�r�� ✓> � Address:,Ja2 (Le n, ,,, ✓?a Telephone: 2 . Owner of Property: IUT'e'�-'i2 IVi kyc-l l Address : ,22'7At'060- 6 Or C-Lr-pace- Telephone: I - . -0 3 . Status of Applicant: \/ Contract Purchaser Lessee Other (explain:_ ) 4 . Parcel Identification: Zoning Map Sheet# ;Z7 Parcel# 36 / , Zoning District (s) (include overlays) URA / W GP Street Address Q _q1 0_ ni M Q? yreQte t'Yl P Required 5 . Existing Proposed bv Zonincr Use of Structure/Property (if project is only interior cork, skip to #6) Building height %B1dg. Coverage (Footprint)_ Setbacks 3n` - front T G 140` - side R L le R Ild Lot size rear © I Frontage Floor Area Ratio %Open 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) ,�,��,� ti. ice, �A� -anP 0v&Z- xT 7 . Attached Plans: Sketch Plan Site Plan 8 . Certification: I hereby certify that, the information contained herein is true and accurate to the best of my knowledge. �Date: SP/�� - Applicant Is Si g nature: - - - - - r. - - - l THIS SECTION FOB OFFICIAL USE ONLY: T t" SEP I I !/Approved as presented/based on .information presented§ r Denied as presented R on for ni 1: s gnat of Build!TJ In r- Date NOTE: Issuance of a zoning permit does not relieve an applicant's burden to comply with 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. /X92 F[.AS ►�►��yy C ,A A a n O C W x d ej CD W CA h W r. 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