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FILE t._....�.�..:,-- -1}
APXLICANT/CONTACT PERSON:_-�, ?
ADDRESSIPHONE:
PROPERTY IAC TION: �Ir�r3�1/I,LI-��
MAP PARCF,L: /CJ ZONE 'C/J. r- ..._
THIS SECTION FOR.OFFICIAL USE ONLY:
PERWr APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
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THE,VOLLOWING ACTION HAS BEEN TAXY I ON THIS AP ICA.TION:_LZ -
Approved as presented/based on information presented
Denied as presented:
_Special Permit and/or Site Plan Required wader:
_PLAN7VINGBOARD ZONWGBOARD
_Received&Recordedat Registry.f Deeds ProofBmdosed
—Finding Required under: § w/ZONBbG BOARD OF APPEALS
_Received& Recorded at Registry of Deeds Proof Enclosed
r
Variance Required under: §_ w/ZONING BOARD OR APPEALS
Received&Recorded at Registry of Deeds Proof Endosed
Otber Permits Required:
_Curb Cut from DPW Water Availability_____Sewer Availability
`Septic Approval-Bal of Health Wetl Water Potability-Rd Health
Permit from Conservation Commission
Signature of e0' —_.Date .
4
NOTE:W.... of a Zing permit does not relieve an appibants burden tc, "alsty with ad
zoning requiremanta and obtain ait requirod permits from the Board of Heaith. Conaervatian
Commisalon. Department of public, Worker and other applicable permit granting authorRiea.
File No. tP��
ZONING PERMIT APPLICATION (§10 . 2)
LEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applica �� A�
Address:..A Telephone�J-��\
2. Ownerof Property: cr� �Z�C`CS\UL
Address: Telephone:
3. Status of Applicant Owner _Contract Purchaser—Lessee
_Other(explain):
4. Job Location: �ok�_ '7�`�
Parcel Id: Zoning Map#_ &7Z,—�- Parcel# '/0j District(s):
(TO BE FILLED IN BY THE BUILDING DEPARTMEN
/ Q
5. Exisling Use of Structure/Property
0 -
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 PermiWariance/Finding ever been issued for/on the site?
NO DON'T KNOW YES IF YES,date issued:
]EYES: Was the permit recorded at the Registry of Deeds?
NO DON'TKNOW YES
IF YES: enter Book Page and/or Document#
9. Does the site contain a brook, body of water or wetlands? NO te"" 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)
10. Do any signs exist on the property? YES NO
IF YES, descnbe size, type and location:
Are there any proposed changes to or additions o 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 DOE TO
LACK OF INFORMATION.
Thies cols® ys fil]n3 is
by �^ H¢ildis9 Dapnrbdat
Required
Existing Proposed By Zoning
Lot size
Frontage
Setbacks
- side L:– R:— L:—R:-
- rear
: R:- rear
Building height
Bldg Square footage
%Open Space:
(Lot area minus bldg
&paved parking)
# of Parking Spaces
#- of Loading Docks
Fill:
-{vol-ume--& location)
13 - Certification: I hereby certify that the information contai erein
r, is true and accurate to the beet of mnowledge. \
DATE: APPLICANT'' :53IGNAi��QS-y�
NOTE: laaunnoa of a zoning permit does not relieve an applioanl'a burden to comply with all
toning requiromente and obtain all required permits from the Board of Health. Conservation
Commisalon, Department of Pubiio Worker e,nd other appiloable permit granting authorities-
-- FILE #
Y > Z
A L
n5 r w
3 o r
7] 1 v Z
Zoning
Miscellaneous Additions.Repairs,Alterations,etc. Tel.NnSS, S��\ Almrauons
NORTHAMPTON, MASS. f91Y7� Additions
APPLICATION FOR PERMIT TO ALTER Repair
Garage
1. Location �C Lot No.
2. Owner's rta ` Address
3. Builder's name
Address
Mass.Construction Supervisors License No. Expiration Date
4. Addition
5. Alteration .41, Al.),
6. New Porch —f
T Is existing building to be demolished?
g. Repair after the fire
9. Garage No.of cars Size
10. Method of heating
11. Distance to lm lines
12. Type of roof
13. Siding house
14. Esumamdcosc- e6t7. A q.sy -
The undersigned certifies that he above statements are true to the best of his, her
knowledge andbelief.
ti Sgnaturt of rziponnble appimm
Remarks
oq-gfux>ro
a �\
a , 3 <ftifg of an
-
e -
D£PARTMf.NT
Of DIRWI yG INSPECTIONS
INSPECTOR 212 Moro Strttt ' Municipal Building -
N.HhT ,,pton, M.,s. 61660
HOMEOWNER LICENSE EXEMPTION
c�( (Please Print)
JOB LOCATION:
c (NaP� rc livt`\ isi. n7�
HOMEOWNER. Cl�`9,._ C 1
(Name k ddress)
(Hgme Phone ) (Work Phone)
The current exempCion for "homeowners" was e_itended to include
Owo er-occupied i-wellaros of one (1 )or two (2) families ,and to allow, such
-
homeowner to engage an rndividuel =er lyre who doe9; not possess a '
license, proviced that the owner acts1xs superui sor . 'pIM7 0 Seci)on 109. 7 , 1
DEFINITION OF 1301�—OWNV-R: Person( s ) two tiwR - =_cel of land on
which he/she reiices or intends to reside, on wh ch there , or is
intended to he , o one or two family dwel) inc, attached or detached
st-,uctures accessory to such use and/or farm structures , a person who
constructs :note than one home in a two-year -ariod shall not. be
considered a homeowner - Such "homeoianer" s'nal_ submit to the Buildine
Official, u:? a form acceptable to the Build3.r,,;i O_fic ial , that he/she
shall he responsible all such �,�o>Y perforr _ med_ under the buildinq
e r _ _
per IV
As acting Construction Supervisor your p,esEnce on the job site
will be repo ire_d r"rom time; to time, during and upon comnleti.on of the
work for which this permit is issued.
Also be advised that with reference to Chapter 152 (Worker, '
Compensation ) and Chanter 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 assium s responsibility
j for compliance with the State Building Code, C..i ty of Northampton
Ordinances, State nd Local Zoningf.Laws , and State oMassachusetts
General Laws Arno ate'd, AND SHALL BE ON THE ,708 A _@RJSSOR.
HOtQOWNP12 SIGNA" A� .� 5 —
CXl�it=-\w. -
if BUILDING PERMIT $