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DEMATMEINT OP DUILDNO INSPECTIONS
INSPECTOR 212 Ivinin Streot Adunicihnl 1.3ulidin� ---�,, ''
Northampton, N1nam 01000
AS A HOMEOWNER I UNDERSTAND THAT I MAY APPLY FOR AND RECEIVE
A BUILDING PERMIT FOR A HOME OR ADDITION I INTEND TO LIVE IN ,
I ALSO UNDERSTAND THAT I AM RESPONSIBLE FOR KNOWING THE STATE
BUILDING CODE AND ZONING ORDINANCE OF THE CI'T'Y OF NORTHAMPTON,
BEING A.HOM50WHER AND NOT A PROFESSIONAL CONTRACTOR IN NO WAY
ABSOLVES ME OF ANY RESPONSIBILITY TO INSURE THAT ALL FACETS
OF THE RULES AND REGULATIONS ARE COMPLIED WITH ,
ti
Date Filed File No
ZONING 12 ERMI'1' APPLICATION
Zoning Ordinz,2100 Sebtion LO , 2
1 . Name of AnLI i.cant ; 1c lw,
Address : Telephone :
2 Owner. of Pr. o er, t:
Address : 'Telephone: =�
3 , Status of April i.cant. ; O�;iner Contract Purchaser
I.,essce Other (e.xplain ; )
A , Parcel :f.denti.f.icata�on ; ZOn.l.Ilg 11c1p Sheet, '3 S_ P•areel# 7p' ,
Zoning District ( s)
Street Address
51 Compliance- with Zon.i.ncl ; existing Proposed
Use of Structure/Property
Size of Structure (sq . ft , )
Building height
Building Coverage
Setbacks - front
- ,side
rear Ux ,
Lot Size
Frontage
Floor Area Ratio
Open Space
Parking Spaces
Loading Spaces
Signs
Fill (volume & location)
6., LTarrati,'ie Description of Pr. onosed work/Protect ; (Use
add ita 6na2. sheets iz necessary)
71 Attached Plans : ��� Sketch Plan A—. Site Plan
a . CEert'if iea�ion ; I hereby certify that the •in�ormati on, contained
herein is true and accurate to the best of my knowledge ,
Date : -,/�-�/ Applicant ' s Signature ;max.X LILA CC
THIS - SECTION FOR OFFICIAL USE ONLY :
'Approved 'as presented
Denied as presented
Reason for Denial ;
Signature of Building inspector. ,/ G i ��_ Dais
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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations
2oas °TOti NORTHAMPTON, MASS. 19 Additions
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w APPLICATION FOR PERMIT TO ALTER Repair Garage
1. Location " 2rS /'t r � Lot No.
2. Owner s namez i t- 9)c:;)Y!t ��c1/2K_ Address JJ U/2TJ i
3. Builder's name Address
Mass.Construction Supervisor's License No. Expiration Date
4. Addition r
5. Alteration '31 a7� i/7 ?F hn),S F
6. New Porch
7. Is existing building to be demolished? �Jn
8. Repair after the fire IM
9. Garage No.of cars Size
10. Method of heating_ ", s
11. Distance to lot lines
12. Type of roof
13. Siding house
14. Estimated cost:-� oo or,
�JV The undersigned certifies that the above statements are true to the best of his, her
knowledge and belief.
Sign. e of res o Bible applicant
Remarks
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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations
NORTHAMPTON, MASS. 19 Additions
APPLICATION FOR PERMIT TO ALTER Repair
�7 AI l7N Garage
1. Location t Lot No.
2. Owner's name�� ��✓/�e'l `( T� Address ;3/1,,/5
3. Builder's name� �'I�1'a lil �f �.� /"i Address
Mass.Construction Supervisor's License No. -71 :3 Expiration Date 7
4. Addition j
5. Alteration /r C 12 14,"1)411---
6. New Porch
7. Is existing building to be demolished? /V
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 abov7,� 11
e`nts are true to the best of his, her
knowledge an lie .
Signature of responsible app,icant
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 columm to be filled in
by the Building Department
Required
Existing Proposed By Zoning
Lot size
Frontage
Setbacks - frnnt
- side L: R: L: R:
- rear
Building height
Bldg Square footage
%Open Space:
(Lot area minus bldg
&paved parking)
# of Parking Spaces
# of Loading Docks
Fill:
(volume & location)
13 . Certification: I hereby certify that the information contained herein
is true and accurate to the best of my knowledge.
-21 DATE: 1q:
APPLICANT's SIGNATURE
NOTE: swan o a zoning permit does not relieve an applioan s b rden to comply ith all
zoning requirements and obtain all required permits from the Boa of Health, Conl4eirvation
Commission, Department of Public Works and other applicable per t grantin�horit
FILE #
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ZONING PERMIT APPLICATION ff (lE m o{ G n y
5
PLEASE TYPE OR PRINT ALL INFORMATION ...;
1. Name of Applicant:
Address: _Telephoned
2. Owner of Property:
Address:_//� 5 Telephone
3. Status of Applicant: Owner Contract Purchaser Lessee
_Other(explain):
4.4. Street Address: 11 7 &f �-q / 5 fR/
Parcel Id: Zoning Map# Parcel# District(s):
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/Property /
6. Descriptio of Pro osed Use/Wor roject/Occupab n: (Use ad ','oval sheets if nee ary): ,
10
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/Variance/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)
J� v ✓
FILE I `-
APPLICANT/CONTACT PERSON: AIX r
ADDRESS/PHONE:
PROPERTY LOCATION:
MAP ' " PARCEL:F ZONE
THIS SECTION FOR-OFFICIAL USE ONLY:
_ PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
FPP Paid
Rn_ i 1, dingPprmit Fiilpd nvit 4 _
FPP Paid
L
Rnilrlina Planc Inrhydpd-
0wnPrL0rrijpnnt ,9tntt-rnPnt
3 Sets of PlAnq I Pint Plan
THyk-FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION:
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 j
fr
Permyfrom Co=eRatiocommission 1 ---
Signature of Bui1d' spect r " ate
NOTE:lseuanoibr lira zoning permit does not relieve an applioant's burden to oomply with all
zoning requirements and obtain all required permits from the Board of Health, Conservation
Commission, Department of Publlo Works and other appiloable permit granting authorities.
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