36-019 (5) *----------------------------------------------*
Official Receipt for Recording in:
Hampshire County Registry of Deeds
33 King St.
Northampton, Massachusetts 01060
Issued To:
CHARLES BARANOWSKI JR
17 FOREST GLEN DRIVE
FLORENCE MA 01062
Recording Fees
*----------------------------------------------*
Document Recording
Description Number Book/Page Amount
*-------------------------------------------*
SP 00017011 7159 213 $75.00
BARANOWSKI
$75.00
Collected Amounts
*---------------------------------------------*
Payment
Type Amount
*----------------------------------------------*
Check 1111 $75.00
$ 500
Total Received $75.00
Less Total Recordings: $75.00
Change Due $.00
Thank You
MARIANNE DONOHUE - Register of Deeds
By: Marilyn H
Receipt# Date Time
0021392 04/24/2003 12:00p
KV
File#MP-2003-0115
APPLICANT/CONTACT PERSON BARANOWSKI CHARLES W JR
ADDRESS/PHONE 17 FOREST GLEN DR (413)586-1398 Q
PROPERTY LOCATION 17 FOREST GLEN DR
MAP 36 PARCEL 019 001 ZONE URA
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FO FILLED OUT
i
Building Permit Filled out
Fee Paid
Typeof Construction: ZPA-ADDITION&CONVERT&ADD TO CARPORT FOR 2 CAR GARAGE
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/Statement or License
3 sets of Plans/Plot Plan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INFOQIATION PRESENTED:
Approved Additional permits required(see below)
PLANNING BOARD PERMIT REQUIRED UNDER: §
Intermediate Project: Site Plan AND/OR Special Permit with Site Plan
Major Project: Site Plan AND/OR Special Permit with Site Plan
ZONING BOARD PERMIT REQUIRED UNDER: §
Finding Special Permit Variance*
Received&Recorded at Registry of Deeds Proof Enclosed (/
Other Permits Required:
Curb Cut from DPW Water Availability Sewer Availability
Septic Approval Board of Health Well Water Potability Board of Health
Permit from Conservation Commission Permit from CB Architecture Committee
Permit from Elm Street ommission
S� ZO O
Signature of Building Official Date
Note: Issuance of a Zoning permit does not relieve a applicant's burden to comply with all zoning
requirements and obtain all required permits from Board of Health,Conservation Commission,Department
of public works and other applicable permit granting authorities.
*Variances are granted only to those applicants who meet the strict standards of MGL 40A. Contact the Office of
Planning&Development for more information.
17 FOREST GLEN DR MP-2003-0115
COMMONWEALTH OF MASSACHUSETTS
CITY OF NORTHAMPTON
GIS#: 7106
Map: 36
,Block: 019 ZONING PERMIT
Lot: 001
jPermit: _ ZONING PERMIT APPL APPLICATION PERMIT
Category: Zoning Permit
Pernut# MP-2003-0115
Pro e t # M-2o003-011 PERMISSION IS HEREBY GRANTED TO:
4 �__ _
Est.Cost: $0.00 Contractor: License:
!Fee: _ $10.00 Homeowner as Contractor
#of Fixtures: Owner: BARANOWSKI CHARLES W JR
-V �_— -
Applicant: BARANOWSKI CHARLES W JR
AT. 17 FOREST GLEN DR
ISSUED ON. 01-May-2003 AMENDED ON.- EXPIRES ON.
TO PERFORM THE FOLLOWING WORK:
ZPA-ADDITION&CONVERT&ADD TO CARPORT FOR 2 CAR GARAGE
THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF
ANY OF ITS RULES AND REGULATIONS.
Signature:
Fee Type: Receipt No: Date Paid: Check No: Amount:
Zoning Permit Application REC-2003-002550 24-Feb-03 1101 $10.00
212 Main Street,Phone:(413)587-1240,Fax:(413)587-1272
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17 FOREST GLEN DR BP-2003-0971
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map:Block:36-019 CITY OF NORTHAMPTON
Lot:-001
Permit: Building
Category_ BUILDING PERMIT
Permit# BP-2003-0971
Project# JS-2003-1563
Est.Cost: $643.00
Fee: $643.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Grouo: JEFFREY CLARK 076998
Lot Size(sg. ft.): 14679.72 Owner. BARANOWSKI CHARLES W JR
Zoning:LIRA Applicant: JEFFREY CLARK
AT. 17 FOREST GLEN DR
Applicant Address: Phone: Insurance:
3 KAREN LANE (413) 527-8338 WC
SOUTHAMPTONMA01073 ISSUED ON.5116103 0:00:00
TO PERFORM THE FOLLOWING WORK.-CONSTRUCT ADDITION (FAM RM,DINING RM,
MS1-R BATH,SCREEN PORCH), EXP KITCH, BEDRM, CONVERT CARPORT TO GARAGE
POST THIS CARD SO IT IS VISIBLE FROM THE STREET
Inspector of Plumbing Inspector of Wiring D.P.W. Building Inspector
Underground: Service: Meter:
Footings:
Rough:g/j1/G ;8 Rough:/,0/�f 7? House# Foundation: b t�V _
/� Driveway Final: Tj
Qtj v/
Final:j �-�al(, Final:
,V`' e
lh?7-14'L 1191 Rough Frame:
Gas: Fire Department Fireplace/Chimney:
Rough: 1t3—0 Oil• Insulation:
Final Smoke: Final:
l�
**30°DAY.:TEMP ORARY OCCUPANCY _ EXPIRES 2/20/04
THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLA ON OF
ANY OF ITS RULES AND REGULATION
Certificate of Occu an Signature:
FeeType: Receipt No: Date Paid: Check No: Amount:
Building 5/16/03 0:00:00 231 $643.00
212 Main Street,Phore(413)587-1240,Fax: (413)587-1272
Building Commissioner-Anthony Patillo