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36-214 (5)
x : v > Oz O a ' FT. Otte . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0 A -fir . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . oC � . 0Z D . vo Z di . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . NOTE:IN ORDER THAT THIS APPLICATION MAY BE ACCEPTED,THE DATA CALLED FOR BELOW MUST BE SO SET FORTH THAT WE CAN DETERMINE FROM THE APPLICATION AND THE ACCOMPANYING PLANS WHAT THE EXISTING CONDI- TIONS ARE AND WHAT THE FUTURE CONDITIONS WILL BE. r Plot Plans and Plans,must be filed with this application before a permit be granted. Zone APPLICANT NOT TO FILL IN SPACES ABOVE THIS LINE Application for a Dwelling Permit Northampton,Mass. . . . . . . . . . . . . . . . . . . . . . . . 19 . . . . . 1lelephone No. .3.�?.�."". .?.�. �.�. . . . . . . . . . . . . . 7b the Supt.of Buildings: Application for a permit to build is hereby made according to the following:- 1. Location, Street and No. . . . . _V5 �Vc!. . . .... . . . . . `. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Lot No. .I" . . . . . . 2. Nearest cross street q. . . . . . . . . . . . . . . . Size of lot . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3. Owner's name . . . . . . . . . . . . .. . . . . . . . . . Address . . .4. . . .1. . . . . . �ti.��. .� �4.L.��La!�yt 0�1 4. Architect's name. . . . . . . . . . . . . . . . . . . . . . . . Address . . . . . .. . . . . . . . . . . . . . . . . . . 5. Builder's name . . . (,-.wx.S. . . .R.? ! V.� s . . . . . . . . . . . Address . .�.�.�. . N. . .�.�.t/��.. . �. �. . . .�-r� e' Mass. Construction Supervisor's License No. . . . . . :�. .�.�G. .. . . . . . . Expiration Date .5-h i.�_. . . . . . . . . . . . . 6. Use of Building:One-family .�. . . . . . . . . . . . . Two-family . . . . . . . . . . . . . . . . . . . . Other . . . . . . . . . . . . . . . . . . . . 7. Number of rooms in each family unit: . . . . . . . . . . . . . . . . . . . . . . . Number of Bathrooms '. . . . . . . . . . . . . . .11. . . . . 8. Is there a garage attached? 9. Size of building . . . . . . . . . . . . . . . . . . . . . . . . . Square footage 10. Number of stories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . i 11. Distance from finished grade to high point of roof . .Z ff. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . 12. Type of construction . . . .x.44 U. . r yC�,n�. . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . 13. Distance from building to street line in feet . . . . .k 5 U.1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14. Distance from building to side lot lines in feet:Left . . .d�. . . . . . . . . . . . . . . . . . . . Right . . . 5. . . . . . . . . . . . . . . . . . . . 15. Distance from building to rear lot line in feet . . . . . ►e.e . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16. Is a plot plan being filed with this application? . . .LAo... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . 17. Species of framing lumber:DF . . . . .1!. . . . . . . . . . . . . Spruce . . . . . . . . . . . . . . . . . . .. Other . . .. . . . . . . . . . . . . . . . . 18. Are all structural conditions noted on drawings? . . .'1 S. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . .. . . . . . . 19. Nature of land upon which the structure will be erected:Natural . . . . .. . . . . . . . . . . . . Filled . . . . . . . . . . . . . . . . . . . 20. Depth of basement or cellar floor below finished grade . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . .. . . . . . . . . . . . . . . . . r� 21. Material of foundation walls . . . . . .( . . . . . . . . . . . . . . . . . . . . . . Thickness in inches . . . . . . . . . .. . . . . . 22. Type of roof: Flat . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . Pitched . 1..!. . . . . . .. . . . . . . . . . . . . . . . . . . . .. . . . . . . 23. Material or roof covering . . .5.p�^�^`. . . . . . �.�^`.�J. : . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24. Method of heating . . . . . . . .`. .` . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25. Will the building conform to the Building and Zoning Ordinances? . . CAA S. . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . 26. Septic Tank? . . . ({ 1.�;V�",t. . . . . . . City Sewer? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27. Construction within 100 ft.of wetlands? . .0K.15 . -Llt `- . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28. Construction within 100 year flood plain? e. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29. Estimated cost: Total $ . . . . q. . . . . . . . . . . . . . . . . . . . . . . . . . . . . No building or structure which is erected or altered,shall be used,in whole or in part,for any purpose until a certificate of occupancy is issued by the Building Inspector. The undersigned certifies that the above statements are true to the best of his knowledge and belief. . . . . . // / . . . . . . . . . . . . . . . . . . Signature of Contractor Signature of responsible applicant WRITTEN DESCRY IPTION OF WORK TO BE DONE fl�. . . . .V fnYi`-�C. . . .(J,'�V . .`. . .�bc!... . .�.C'ta�.�. . ....� . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .� CA Ll ay.e. ! . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . I . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . at f Date Filed 11� 161 Z ' Q 0 o`') File No. ZONING PERMIT APPLICATION (§10.2) 1. Name of Applicant: C�Nv\ S Re Vno \ � S Address: L-,, C„,- N (� _ Telephone: L_e e-,c ck 2 . Owner of Property: � �1n ,, t-�0Y 5 Address: 2- :VC Telephone: 3 . Status of Applicant: Owner Contract Purchaser Lessee Other (explain: ) 4 . Parcel Identification: Zoning Map Sheet# _96 Parcel# c214/ , Zoning District(s) (include overlays) C'R/ W P Street Address ;L4 2jrch Lo 7,P Required 5. Existing Proposed bv Zoning Use of Structure/Property �.., (if project is only interior work, skip to #6) Building height B1dg.Coverage (Footprint) Setbacks - front o ioa - side iov` R fir ' L co ' R S - rear leo' o Lot size Frontage Floor Area Ratio %Open Space (Lot area minus building and parking) Parking Spaces Loading Signs Fill (volume & location) 6. Narrative Descript 'on of propord Work/Project: (Use additional sheets if necessary) 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: (/ 0 Z —Applicant' s Si � rr nature:� - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - / THIS SECTION FOR OFFICIAL USE ONLY: y Approved as presented/based on information presented Denied as resented s fo a ial: S natu c Bui ng Inspector 1Xate,1 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. PERMIT APPLICATION CHECK LIST PAGE PLOT 1 ZONE �I� YES NO DA.rE � `t I . ZONINQ FORM APPLICATION 2 . PERMIT APPLICATION L-- 3 . OWNER OCCUPANT alATEMENT IC . IF NOT �---' 4 . 3 SETS OF NS /PLOT PLAN �--- 5 . NEW CONSTRUCTION 6 , CURB CUT 7 , WATER UAILABI IT FORMS 8 . REMODELING INTERIOR 9 . ADDITION 0 , ACCESSORY STRUCTURE 11 , SIGN Z AWNING 12 . PERMIT FEE - CHECK ONLY - MONEY O 4 OR4 3t, 7a �� 13 , SPECIAL PERMIT REQUIRED WITH DEED IF APPLICABLE 14 , UNDER SECTION 127 - CMR 780 15 , FORM A 16 , FILL COMMENTS : 1'1 ,_- tj� ��.a a - � � z �.w•iv. n �. Cl Er Ln CL LI) OD CD R Q CD FT ° CD s y � Qcz� g' c.cm n, a N N W � E ' r Q o f° L o y � ° long O � 0 'Pow tz 5 y o d J R. R O D O cr D H+ Ul 0 0 c6 Q• I CT7 N p O O O• � � � S � �.. � I I s i I � o �• CD aCO) g � Jz tz CD i.�� v ►�'1 � � r'3• 'T "� r'7" 'r�• � �. �, �•• � fA Q CD /F••�+ � ra s � �• 5" o Cr ro O (S' OD n y CC3 rt c� cr �., c� a q��°! OA q EEL ID 1-1 CM o � R �Ly � o cm y � � j Cr1 5 5 0 0 .d �d p� N cn EL cr cr 1 p 5 O S cm O �j CO -ri A y (D r� }7. C C R• C O 5 N p Q C� O cn O Utz O cm Q 0 ON rA a y c z W