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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. J e y— I JI"r— Alterations
NORTHAMPTON, MASS. -4,-C -?s- 19 Additions
APPLICATION FOR PERMIT TO ALTER Repair
Garage
1. Location 7 3 Lot No.
2. Owner's name C Address 1 ? �f/°"y S7` >//�✓� ¢> .�``�`=r
3. Builder's name ° (�?--�t.fi� Address
Mass.Construction Supervisor's License No. 0ls� 7 Expiration Date--Z-0k«lP
4. Addition
5. Alteration
6. New Porch
7. Is existing building to be demolished?
8. Repair after the fire
9. Garage No.of cars Size
10. Method of heating
11. Distance to lot lines Zc6— 90' �cc-f— 7 S lee-"<- `<
12. Type of roof
13. Siding house
Goa
14. Estimated cosL- ,30LX-)
The undersigned certifies that the above statements are true to the best of his, her
knowledge and belief. —y
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Signature of responsible appJcant
Remarks
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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 col— to be filled in
by the Building TJepaztment
Required
Existing Proposed By Zoning
Lot sizeoG k i so
Frontage
Setbacks s
- side L: Ito R: TO L: l-Z6 R:_70
- rear
Building height 19c , -
Bldg Square footage
JUG 6 3 ooG
%Open Space:
(Lot area minus bldg
' &paved parking)
# .of -Parking Spaces
f 8 Loading Docks
Fill:
_4 vol-ume--& location)
13 . Certification: I hereby certify that the information contained herein
is true and accurate to the best of my knowledge.
DATE: �l�` /�6 APPLICANT's SIGNATURE
J" NOTE: issuance of a zoning permit does not relieve an -pp lioanYs burden to oompltr witlr,,.rQi�i
zoning requirements and obtain all required permits from the Board of Health. Conservation
Commission, Department of Publio Works and other appiloabla permit granting authorities:,
;,;; FILE #
3 W
File No.
ZONING PERMIT APPLICATION (§10 . 2)
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant:
Address:—,?/ OU���� S� 1 ��`� Telephone: RY7° .S^;4,��L
2. Owner of Property: yt%�'e�'` cze-1—
Address: / 7.3 Off° S"y" Telephone: Sey" -35
3. Status of Applicant: Owner U Contract Purchaser Lessee
Other(explain):
4. Job Location: 17J
Parcel Id: Zoning Map# Parcel# District(s): �''
(TO BE FILLED IN BY THE BUILDING DEPARTMENT
5. Existing Use of Structure/Property
6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary):
7. Attached Plans: t1--"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/Vadance/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 t'/ 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)
' FILE #
L- 3 IM 3
APPLICANVCO�fT CT PERSON:
ADDRESSIPMON'E: c,21 e02c
PROPERTY LOCATION:OCATION:
MAP Iz5t�- PARCEL:
THIS SECTION FOR�OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONTNC-FORM M-I ED OUT
FPO Pnid
Additirin to Existing
Cec�
G�2.
62&3
THE JEOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION:
Approved as presented/based 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
Permit from Conservation mission
Signature of ui p Date
NOTE: Issuance of at zoning permit does not relieve an applicant's burden to oomply with all
zoning requirements and obtain all required permits from the Board of Health. Conservation
Commission. Department of Publio Works and other applicable permit granting authorities.
City of Northampton REQUIRED INSPECTIONS
e BUILDING DEPARTMENT 2. Strucntural Components in Place*
3. Complete Building*
No. i 116 Office of the Building Inspector
Zoning Form No. 961768 Date 12 10 96 Fee$40.00 Check#11618
Page, 25C Parcel 139 ,Zone URB Section 127 ❑ Yes No
BUI]LDINGPERMIT
*Plumbing and Electrical Inspections required
THIS CERTII US THAT Roy Omasta before Building Inspections
has permission to install access ramp to rear entry door Inspection on Site—Foundations
situated on 173 North St - Robert Czelusniak Inspection of Plumbing—Rough
provided that the person accepting this permit shall in every respect Inspection of Plumbing—Finish
conform to the terms of the application on file in this office,and to the Gas Inspection
provisions of the Statutes and the Ordinances relating to the Construction, Inspection of Wiring—Rough
Maintenance and Inspection of Buildings in the City of Northampton.
Any violation of any of the terms above noted is an immediate revocation Inspection of Wiring—Finish
of this permit.Expires six months from date of issuance,if not started. Building Inspection—Rough
Note:A certificate of occupancy will be issued by this office upon return Insulation Inspection
of this card signed by the Plumbing,Wiring and Building Inspectors.
Building Inspection—Finish
Smoke Detectors(Fire Department)
Other
THIS CARD MUST BE DISPLAYED IN A CONSPICUOUS PLACE ON THE PREMISES
Certificate of Occupancy
Building Inspector