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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations
1
NORTHAMPTON, MASS. 19 Additions
APPLICATION FOR PERMIT TO ALTER Repair
Garage
I. Location 1 ' ` `rrzifA�ri% �` �` Lot No.
2. Owner's name ;'#LAY �:�'f�5<'' Address /d
3. Builder's nameG �9,'��'f i, � �f Address �}�`=� S s F'�4,✓
Mass.Construction Supervisor's License No. 11-1 yT Expiration Date
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
12. Type of roof
13. Siding house
14. Estimated cost-,,J G}er"%
The undersigne certifies that the above statements are true to the best of his, her
knoe d belief.
y�
r'
Signature of responsible app,lcant
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 k'
IF YES,describe size,type and location:
11. ALL INFORMATION MAST BE COMPLETED, or PERMIT CAN BE DENIED DUE TO
LACK OF INFORMATION.
This colunin to be filled in
by the Building Department
(Required
Existing Proposed By Zoning
Lot size
Frontage
Setbacks - front
- side L: R: L: R:
- rear
Building height
Bldg Square footage
%Open Space:
(Lot area minus bldg
&paved parking)
# .,f -Parking Spaces
f rof Loading Docks
Fill:
Avol-ume--& location)
13 . Certification: I hereby certify that the information contained herein
is true and accurate to the best of my knowledge.
DATE: APPLICANT's SIGNATURE
NOTE: 1 an a of as zoning permit does not relieve m PP oanrs bu den to oom PAY wit
4,.•ell
zonin g requirements and obtain all required permits
from the Board of Health, Conservation
Commission, Department of Publio Works and other appiloable permit granting authorities:.-
?!; FILE #
,U
File No. a, 67)s
1
ZONING PERMIT APPLICATION (§10 . 2)
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant:-ff'%'/'S � clC
Address:, Telephone: / v��
2. Owner of Property:/ILIP�-' / ��
Address: -'v fz': ✓Telephone:
3. Status of Applicant: Owner Contract Purchaser Lessee
Other(explain):
4. Job Location: ?/--l
Parcel Id: Zoning Map# C _ 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: 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 X 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#
l
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)
FILE # f .� ,. ,..
JJ �
APR APPLWANVCONTACT PERSON:
,� -HONE:
ADD,.... � .a ,,,,nn
PROPERTY LOCATION: -)J-d3 6, nddt-
M[A-P___,�? - PARCEL: /!:°Z) ZO
THIS SECTION FOR.:OFFICIAL USE ONLY:
PER 11T APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM M.T,FD ()TTT
Bziilding Permit Filled nilt
- Fee Paid D
THE LLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION-
P"
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 Conservatio om i '
Signature of Building or Date
NOTE:Issuanoa of a zoning permit does not rolieva an applioant's burden to oompty with all
zoning requirements and obtain all required permits from the Board of Health, Conservation
Commission, Department of Publio Works and other applioabie permit granting authorities.
1tWY
A�°���"•A City Northampton TIof REQUIRED INSPECTIONS
BUILDING DEPARTMENT 1. Footings and Walls
2. Structural Components in Place*
3. Complete Building*
No. X32
Office of the Building Inspector
Zoning Form No. 962055 Date 4/3/97 Fee$20.00 Check# 1086
Page, 25(- Parcel 1 5o ,Zone_uRB Section 127 ❑ Yes 0 No
BUIULDING PERNUT
* Plumbing and Electrical Inspections required
THIS CERTIFIES THAT Charles Laveck before Building Inspections
has permission to install vinyl siding Inspection on Site—Foundations
situated on 21-23 Orchard St - Henry Bilsza 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
** Install per Manufacturer's information: windows,vinyl siding,roofs
and woodstoves Smoke Detectors(Fire Depamnent)
Other
THIS CARD MUST BE DISPLAYED IN A CONSPICUOUS PL C , T ISES
Certificate of Occupancy