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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations
NORTHAMPTON, MASS. 19 Additions
APPLICATION FOR PERMIT TO ALTER Repair
a
/}y, Garage
1. Location 16 / 'Y' / Lot No.
2. Owner's name Address UVe, /4
3. Builder's name Address
Mass.Construction Supervisor's License No. rye 9VI Expiration Dat
4. Addition
5. Alteration C�2
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 cosL
The undersigned certifies that the above statements are true to the best of his, her
knowledge1 and belief. �}
Signature of responsible app!cane
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_X
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 Department
Required
Existing Proposed By Zoning
Lot size
Frontage
Setbacks
- side L: R: L: R:
- rear
Building height
Bldg Square footage
%Open Space:
(Lot area minus bldg
&paved parking)
# of Parking spaces
# fof Loading Docks
Fill:
(volume--& location)
13 . Certification: I hereby certify that the information contained herein
�f is true and accurate to the best of my knowledge.
DATE: APPLICANT's P"'6-
NOTE: Issunnoe of as zoning permit does not relieve an applioant's burden to comply with all
zoning requirements and obtain all required permits from the Board' of Health. Conservation
Commission, Department of Publio Works and other mpplionble permit granting authorities.
FILE #
File No.
ZONING PERMIT APPLICATION (§10 . 2)
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant: M 1
Address: / 7 Telephone: 9/
2. Owner of Property:
Address: X67 Telephone:
3. Status of Applicant: Owner /' Contract Purchaser Lessee
Other(explain): ( /�'Y.,z•aj
c_ -
4. Street Address: � a ��
Parcel Id: Zoning Map# 3/-PP Parcel#
J,') District(s): h ' ---
(TO BE FILLED IN BY THE BUILDING DEPARTMENT
5. Existing Use of Structure/Property ,�� /
6. Descnp'on of Propped Use/Work/Project/O cupa ' n: (Use ad ''onalsh is if necessary):
LA� t.
7. Attached Plans: C- 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__X___ 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 if
c _
APPLICANT/CONTACT PERSON: . . .
ADDRESS/PHONE:
PROPERTY LOCATION: _ et-
MAP
c=; %) PARCEL• . ONE ` Wit— vim'
THIS SECTION FOR-OFFICIAL USE ONLY:
PERK U T APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
7.nNING FORM VU,TFD 01I 7
Rnildinfir Permit Filled nia
-�' - , =�
L
OLLOWING ACTION HAS BEEN TARN 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: § w1ZONING 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
___Yerw4Lfrom CXjprvation Comm' n
FJ' -
Signature of Building Inspeclof Date _.
NOTE:lssuanoe of a zoning permit does not relieve an applioant's burden to oompty with all
zoning requirements and obtain all required permits from the Board of Health, Conservation —
Commisalon, Department of Publio Works and other appiioable permit granting authorities.
City p of Northam ton REQUIRED INSPECTIONS
BUILDING DEPARTMENT 1. Footings and Walls
2. Structural Components in Place*
3. Complete Building*
No. 65 Office of the Building Inspector
Zoning Form No. 960627 Date 2/13/96 Fee $20 Check# 1374
Page, 31B Parcel 35 , Zone URC Section 127 ❑ Yes U No
BUI]LDING PERMIT
* Plumbing and Electrical Inspections required
THIS CERTIFIES THAT Chimney Saver of W. MA/Andrew Church before Building Inspections
has permission to repair chimney,line chimney, install connector/clearoutli-tspection on Site—Foundations
situated on 16 Myrtle Street - Jim Young Inspection of Plumbing—Rough
provided that the person accepting this permit shall in every respect Inspection of Plumbing—Finish
conform to the terms of the application on file in this office, and to the Gas Inspection
provisions of the Statutes and the Ordinances relating to the Construction, Inspection of Wiring—Rough
Maintenance and Inspection of Buildings in the City of Northampton.
Any violation of any of the terms above noted is an immediate revocation Inspection of Wiring—Finish
of this permit.Expires six months from date of issuance,if not started. Building Inspection—Rough
Note:A certificate of occupancy will be issued by this office upon return Insulation Inspection
of this card signed by the Plumbing,Wiring and Building Inspectors.
Building Inspection—Finish
** Install per Manufacturer's information: windows, vinyl siding, roofs Smoke Detectors (Fire Department)
and woodstoves
Other
THIS CARD MUST BE DISPLAYED IN A CON$PjCjJOUS PLACE N T P SES
Certificate of Occupancy
Building Inspector
e City of Northampton REQUIRED INSPECTIONS
I- Footings and
$ BUILDING DEPARTM ENT 2. Structural Com P olnents in Place*
3. Complete Building*
No. 65 Office of the Building Inspector
Zoning Form No. 960627 Date2/13/96 Fee $20 Check# 1374
Page, 31B parcel 35 , Zone URC Section 127 ❑ Yes ®No
Bull.dDINGPEIR]
* Plumbing and Electrical Inspections required
THIS CERTIFIES THAT Chimney saver of W. MA/Andrew Church before Building Inspections
has permission to repair chimney,line chimney, install connector/clearoutl3rspection on Site—Foundations
situated on 16 Myrtle street - Jim Young Inspection of Plumbing—Rough
provided that the person accepting this permit shall in every respect Inspection of Plumbing—Finish
conform to the terms of the application or file in this office, and to the Gas Inspection
provisions of the Statutes and the Ordinances relating to the Construction, Inspection of Wiring—Rough
Maintenance and Inspection of Buildings in the City of Northampton.
Any violation of any of the terms above not A is an immediate revocation Inspection of Wiring—Finish
of this permit.Expires six months from da to of issuance,if not started. Building Inspection—Rough
Note:A certificate of occupancy will be issued by this office upon return Insulation Inspection
of this card signed by the Plumbing,Wiring and Building Inspectors.
Building Inspection—Finish 1z If 3 qG__�--
** Install per Manufacturer's information: windows,vinyl siding, roofs Smoke Deteo,ors (Fire Department)
and woodstoves
Other
THIS CARD MUST BE DISPLAY IN CON$PJCVOUS PLACE N TWPn U SES
Certificate of Occupancy
Building Inspector _�,