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12C-070 (7) 7 C j T � z v a � o v rn .. m �_ Zoning Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations NORTHAMPTON, MASS. Z0 Z f 7 19 Additions APPLICATION FOR PERMIT TO ALTER Repair /� / Garage 1. Location t., A ( a,,o l i c-t e Ff>� - fk rc � / r Lot No. 2. Owner's name .Iqd R Address A, a r CD 3. Builder's name_(x) e 7,et ,- OL T n Red. .-Address 63 Mass.Construction Supervisor's License No. ( i 6 3 C� 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 /I C, 13. Siding house 14. Estimated cosL- 0. The undersigned ce ifies that the above statements are true to the best of his, her knowled Ijti f. L Signature oJresponsible appicanl Remarks A . Do an signs exist on the roe YES NO 10 Y 9 property?.� 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: I.I. ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE DENIED DUE TO LACK OF INFORMATION. This col— to be Pilled in by the Bt ldiag 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 # of Loading Docks Fill: 4 vol-lime--& location) 13 . Certification: I hereby certify that the information contained herein is true nd accurate to the best of my knowledg DATE: � � APPLICANT's SIGNATURE S" NOTE: Issues cW#V a zoning permit does not relieve an pp \cant's bu en to comply witfr,'"h zoning requirements and obtain all required permits from the Board of Health, coinsarvation Commission, Department of Publio Works and other applionble permit granting authorities.,- ,. FILE # File No. �4`' ► ZONING PERMIT APPLICATION (§10 . 2) PLEASE TYPE OR PRINT ALL INFORMATION r 1. Name of Applicant: (� "e�7`r �-�7 /9 T5 �l/." z %Y a ,►/''r�.=�_ L _ - Address: �.4�` 5T S �` ��. ,�`���Telephone: 2. Owner of Property: /L'/24 L'e Address: 42 C 1 y'o �r �� r Fl-,t 0?e C, Telephone: SIK-1� Z 3. Status of Applicant: Owner Contract Purchaser r Lessee Other(explain) 4. Job Location: ,n l.�A I Parcel Id: Zoning Map# Parcel# District(s): (TO BE FILLED IN BY THE BUILDING DEPARTMENT) 5. Existing Use of Structure/Property fivlp1 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/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 rDDocument# 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 # 961613 APPLICANT/CONTACT PERSON: :n < ADDRESS/PHONE: PROPERTY LOCATION: � Zr� MAP PARCEL: 20 ZONE . . i THIS SECTION FOR-OFFICIAL USE ONLY: PER UT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ]RyiilfJin2 Permit MUM ptit -gernndelin2 Interior 4' lc d OLLOWING 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 I/ Variance Required under: § wIZONING 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 ommissio Signature of Building Ins Date NOTE:Issuanoe of a zoning permit does not relieve an applioant'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 applioable permit granting authorities. — tw,t City of Northampto n REQUIRED INSPECTIONS B . e 1. Footings and Walls BUILDING DEPARTMENT 2. Structural Components in Place* 3. Complete Building* No. 967 Office of the Building Inspector Zoning Form No. 961613 Date10/23/96 F420.00 Check# 1319 Page, 12C Parcel 70 ,Zone URA/WSP Section 127 ❑ Yes ©No BUHJDINGPERMIT * Plumbing and Electrical Inspections required THIS CERTIFIES THAT Western Mass siding & Roofing before Building Inspections has permission to strip & reshingle house roof Inspection on Site—Foundations situated on 42 Carolyn St - Addisson Kate 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 I s THIS CARD MUST BE DISPLAYED IN A CON$PJCVOUS PLACE ON VE PREMISES Certificate of Occupancy Building TnsPector __,-