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Miscellaneous Additions,Repairs,Alterations,etc. / 1 Tel.No. � �" ( � Alterations
NORTHAMPTON, MASS. C 19 Additions
APPLICa ATION FOR PERMIT TO ALTER Repair
Garage
1. Location �- � � j Lot No.
2. Owner's name Address r q L,c.l<,�- -SI ..
3. Builder's name �c�c°�U�� `� <�.1 � S Addresses
Mass.Construction Supervisor's License No. �'irc7� - Expiration Date 7 z
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:-
The undersigned certifies that the above statements are true to the best of his, her
knowledge and belief. F'
Signature of responsible app,icant
Remarks
Y
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 L'
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 - frnnt
- 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:
':(vol-time--& location)
13 . Certification: I hereby certify that the information contained herein
is true and accurate to the best of my knowledge.
DA'Z'E: APPLICANT's SIGNATURE ___�_eA
NOTE: isau o f a zoning permit does not relieve an ioanYs burden to oompty with ali
zoning requirements and obtain aii required permits from the Board of Health, conservation
Commissian, Department of Publio Worlts and other npplionble permit granting authorities.
?! FILE
t� i File No.
t .. �
XNG PERMIT APPLICATION (§10 . 2)
PLEASE TYPE OR P=T ALL INFORMATION
1. Name of Applicant:
Address: �.r.f , Fes:?=.�S�r 1 Telephone:__ �--
2. Owner of Property: C �
Address: »�`f Telephone:
3. Status of Applicant: Owner contract Purchaser Lessee
Other(explain):
4. Job Location: '?L1 �j�"��r�_ ST _
Parcel Id: Zoning Map# / %+!`.- Parcei# District(s): C� �
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/Property
J
6 Description of Proposed UseANork/ProjecUOcc\u,pation: (Use additional sheets if necessary):
-4 �J1 GS `_VN.t?\�,.
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 PermiUVadance/Finding ever been issued for/on the site?
NO V 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 L' 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 3 3
o � �. �
ONA( T PERSON:
PROPERTY LOCATION: '7 �C6 '_
MAP / PARCEL: & ZONES THIS SECTION FOR-OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
MNTNCt FORM FTT,T,FD QITT ✓
FPP Pnirl
FPP Pnirl C LZ ZL2/<S�
1) '
Remndelina Tnterior lU'L cr- i
Addition t 0—
ArrPCCnry Stnirtnre
0 rnPr/0rrnnnnt ',qtntPment n .irf-me /'1,- 0 — —�
3 Setc of Plnnc /Plot Pinn
THE LOWING ACTION HAS BEEN TAKEN ON THUS AP ICATIOM .
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 Commissio
oe
O
Signature of Building Inspect ate
NOTE:tssuanoe of a zoning permit does not relieve nn npplloant's burden to oompty with ail
zoning requirements and obtain all required permits from the Board of Health, Conservation
Commisalon, Department of Public), Works and other applioable permit granting authoritles. _
t�M
City of Northampton REQUIRED INSPECTIONS
1. Footings and Walls
BUILDING DEPARTMENT
` 2. Structural Components in Place*
3. Complete Building*
No. 234 Office of the Building Inspector
Zoning Form No. 960833 Date 4/10/96 Fee $20.00 Check# 1212
Page, 17C Parcel 6 , Zone URB Section 127 ❑ Yes 0 No
BUI]LDINGPERMIT
* Plumbing and Electrical Inspections required
THIS CERTIFIES THAT Scott Harlow before Building Inspections
has permission to install replacement windows & repair slate. Inspection on Site—Foundations
situated on 24 Lake St. - Frederick & Arlene Fleisher Inspection of Plumbing—Rough
provided that the person accepting this permit shall in every respect Inspection of Plumbing—Finish
conform to the terms of the application on file in this office, and to the Gas Inspection
provisions of the Statutes and the Ordinances relating to the Construction, Inspection of Wiring—Rough
Maintenance and Inspection of Buildings in the City of Northampton.
Any violation of any of the terms above noted is an immediate revocation Inspection of Wiring—Finish
of this permit.Expires six months from date of issuance,if not started. Building Inspection—Rough
Note: A certificate of occupancy will be issued by this office upon return Insulation Inspection
of this card signed by the Plumbing,Wiring and Building Inspectors.
Building Inspection—Finish
** Install per Manufacturer's information: windows, vinyl siding,roofs Smoke Detectors (Fire Department)
and woodstoves
Other
THIS CARD MUST BE DISPLAYED IN A CON$PJCVOUS PLACE ON T P"MISES
Certificate of Occupancy
Building Inspector
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