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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No.. �� � Alterations
SN r -`�
NORTHAMPTON, MASS. ,� 19 2�1_ Additions
APPLICATION FOR PERMIT TO ALTER Repair
Garage
1. Location: O/ 00 L E C /44 Ed DL) Lot No.
2. Owner's names D09707 Address a Ph/0--i F t N L&Z F40
3. Builder's name C?Address /r.-r-i f G7
Mass.Construction Supervisor's License No. Expiration Date �f 7
4. Addition
5. Alteration V'sm- b
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 costa
7v�• o c�
The undersigned certifies that the above statements are true to the best of his, her
know l and belief.
$ignaEttre ponsble .Pp,icanl
Remarks
10. Do any signs east 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 columm to be filled in
by the Building Department
Required
Existing Proposed By Zoning
Lot size
Frontage
Setbacks - frnnt
- side L: R: R:
- rear
Building height
Bldg Square footage
%Open Space:
(Lot area minus bldg
&paved parking)
# of Parking Spaces
# of Loading Docks
Fill:
(volume & 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: Innui6noib of an zoning permit does not relieve an npplioant's burden to oo with all
zoning requirements and obtain all required permits from the Board of Health, C servati.n
Commission, Department of Publio Works and other applioable permit granting authorities.
FILE #
File No.
ZONING PERMIT APPLICATION (§10 � Tf AMA
P T.F,A E TYPE OR P=T ALL =ORMATION
1. Name of Applicant:__ /D S f /U' K f lti f L Z
Address:, D / 04)1--C-5 I'te ged j Telephone:p 6�/-3j �� - yD(O's-
2. --
Owner of Property: Do /U OS
Address:,:,2,� FH/oeFC L b Al) FX0006-AJCCTelephone ,S .-S8 5 n f
3. Status of Applicant: Owner Contract Purchaser V Lessee f
- f
Other(explain):
4. Street Address: �J a � 197Ci'
Parcel Id: Zoning Map# Parcel# 0K J � District(s): Ul
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/Property_ I AJ G L r= FAM I L i oos
6. Description of Proposed Use/Work/Project/Occupation: (Use additonaFsheets 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 PermWad2nce/Finding ever been issued for/on the site?
NO DON'T KNOW 1/ 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? NC V 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 #
APPLICANT/CONTACT PERSON:
ADDRESS/PHONE: 7
PROPERTY LOCATION:
MAP Q`-I PARCEL: aLXZ-- ZONE
THIS SECTION FOR-OFFICIAL USE ONLY:
PERMTr APPLICATION CHECKLIST
ENCLOSED REQUIRED DATV
ZQNTNC�FORM M.IED MIT
Ft-g-paid
OLLOWING ACTION HAS BEEN TAKEN 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. § 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 Conservat Comm' s'on
�' 1r
Signature of Buil for D to
NOTE:Issuance of a zoning permit does not relieve an applicants burden to comply with call
zoning requirements and obtain all required permits from the Board of Health, Conservation
Commission, Department of Public Works and other applicable permit granting authorities.
tUW
Cit y Northampton of REQUIRED INSPECTIONS
$ e 1. Footings and Walls
BUILDINGDEPARTMENT 2. Structural Components in Place*
3. Complete Building*
No. 848 Office of the Building Inspector
Zoning Form No. 960305 Date 10/3/95 Fee $20 Check#2745
Page, 03 Parcel 9-601 Zone RR Section 127 ❑ Yes ® No
BUI]LDINGPERMIT
* Plumbing and Electrical Inspections required
THIS CERTIFIES THAT Frank Sienkiewicz before Building Inspections
has permission to construct a shed Inspection on Site—Foundations
situated on 501 Coles Meadow Road - Dlorothy Andros Inspection of Plumbing—Rough
provided that the person accepting this permit shall in every respect Inspection of Plumbing—Finish
conform to the terms of the application on file in this office, and to the Gas Inspection
provisions of the Statutes and the Ordinances relating to the Construction, Inspection of Wiring—Rough
Maintenance and Inspection of Buildings in the City of Northampton.
Any violation of any of the terms above noted is an immediate revocation Inspection of Wiring—Finish
of this permit.Expires six months from date of issuance,if not started. Building Inspection—Rough
Note:A certificate of occupancy will be issued by this office upon return Insulation Inspection
of this card signed by the Plumbing,Wiring and Building Inspectors.
Building Inspection—Finish
** Install per Manufacturer's information: windows,vinyl siding,roofs Smoke Detectors (Fire Department)
and woodstoves
Other
THIS CARD MUST BE DISPLAYED IN A C0N$PjCV0US PLACE ON THE PR,4MISjCLi0
Certificate of Occupancy
wilding Inspector