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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations
NORTHAMPTON, MASS. 19 Additions
APPLICATION FOR PERMIT TO ALTER Repair
Garage
1. Location S-}-1 L.Sn+.) P+4C FLu(Z Co.3C f- V–\A- Lot No.
2. Owner's name MQS. L C L A 0 U Address
3. Builder's name S.Orj R00F,N(, Address �7 ►•J S "r L�A�tO��tJ���6_ i�Ps.
Mass.Construction Supervisor's License No. c) Z-1 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 5�vfj � �S't 2:r k%S T t NC 4,i A V 414 t �4-ti O-A %)-t- COY. , Cc LT fi'vx C,-C
13. Siding house %40
14. Estimated cost:- Z C1 o'O
The ndersign d certifies th t the above statements ar ue the best of his, her
knowl dg e and belief.
Slgnat-11. of responsible app, ant
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
IF YES,describe size,type and location:
11. ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE DENIED DUE TO
LACK OF INFORMATION.
This comma 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 minas bldg
&paved parking)
of -Parking spaces
t 6f Loading Docks
Fill:
4 vol-lime--& location)
13 . Certification: I hereby certify that th "nformation :contained h ein
rf+ is tru and accurate to the best of my o ledg
DATE
q S APPLICANT,s SIGNATURE
NOTE: Issuance of a zoning permit does not relieve an p liomnVu burden to oomp with all
zoning requirements and obtain all required permits f the Board of Health, C servation
Commission, Department of Publio Works and other a p cable permit granting a horities.
FILE #
OCT 1 61" r
Fi 1 e No.
DEPT c,F SUILM.-
ZONING PERMIT APPLICATION (� sy � ' <<n . ��
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant: m o 2 S c -�— S C�oJ �C?C' ► t-6
Address: 1 ? �� +,J szj i4kO�aV1Lc[elephone:
2. Owner of Property: -i=s --- -vim-- 4"A e S
Address:_ LScTN (�.� F_ Telephone:
3. Status of Applicant: Owner Contract Purchaser Lessee
Other(explain):
4. Street Address:
Parcel Id: Zoning Map# Parcel#� _ District(s):.
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/Property S „n EN + i
6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary):
I? {� r•)L Q (10-z C , - V-\t li 2 f-N S P a s ,� / �,S�Pr
1 0)4- QL / T L C0 Sty +N I�
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 YES IF YES,date issued:
IF YES: Was the permit recorded at the Regis f Deeds?
NO DON'T KNOW YES
IF YES: enter Book Page and/or ocument#
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 #
_ 1
APPLICANT/CONTACT PERSON*
ADDRESS/PHONE:
PROPERTY LOCATION:
MAP Z2 C, PARCEL: Zed ,3 ZONE
THIS SECTION FOR-.OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
Fee PAid
Rnilding Permit Filled ollt
a
T 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
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 r m Consery o Com is 'on
Signature of Buil for ate
NOTE:tssumnoe of es zoning permit does not relieve an applloanta burden to oomply with all
zoning requirements and obtain all required permits from the Board of Health, Conservation
Commisalon, Department of Publio Works and other applicable permit granting authorities.
City of Northampton REQUIRED INSPECTIONS
. Footings DEPARTMENT 2tructu al Components in Place*
3. Complete Building*
No. 897 Office of the Building Inspector
Zoning Form No. Date 10/16/95Fee$40 Check#
Page, 17C Parcel 103 ,Zone uRB Section 127 ❑ Yes No
BUI]LDING PERNM
*Plumbing and Electrical Inspections required
THIS CERTIFIES THAT J. Morse & Son Roof ing before Building Inspections
has permission to strip & re-shingle roof Inspection on Sites--Foundations
situated on 17 Stilson Ave. - Virginia Leland Inspection of Plumbing—Rough
provided that the person accepting this pen-nit 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
Smoke Detectors(Fire Department)
Other
THIS CARD MUST BE DISPLAYED IN A CONSPICUOUS PLACP VQ
Certificate of Occupancy
Building Inspector
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