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17A-070 (4) a > ? i T � D 3 O rn _ r C_ Z > yp Z �� v re r ...1 •.► m .Z1 r � Q Zoning Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. _ Alterations NORTHAMPTON, MASS. 19__ Additions APPLICATION FOR PERMIT TO ALTER Repair Garage 1. Location I I)v v1� (%e In a, Lot No. 2. Owner's name -VN C� vY-, s c.t^I- Address c, t- 3. Builder's name `� j 1 i Mass.Construction Supervisor's License No. ice Expiration Date t 4. Addition 5. Alteration 6. New Porch 7. Is existing building to be demolished? S. Repair after the fire 9. Garage No.of cars Size 10. Method of heating 11. Distance to lot lines 12. Type of roof I- `z. '° i�l�C', -- �TYZ� h ©2�.�'t 13. Siding house 14. Estimated cost:- ` S C 0 The undersigned certifies that the above statements are true to the best of his, her knowledge and belief. 1 Signature of responsible appicam 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 -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: 4 vo1-dme--& location) 13 . Certification: I hereby certify that the information contained herein �f is true and accurate to the best of my knowledge. _1. DATE: APPLICANT's SIGNATURE NOTE: lss ano of a zoning permit does not relieve an appl ant's burden to comply with all z9ning requiraments and obtain all required permits from t e Board of Health. Conservation .. Commission. Department of Publio Works and other appliogible permit granting authorities. !,. FILE # Fi1e No. � ZONING PERMIT APPLICATION (§10 . 2) PLEASE TYPE OR PRINT ALL INFORMATION .� ll 1. Name of Applicant: 4e �js Address: 2 � ' Telephone: L4 ioH S 2. Owner of Property: Address: 12 � LyTelephone: 3. Status of Applicant: _Owner Contract Purchaser Lessee Other(explain): / 9 4. Job Location: Sa w� Parcel Id: Zoning Map# Parcel# "70 District(s): ,Z� (TO BE FILLED IN BY THE BUILDING DEPARTMENT) 5. Existing Use of Structure/Property � � N�sc r � 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_ >e _ YES IF YES: enter Book Page and/or Document# 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 # lJ `� 7 r / APPLICANT/CONTACT PERSON ADDRESS/PHONE: 9 PROPERTY LOCATION: mAP 12W PARCEL: ZONE_ THIS SECTION FOR.OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLO ED REQUIRED DATE MNYNC�FORM FILLED 0111 Fee Paid 11nilding Permit Filled out 3 Sets of Plans I Pint Plan J _ V� L� THE/10-LLOWING ACTION HAS BEEN TAKEN ON THIS AP ICATION: 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 Mlimission �/ /.S z Signature of Building Da(e NOTE:lssuanoe of a zoning permit does not relieve an applioant's burden to oomply with all _ zoning requirements and obtain ail required permits from the Board of Health, Conservation Commission, Department of Publio Works and other applioeble permit granting authortUes. City of Northampton REQUIRED INSPECTIONS 1. Footings and Walls �► BUILDING DEPARTMENT 2. Structural Components in Place* 3. Complete Building* No. 730 Office of the Building Inspector Zoning Form No. 961347 Date 8 15/96 Fec$20.00 Check# 569 Page, 17A Parcel 70 ,Zone URA/WSP Section 127 ❑ Yes ® No BUI]LDINGPERNUT * Plumbing and Electrical Inspections required THIS CERTIFIES THAT Newman's Construction/Cyrus Newman before Building Inspections has permission to strip & reroof house Inspection on Site—Foundations situated on 12 Mountain St - Mario Simeone Inspection of Plumbing—Rough provided that the person accepting this pemiit 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 CONSPICUOUS P C Old ISES Certificate of Occupancy Building Inspector