17A-149 (10) -p o
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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No.725._Ll?'2.5— Alterations
NORTHAMPTON, MASS. l 1926 Additions
a I APPLICATION FOR PERMIT TO ALTER Repair
Garage
1. Location e,>C ` Lot No.
2. Owner's name Address . '
3. Builder's name Address � of
Mass.Construction Supervisor's License No. C5 o��-�, 9 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
13. Siding house
14. Estimated cost-
The undersigned c that the above ements are true to the best of his, her
knowledg beli
2
ignature of responsible app,icane
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 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:
(volume & location)
13 . Certifi tion: I hereby certify that the information conta n d herein
is tr n accurate to the best of my kno edg .
DATE: APPLICANT's SIGNATU
NOTE: Issuanoe of a zon ng permit does not relieve an ap ioanVs 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.
FILE #
j File No.
ZONING PERMIT APPLICATION (§10 . 2)
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant: d
Address: % C c' eleph ee
2. Owner of Property:
Address: YZe! D:> 0 6 06 A�d2 /16-4/-:�
pho/ne:
3. Status of Applicant: Owner <,<— Contract Purchaser Lessee
Other(explain): �/C,
4. Street Address:
Parcel Id: Zoning Map# Parcel# District(s): .
(TOD IN BY THE BUILDING DEPARTMEN
5. Existing Use of Structure/Property �
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/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 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 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 # g�
APPLICANT/CONTACT PERSON:
ADDRESS/PHONE:
PROPERTY L CATION: ��!i! !�u� Z 2C/ r''ifL
MAP PARCEL: ZONE Jf �G
THIS SECTION FOR-OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
lffizildin2 Permit Filled plit
Fp�; Paid
-Remndelin2 Interior
Additenn to Existing
!'C
Z
�r
TOLLOWING ACTION HAS BEEN TAKEN ON THIS AP ICATION:
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 rom Consery 0
L1 C
Signature of Building Ins for Date
NOTE: Issuance of a zoning permit does not relieve an applicant'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.
City of Northampton REQUIRED INSPECTIONS
$ e 1. Footings and Walls
BUILDINGDEPARTMENT 2. Structural Components in Place
3. Complete Building*
No. 901 Office of the Building Inspector
Zoning Form No. 961543 Date 10/1/96 Fec$20.00 Check# 5519
Page, 17A Parcel 149 Zone URA Section 127 ❑ Yes ® No
BUI]LDINGPERMIT
* Plumbing and Electrical Inspections required
THIS CERTIFIES THAT Bob Thibodo before Building Inspections
has permission to strip & reshingle house Inspection on Site—Foundations
situated on 28 Fox Farms Rd - Helen Ahearn Inspection of Plumbing—Rough
provided that the person accepting this permit shall in every respect Inspection of Plumbing—Finish
conform to the terms of the application on file in this office, and to the Gas Inspection
provisions of the Statutes and the Ordinances relating to the Construction, Inspection of Wiring—Rough
Maintenance and Inspection of Buildings in the City of Northampton.
Any violation of any of the terms above noted is an immediate revocation Inspection of Wiring—Finish
of this permit.Expires six months from date of issuance,if not started. Building Inspection—Rough
Note:A certificate of occupancy will be issued by this office upon return Insulation Inspection
of this card signed by the Plumbing,Wiring and Building Inspectors.
Building Inspection—Finish
** Install per Manufacturer's information: windows,vinyl siding, roofs Smoke Detectors (Fire Department)
and woodstoves
Other
THIS CARD MUST BE DISPLAYED IN A CON$PJCIJOUS ACE MISES
t Certificate of Occupancy ,•�
Building Inspector
o =