17A-174 r�
r�
10. Do any signs ebst 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 N0
IF YES,describe size,type and location:
11. ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE DENIED DUE TO
LACK OF INFORMATION.
This ccly W be filled in
by the 8nilding Department
Required
Existing Proposed By Zoning
Lot size g S
s.
Frontage
Setbacks
- side L: R: L: R:
- rear v
Building height
Bldg Square footage �d
%Open Space:
Lot area minus bldg �Z}
&Paved parking!
# of -Parking spaces
f of Loading Docks
Fill:
{vol-ume--& location)
13 . Certification: I hereby certify that the information contained herein
is true and accurate to the best of my kno edge.
DATE: APPLICANT's SIGNATURE l �>
NOTE: Issuan a of a zoning permit does not relieve an appli ant's burden to oomply wit4-all
zoning requirements and obtain all required permits from the Board of Health. Conservation
Commission. Department of Publio Works and other applloable permit granting authorities.
FILE #
AU G - ? "Col File No. moo
DEPT OF BUILDING IN N PERMIT APPLICATION (§10 . 2)
TypE OR PRINT ALL INFORMATION
1. Name of licant:
AAP q
Address: G G Telephone: / 73
2. Owner of Property: C 9 C Z' (C
Address: 7 AV f Telephone:
3. Status of Applicant: Owner Zcontract Purchaser Lessee
Other explain): f (�
4. Job Location: Q ���� ( �^� 1 ►—lL�' 7 l�.S
Parcel Id: Zoning Map# Parcel# District(s):
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
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 wi the Building Dept or Planning Department Files.
8. Has a Special Permit/Variance/Finding ever be issued for/on the site?
NO DON'T KNOWS YES IF YES,date issued:
IF YES: Was the permit recorded at the Registf Deeds?
NO DON'T KNOWL_ YES
IF YES: enter Book Page and D ument#
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)
08/07/01 3:23:36 PM
RESIDENTIAL PROPERTY RECORD CARD CITY OF NORTHAMPTON, MASSACHUSETTS EFFECTIVE DATE OF VALUE: J Y 1, 1998
PARCEL ID: 17A-174-001 KIMBALL ST PLOT: LIVING UNITS: 0 CLASS: R - 130 CARD #: 1 OF 1
CURRENT OWNER/ADDRESS ZONING: URB NEIGHBORHOOD ID: 5.00 FINAL VALUE FLAG: COST VALUE
KIREJCZYK JOSEPH C & MADALYN J LAND DATA
173 NORTH MAPLE ST TYPE SIZE INFLUENCE FACTORS LAND VALUE ASSESSMENT INFORMATION -
FLORENCE MA 01062 SECONDARY 7668 -50 9,780 PRIOR COST CURRENT
LAND 9,800 9,800
BLDG
DEED BOOK: 1518 TOTAL 9,800 9,800 9,80C
DEED PAGE: 604 SALES INFORMATION
DEED DATE: TOTAL ACREAGE: 0.176 TOTAL LAND VALUE: 9,800
LAST UPDATE/COST: 8291997 DATE TYPE PRICE VALIDITY
LAST UPDATE/COST: 8291997
ADDITION DATA
X DATE:
DATA COLLECTION INFORMATION Lower Level First Floor Second Floor Third Floor Area
A
ENTRANCE CODE: EXTRY & SIGN B
INFORMATION SOURCE: C
DATA COLLECTOR: D
DATE: E
F
DWELLING INFORMATION G -
H �.
STYLE:
YEAR BUILT:
J O
STORY HEIGHT:
ATTIC: af
Basement: {
TOTAL ROOMS: p
z
TOTAL BEDROOMS: o z n V
FULL BATHS: ADDITIONAL DWELLING INFORMATION B
Half Baths:
BASEMENT GARAGE(#CARS) ADDITIONAL FIXTURES: o a
EXTERIOR WALLS: BRICK TRIM: X �
UNFINISHED AREA: STONE TRIM: X rn Q
GROUND FLOOR AREA: Z
TOTAL LIVING AREA: REMODELING DATA
FINISHED BASEMENT LIVING AREA: X �
BASEMENT RECREATION AREA: X YEAR REMODELED:
MASONARY FIREPLACE STACKS/OPENINGS: /
METAL FIREPLACES: KITCHEN REMOD(Y/N)
HEAT/CENTRAL A/C: BATH REMODEL (Y/N)
HEATING SYSTEM:
FUEL TYPE:
QUALITY GRADE: PHYSICAL CONDITION
COND/DESIRABILITY/UTILITY INTERIOR/EXTERIOR
OUTBUILDINGS & YARD ITEMS PERMIT DATA ?' '
TYPE QTY YR SIZEl SIZE2 GRD COND DATE PURPOSE PRICE Ti
1
NOTES:
File#MP-2002-0019
APPLICANT/CONTACT PERSON David McCutcheon
ADDRESS/PHONE P O BOX 43 (413)529-9973
PRO
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
C=:FO ILLED O T
Building Permit Filled out
Fee Paid
Typeof Construction: LEGAL BUILDING LOT
New Construction I �
Non Structural interior renovations r
Addition to Existing;
Accessory Structure1 � , `!
Building Plans Included:
., LJi
Owner/Statement or License
3 sets of Plans/Plot Plan t4j '
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICA
INFORMATION PRESENTED: � 1
Approved Denied
PLANNING BOARD PERMIT REQUIRED UNDER: § ,, ,t ;j��� � ;�1;•�
Intermediate Project: Site Plan OR Special Permit a
Major Project: Site Plan OR Special Permit ar
ZONING BOARD PERMIT REQUIRED UNDER: §
Find 9i Vari
Proo
1(415 ov
ty
cr G11 — to
1oi-J5 Sa (gotS 11 Wate
C I _ Permi
Signature of
Note: Issuance of a Zoning permit does not relieve a applicant's burden to comply with all zoning
requirements and obtain all required permits from Board of Health,Conservation Commission,Department
of public works and other applicable permit granting authorities.
*Variances are granted only to those applicants who meet the strict standards of MGL 40A. Contact the Office of
Planning&Development for more information.