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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations
NORTHAMPTON, MASS. 2.� —19 Additions
APPLICATION FOR PERMIT TO ALTER Repair
a Garage
1. Location Lot No.
2. Owner's name i= Address--) :,
3. Builder's name Address
J,
Mass.Construction Supervisor's License No. 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 certifies that the above statements are true to the best of his, her
knowledge and belief.
Signature of responsible app�icanl
Remarks
iAl.
R J. Dzialo & Associates
Consulting
Structural
Engineers
Registration
Connecticut
Massachusetts
New York
Vermont
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4s � 2
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n,.`�^ ;n •;�'� 19 Pleasant View Drive,Hatfield,MA 01038 Tel/Fax 413.247.5740
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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.
Thms colu= to be fiT7,.d ;Ln
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
%0p,en Space:
(Lot area minus bldg
&paved parking) �/ ✓ .. �f`. _ �/C
# 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: lase no of a zoning permit does not relieve an applioanYs burden to comply with all
zoning requirementa and obtain all required permits from the Board of Health, Conservation
Commission, Department of Publio Works and other applioabie permit granting authorities.
FILE #
3
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F11 e
DE"I OF SUILONG
ZONING PERMIT APPLICATION (§10 . 1
PLEASE TYPE OR PRINT ALL INFORMATION
1. Narne of Applicant:
Address: I, RAJ/, Telephone:_
2. Owner of Property:
Address: Telephone:
3. Status of Applicant: Owner Contract Purchaser Lessee
Other(explain):
4. Street Address:
- —
Parcel Id: Zoning Map# Parcel District(s): f
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
S. Existing Use of Structure/Property
Description of Proposed Use/Work/Project/Occupabon: (Use additional sheets if necessary):
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.
3 Has a Special PermitNanance/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#
3 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 # /
APPLICANT/CONTACT PEJtSON: 4 ° t2
ADDRESS/PHONE: �� , ��
PROPERTY LOCATION:
MAP PARCEL: ZONE ���`
THIS SECTION FOR-OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
Ee�;Paid ;O
.o ,
e . 3 � ,,-
rL��'� -
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OLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION:
A HI
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
P it from ervat' Commission
gnature of B ect — ate
NOTE:leauanoa of a zoning permit does not relieve an applicants 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.
19
City of Northampton REQUIRED INSPECTIONS
BUILDING DEPARTMENT 2. Footings Compo Walls
in Place*
3. Complete Building*
No. �___
Office of the Building Inspector
Zoning Form No. 960159 Date-8/31/95 Fee$100 Check#Money Order
Page, 05 Parcel 024 ,Zone RR/WSP Section 127 ❑ Yes El No
� r
BUILDING
PER?,.'4' 1T
* Plumbb-ig and Electrical Inspections required
THIS CERTIFIES THAT Larry Yntsch before Building Inspections
has permission to Add 2nd story bed,-oom & reconstruct front & back porches Inspection on Site—Foundations
ray
situated on 264 Audubon Road - Leeds - Ronald & Kathleen Korza Inspection of Plumbing—Rough t2- 2! {t' ` ,s `-
provided that the person accepting this permit shall in every respect
Inspection.of Plumbing—Finish n-PS"
conform to the terms of the application (,,.n file in this office, and to the Gas Inspection
provisions of the Statutes and the Ordinaw-es relating to the Construction, Inspec&.,)n of Wiring—Rough 1112 sus
Maintenance and Inspection of Buildings in the City of Northampton. / �
m �
Any violation of any of the terms above noted is an immediate revocation Inspection of Wiring—Finish �,yc Erg
of this permit.Expires six months from a ate of issuance if not started. tv U�
P ' Buildirvg Inspection—Roug �Tr
2 rtn;
Note:A certificate of occupancy will be issued by this office upon return Insulation Inspection k
of this card signed by the Plumbing,Wia-';ng and Building Inspectors.
Buildng Inspection—Finish r7k
Smoke Detec,,ors(Fire Department)
Other
THIS CARD MUST ]EAS LA IN CONSPICUOUS PLA("E N P SES
Certificate of Occupancy
Bu' ding Inspector
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