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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations
NORTHAMPTON, MASS. l9 4(o Additions
APPLICa ATION FOR PERMIT TO ALTER Repair
Garage
1. Location 6A 2A A410ZIOdAl A04'7 L"Elf-1-25 Lot No.
2. Owner's name R, G'- Ali GoL✓ Address X70 A,,,o i<3��r✓ / �i�tJ , L EIS
3. Builder's name /-L7 12-/L`f .T 51,-1v73Gh- Address /// �ll�`
Mass.Construction Supervisor's License No. 6)Y 611116 Expiration Date S-/i L L�iv
4. Addition
5. Alteration SHilydG Cayrti �niTl /���
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 /.Voj%)7
14. Estimated cost-
The undersigned certifies that the above statements are true to the best of his, her
knowledge and belief.
nature of responsible app icant
Remarks
10. Do any signs exist on the property? YES NO t--l"
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 DUB TO
LACK OF INFORMATION.
This colts= 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 minus bldg
' &paved parking)
of -Parking spaces
fHof Loading Docks
Fill:
4vol-ume-& location)
13 . Certification: I hereby certify that the information contained herein
is true and accurate to the best of my knowledge.
DATE =v2r!�- '7-6 APPLICANT's SIGNATURE -�.1-, �„ a
NOTE: issuanoe of a zoning permit does not relieve an eapplican4i IJACjr6den to Damply 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 ,
MAR
File No. / J �
ZONING PERMIT APPLICATION (§10 . 2)
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant: ,r jilt /2 T
Address: /i/ 14/s9 ii=2 �T/Ld` T 4�E , 5 T elephone: acs y- `17Sy
2. Owner of Property: R. C. All cO4-
Address: AUDU,30if/ S Telephone: 6 r 4'!Z&
3. Status of Applicant: Owner r-"'Contract Purchaser Lessee
Other (explain):
4. Job Location: of o9Liv��J.�d/✓ 2aJt0 Ls�d�5
Parcel Id: Zoning Map# Parcel# '�1 1 P District(s):
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
S. 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/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 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 # J
MAR 2 7 199Ei
S
A , LICANT/CONTACT PERSON:
ADIESS/PHONE:
PROPERTY LOCATION: r 6,-Ix ,:
MAP ' PARCEL: ZONE
THIS SECTION FOR-OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
Fee Pnid
FPPPnid C 2 ��
M e�`
TH,,FOLLOWING ACTION HAS BEEN TARN 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 from Conservation Co "ission
Signature of Building Inspector D to
NOTE:Issuanoa of a zoning permit does not relieve an applioant's burden to oompty with all
zoning requirements and obtain ail required permits from the Board of Health, Conservation
Commission, Department of Publio Works and other appiioable permit granting authorities.
City of Northampton REQUIRED INSPECTIONS
$ � 1. Footings and Walls
BUILDING D 2. Structural Components in Place*
3. Complete Building*
No. 181 Office of the Building Inspector
Zoning Form No. 960773 Date 3/28/96 Fee$20.00 Check# 124
Page, 5 Parcel 27 , Zone RR/WSP Section 127 ❑ Yes ❑ No
BUI]LDING PERMIT
* Plumbing and Electrical Inspections required
THIS CERTIFIES THAT Larry Yentsch before Building Inspections
has permission to isntall new shingles on roof. Inspection on Site—Foundations
situated on 278 Audubon Road - Leeds - Richard Nicoli Inspection of Plumbing—Rough
provided that the person accepting this permit shall in every respect Inspection of Plumbing—Finish
conform to the terms of the application on file in this office, and to the Gas Inspection
provisions of the Statutes and the Ordinances relating to the Construction, Inspection of Wiring—Rough
Maintenance and Inspection of Buildings in the City of Northampton.
Any violation of any of the terms above noted is an immediate revocation Inspection of Wiring—Finish
of this permit.Expires six months from date of issuance,if not started. Building Inspection—Rough
Note:A certificate of occupancy will be issued by this office upon return Insulation Inspection
of this card signed by the Plumbing,Wiring and Building Inspectors.
Building Inspection—Finish
** Install per Manufacturer's information: windows, vinyl siding, roofs Smoke Detectors (Fire Department)
and woodstoves
Other
THIS CARD MUST BE DISPLAYED IN A CON$PJCVOUS PLAC ON T ISES
Certificate of Occupancy
Building Inspector