17A-188 (5) T ,.y
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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. ->�� Alterations
a NORTHAMPTON, MASS. aZ Z.- 192—,7 Additions
APPLICATION FOR PERMIT TO ALTER Repair
Garage
1. Location �/ .fi ,e j Lot No.
2. Owner's name Address wai/
3. Builder's name �� F:+=+�°L Address a v 0/O
Mass.Construction Supervisor's L' ense No. Expiration Date
4. Addition
5. Alterations A
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 cos4 �,�qzv oo
The undersigned certifies that the above statements are true to the best of his, her
knowledge an lief.
$1 pure of responsible app:icani
Remarks Z;;c/,� CifS /.d✓e'r>.o .,� i; i4 fact�/J,Pvr
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FEB 1 1 1997
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10. Do an signs exist on the roe YES NO
Y 9 property?�
IF YES,describe size,type and location:
Are there any proposed changes to or additions of signs intended for the property?YES NO y
IF YES,describe size,type and location:
11. ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE DENIED DUE TO
LACK OF INFORMATION.
This cola 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)
o.,f -Parking Spaces
# of Loading Docks
Fill:
_(vol-time--& location)
13 . Certification: I hereby certify that the information contained herein
is true and accurate to the best of my know dge.
DATE: // 7 APPLICANT's SIGNATURE
?" NOTE: lss anoe of a zoning permit does not relieve an a lloant' urden to oom wit
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zoning requirements and obtain all required permits from the Bbfird of Health, Conservation
Commission, Department of Publio Works and other applioable permit granting authorities:..
?' ,, FILE #
y 4l
YuEB I File No. i
ZONING PERMIT APPLICATION (§10 . 2)
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant: p
Address: �pX /o?o' &; 4, Otdj�S' _Telephone:
2. Owner of Property: g 4 /O
Address: Telephone: 6w- Odlyd
3. Status of Applicant: Owner Contract Purchaser Lessee
Other(explain):
4. Job Location: / ��
Parcel Id: Zoning Map# Parcel#� District(s): f %�
(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 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 KNOA/ 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 l// 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)
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FILE if
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APPLICANT/CONTACT PERSON:
ADDRESS/PHON'E: Z-1 c- / �! ��� cis 3
PROPERTY LOCATION:
MAP PARCEL: I ZONt ,�-
THIS SECTION FOR-OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FH.T.F.D OUT
Fee P-gid
Mdldin2 Permit Filled mit
Fee PAii
Type of Constmirtion-
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THEYOLLOWING 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
it fr con ion
Signature of Building e for D to
NOTE:Issuanoe of a zoning permit does not relieve an applioant's burden to oompty with all
zoning requirements and obtain all required permits from the Board of Health, Conservation
Commission, Department of Pubiio Works and other applioable permit granting authoritles.
City of Northampton REQUIRED INSPECTIONS
BUILDING DEPARTMENT 1. Footings and Walls
V a 2. Structural Components in Place*
3. Complete Building*
No. 100 Office of the Building Inspector
Zoning Form No. 961923 Date 2/11/97 Fee $40.00 Check# 1292
Page, 17A Parcel 188 ,Zone URB Section 127 ❑ Yes 0 No
BUI]LDINGPERMIT
*Plumbing and Electrical Inspections required
THIS CERTIFIES THAT Craig Marney before Building Inspections
has permission to Remodel closet area into new bathroom Inspection on Site—Foundations
situated on 21 Kimball St - George/Margaret Tobin 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 ofissuance,ifnot 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
Smoke Detectors(Fire Department)
Other
r THIS CARD MUST BE DISPLAYED IN A CONSPICUOUS PLACE ON SES
• Certificate of Occupancy
Building Inspector