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14. Estimated cost:- 1-4 t a U U
The undersigned certifies that the above statements are true to the best of his, her
Signfiture of responsible app icant
Remarks ��/,t=�� rnt tt iy- „; ;) yf
Zoning
Miscellaneous Additions,Repairs,Alterations,etc.
Tel.No. J
Alterations
Alterations
ti NORTHAMPTON, MASS._-
�7/ g�
Additions
APPLICATION FOR PERMIT TO ALTER
Repair
Garage
1. Location
Lot No.
2. Owner's name
Address
3. Builder's name l � �„
Address t V -13
O S
Mass.Construction Supervisor's License No.Tj
"3 Expiration Date
�U// 2
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:- 1-4 t a U U
The undersigned certifies that the above statements are true to the best of his, her
Signfiture of responsible app icant
Remarks ��/,t=�� rnt tt iy- „; ;) yf
10. Do any signs exist on the property?
IF YES,describe size,type and location:
YES
NO ><
Are there any proposed changes to or additions of signs intended for the property?YES
IF YES,describe size,type and location:
I►LTL07
II. ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE DENIED DUE TO
LACK OF INFORMATION.
This cols to be filled in
by the Building Department
r1_-...•.._J
13 . Certification: I hereby certify that the information contained herein
is true and accurate to the best of my knowledge.
DATE: APPLICANT's SIGNATURE fi
NOTE: laadan'q6 i6f I zoning permit does not relieve a applio nt-s burden to oom
PAY wit h,.,all
zoning requirements and obtain all required permits from the Board of Health, Conservation
Commission, Department of Publio Works qnd other applioable permit granting authorities:..
FILE
Existing
Proposed
Inuquiieu
By Zoning
Lot size
Frontage
Setbacks
- side
- rear
L: R:
L: R:
Building height
Bldg Square footage
%Open Space:
(Lot area minus bldg
&paved parking)
of _Parking Spaces
f rof Loading Docks
Fill:
(vol-lime--& 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 fi
NOTE: laadan'q6 i6f I zoning permit does not relieve a applio nt-s burden to oom
PAY wit h,.,all
zoning requirements and obtain all required permits from the Board of Health, Conservation
Commission, Department of Publio Works qnd other applioable permit granting authorities:..
FILE
File No. cv % ,
ZONING PERMIT APPLICATION (§10 . 2)
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant: �Mcs CA
Address: C, 0 0 5 Telephone:
2. Owner of Property: Ec (a 4�� I V
Address: (ri U yW �Y �je r I 0 Telephone:
3. Status of Applicant: Owner _Contract Purchaser Lessee
Other(explain):
4. Job Location: S V rv1 vk e, tie
Parcel Id: Zoning Map# Parcel#��l 3i�trict(s): t
(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/Vadance/Finding ever been issued for/on the site?
NO DON'T KN011A___X _ 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 if 1 /)<0
LICJANT/CONTACT PERSON:
ADDRESS/PHONE:
io
PROPERTY LOCATION:
MAP PARCEL: ZONE
I- 7(-
THIS SECTION FOR-OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
=1 0(1
_ENCLOSED.REOUIRED DATE
THE�LLOWING ACTION HAS BEEN TAKEN ON THIS APMICATION:
!!//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
_Septic Approval-Bd of Health
!Permit from Conservation
Water Availability Sewer Availability
_Well Water Potability-Bd Health
9%
Signature of BU g Date
NOTE:lssuanoe 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 Publio Works and other applioabie permit granting authorities.
City of Northampton REQUIRED INSPECONS
TI
BUILDING DEPARTMENT 1. Footings and Walls
2. Structural Components in Place*
3. Complete Building*
No. �Sn
Office of the Building Inspector
__
Zoning Form No. 962081 Date 4/9/97 Fee $20.00 Check# 570
Page, 17C Parcel 171 ,Zone URB Section 127 ❑ Yes 0 No
BUI]LDING PERNUT
* Plumbing and Electrical Inspections required
THIS CERTIFIES THAT Ronald Mistarka before Building Inspections
has permission to strip & reshingle house roof Inspection on Site—Foundations
situated on 26 Sumner Ave - Ed Adkins Inspection of Plumbing—Rough
provided that the person accepting this perrnit 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 pen-nit.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
and woodstoves Smoke Detectors(Fire Department)
Other
THIS CARD MUST BE DISPLAYED IN A CONSPICUOUS PLACE ON TNt PKPMISES
Certificate of Occupancy