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17C-164 (6) 'C o j T � v � o. Oil v Z r"7 Ile rn Z a Zoning Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Shy—/��� Alterations NORTHAMPTON, MASS. Coot )-� 19 Additions APPLICATION FOR PERMIT TO ALTER Repair 1 r f -t Garage I. Location Y-f C4 L°S fi ILL)l 5/ / Lot No. 2. Owner's name 41r"yZP_ �►-i d f-os Address �('l �i e-5' n t,-If 3. Builder'sname ��r�r Ps C��fk Address Mass.Construction Supervisor's License No. CAW 3/0 Expiration Date !t-" 4. Addition A/A 5. Alteration 6. New Porch 7. Is existing building to be demolished? 8. Repair after the fire /1''/oq 9. Garage /?/ No.of cars Size 10. Method of heating l✓ 11. Distance to lot lines��// 1 j 12. Type of roof C_-/')G n r to Old /5 f r,p 1 'f n e W �e UL e 0L1 b ,206'x, 13. Siding house 14. Estimated cost--� 9000 The undersigned certifies that the above statements are true to the best of his, her knowledge and belief. /►� Signature of responsible app!cant Remarks 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. T2ds color= to be ffll«i im by the Bnildiny Department Required Existing Proposed By Zoning Lot size Frontage Setbacks -side L: R: L: R: - rear Building height Bldg Square footage %Open Space: (Lotarea minus bldg ' &paved parking) of Parking spaces f of Loading Docks Fill: y _4v0l-1ime--& location) 13 . Certification: I hereby certify that the information contained herein �f is true and accurate to the best of my knowledge. .1 DATE: -7/J C- c' APPLICANT's SIGNATURE NOTE: Issuance Jf a zoning permit does not relieve an appl cant's burden to oom zonin Ply_ .; � g requirements and obtain all required permits from the Board of Health. Congervatlon.;; Commission, Department of Publio Works and other appiiomble permit granting authorities _- ';t. FILE # File No. �f1 ZONING PERMIT APPLICATION (§10 . 2) PLEASE TYPE OR PRINT ALL INFORMATION 1. Name of Applicant: v^ d c J Address. curet Telephone: ( 7 2. Owner of Property: 13Ut-- Address: (9( �V ���� S� Telephone: 3. Status of Applicant: Owner �Contract Purchaser Lessee Other(explain): 4. Job Location: c�l C�1�7�i��rt� Parcel Id: Zoning Map# I"7e—. Parcel# l ' District(s): 'Ci (TO BE FILLED IN BY THE BUILDING DEPARTMENT) 5. Existing Use of Structure/Property ?+�"U1• 6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary): n NQom" voz i N24ZI-4J644 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) i ' FILE � 6 APPLICANT/CONTACT PERSON: ADDRESS/PHONE: PROPERTY LOCATION: MAP '(� PARCEL: ZONE ..�{ THIS SECTION FOR-OFFICIAL USE ONLY: PERNUT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONTNC�FORM FULED OUT 1Rjdldin2 Permit Filled plit ' 1,3%C THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS AP ICATION: < Approved as presentedlbased 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 mission Signature of Building Ins p Date NOTE:Issuance of a zoning permit does not relieve an applicant's burden to comply with all zoning requirements and obtain ail required permits from the Board of Health. Conservation Commission. Department of Public Works and other applicable permit granting authorities. City of Northampton REQUIRED INSPECTIONS e BUILDING DEPARTMENT 2. Swccttugral Walls Components in Place* 3. Complete Building* No. 877 Office of the Building Inspector Zoning Form No. 961523 Date_9/27/96 Fee$40.00 Check#3631 Page, 17C Parcel 164 ,Zone URB Section 127 ❑ Yes No BU1[1,.'-,D1NGPERM1r1 * Plumbing and Electrical Inspections required THIS CERTIFIES THAT Roger Clark before Building Inspections has permission to strip, plywood, & reroof Inspection on Site—Foundations situated on 81 Chestnut St - olive Andrus Inspection of Plumbing—Rough provided that the person accepting this permt 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 el-K . Smoke Detectors(Fire Department) Other THIS CARD MUST BE DISPLA IN A CONSPICUOUS PLACE ON RE ISES Certificate of Occupancy OP"building Inspector Go�'1 l:�f" Bile