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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. `� � Alterations
NORTHAMPTON, MASS. F� . 1 19 Additions
APPLICATION FOR PERMIT TO ALTER Repair
(� t� Garage
1. Location NAct: IN I IU'i- Itc Lot No.
c �7
2. Owner's name l.4 o-c-� Address
3. Builder's name t, t- Address f 1?4,/!Ad6-1 5fi
Mass.Conswc6on Supervisor's License No. l Expiration Date 5
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 cJ � � F> �/ cmot h r
13. Siding house
14. Estimated cost:-
The undersigned certifies that the above statements are true to the best of his, her
know edge and belief.
/ Signature of responsible app icant
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.
This CO2== to be oiled in
by the Balding 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)
-Parking Spaces
.,i_fof 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 knowledge.
a
DATE: . APPLICANT's SIGNATURE
NOTE: tasuanoa of at zoning permit does not relieve an ioant's bukden to ply
zoning requirements and obtain all required permits from the Board of Health, Convervation,s
Commission, Department of Publio Works and other applicable permit granting authorities:. =3 -
Sri: Y. FILE #
� File No.
/k&
ZONING PERMIT APPLICATION (§10 . 2)
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant: —�G�,� �` Q.k-etc,
r` '1
Address: 4�c','Tk Telephone:
2. Owner of Property: Iv I"cf--t c' r v.`•
Address/14r;.-',t Si- F/; (r.cc t' TTelephone:
3. Status of Applicant: Owner Contract Purchaser Lessee
Other(explain):
4. Job Location: ctw�
Parcel Id: Zoning Map# Parcel# c;2// District(s): 6 73
(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):
A4_i/ `�t�/!✓l.X/ 1KA''�"c
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
APPLICA /C61vTACT PERSON:
ADDRESS/PHONE: `
PROPERTY LOCATION:
MAP
17 c, PARCEL: ZONE C;�
THIS SECTION FOR OFFICIAL USE ONLY:
PERNUT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
Fop Pnid
Addition to Existing
f
THE FPL,LOWING 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
Permit from Conservatio ommissio
r
Signature of Bui g Ins Date
NOTE:Issuanoa of a zoning permit does not relieve an applicant's burden to comply with all
zoning requirements and obtain all required permits from the Board of Health, Conservation
Commission, Department of Public Works and other applicable permit granting authorities. —
e City of Northampton REQUIRED INSPECTIONS
RTMENT 1. Footings and Walls
G DEPA 2. Structural Components in Place*
3. Complete Building*
No. 814 Office of the Building Inspector
Zoning Form No. 961446 Date 9/11/96 Fee$112.00 Check#M07048669017
Page, 17C Parcel 211 , Zone GB Section 127 ❑ Yes ®No
BUI]LDINGPERMIT
* Plumbing and Electrical Inspections required
THIS CERTIFIES THAT John Young before Building Inspections
has permission to remove & install rubber membrane roof Inspection on Site—Foundations
situated on 85 Main St — Florence Savings Bank Inspection of Plumbing—Rough
provided that the person accepting this permit shall in every respect Inspection of Plumbing—Finish
conform to the terms of the application on file in this office, and to the Gas Inspection
provisions of the Statutes and the Ordinances relating to the Construction, Inspection of Wiring—Rough
Maintenance and Inspection of Buildings in the City of Northampton.
Any violation of any of the terms above noted is an immediate revocation Inspection of Wiring—Finish
of this permit.Expires six months from date of issuance,if not started. Building Inspection—Rough
Note:A certificate of occupancy will be issued by this office upon return Insulation Inspection
of this card signed by the Plumbing,Wiring and Building Inspectors.
Building Inspection—Finish
** Install per Manufacturer's information: windows, vinyl siding,roofs Smoke Detectors (Fire Department).
and woodstoves
Other
THIS CARD MUST BE DISPLAYED IN A C0N$PjCV0US PLACE ONE THE VAEMISES
!Certificate of Occupancy J
Building Inspector