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17C-284 (6) a ,> T A z > > v0 Z ^' m -s Zoning Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations NORTHAMPTON, MASS. 19 Additions APPLICATION FOR PERMIT TO ALTER Repair a Garage 1. Location L, Lot No. 2. Owner's name D e lklt,CLS Address ov 3. Builder's name Sa C C Address Mass.Construction Supervisor's License No. © x-1-4 alt Expiration Date 30 l' 4. Addition p� 1 � 5. Alteration I�,c� Q✓e�`�t��i r., C�N�f1P�! TC�P � � �,� � � vV i���� 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- \t (g p o The undersigned certifies tha the above statements are true to the best of his, her knowledge and bqief. U Inature of responsible appicant 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 colu= 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 # of Loading Docks Fill: (volume & location) 13 . Certification: I hereby certify that the information contained herein is true nd accurate to the best of my knowled e. DATE: �,"S �� APPLICANT'S SIGNATURE NOTE: lean noe of a zoning permit does not relieve an applioant's bu den to oomph/ with all zoning requirements and obtain all required permits from the Board of Health. Conservation Commission. Department of Publio Works and other appiloable permit granting authorities. FILE # k LLUfi y 4 Fi 1 e No. % � �`( AUG ZONING PERMIT APPLICATION (§1 D A �t F1l.}`dli;Y PLEASE TYPE OR PRINT ALL INFORMATI 1. Name of Applicant: � r Address: -1 r n Telephone: 2. Owner of Property: a ( 0 Address: ZS �� T �c C Telephone: 3. Status of Applicant: Owner Contract Purchaser Lessee Other(explain): 4. Street Address: Z Parcel Id: Zoning Map# C— Parcel#_c�, 1 District(s): (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 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`1 _ FILE F APPLICANT/CONTACT PE ON: ADDRESS/PHONE: � PROPERTY LOCATION: C � e-e Ax/t/-1)-/xAa17 MAP PARCEL: ZONE THIS SECTION FOR-OFFICIAL USE ONLY: PERMUI'APPLICATION CHECKLIST ENCLOSED REQUIRED DATE Rito ding Permit Filled nut Epe Paid -Remodeling Intprenr C� t t, 77717-1 I Srtc of Pia �OLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION: y 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 Permi onservation Commission Signature of Bui ding Inspecto Date NOTE:iss canoe 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. City of Northampton REQUIRED INSPECTIONS ' s BUILDING DEPARTMENT 1. Footings and Walls 2. Structural Components in Place* 3. Complete Building* No. 717 Office of the Building Inspector Zoning Form No. 960158 Date 8/24/95 Fee$20 Check# 5648 Page, 17C Parcel 284 , Zone URB Section 127 ❑ Yes No BUI]LDINGPERMIT * Plumbing and Electrical Inspections required THIS CERTIFIES THAT Sam Gabriel before Building Inspections has permission to rebuild chimney Inspection on Site—Foundations situated on 28 Lilly St. - Florence - Robert Ross Inspection of Plumbing—Rough provided that the person accepting this permit shall in every respect Inspection of Plumbing—Finish conform to the terms of the application on file in this office, and to the Gas Inspection provisions of the Statutes and the Ordinances relating to the Construction, Inspection of Wiring—Rough Maintenance and Inspection of Buildings in the City of Northampton. Any violation of any of the terms above noted is an immediate revocation Inspection of Wiring—Finish of this permit.Expires six months from date of issuance,if not started. Building Inspection—Rough Note:A certificate of occupancy will be issued by this office upon return Insulation Inspection of this card signed by the Plumbing,Wiring and Building Inspectors. Building Inspection—Finish ** Install per Manufacturer's information: windows, vinyl siding,roofs Smoke Detectors (Fire Department) and woodstoves Other THIS CARD MUST BE DISPLAYED IN A C0N$PJCV0 P ACE O H PREMISES Certificate of Occupancy Building Inspec ttAM Gty of Northampton REQUIRED INSPECTIONS e 1. Footings and Walls BUILDING DEPARTMENT'. 2. Structural Components in Place* 3. Complete Building* No. 717 Office of the Building Inspector Zoning Form No. 960158 Date, 8/24/95 Fee$20 Check# 5648 Page, 17C Parcel 284 , Zone URB Section 127 ❑ Yes No BUHI,JDING PE ' !1 * Plumb:ng and Electrical Inspections required THIS CERTIFIES THAT Sam Gabriel before Building Inspections has permission to rebuild chimney Inspection on Site—Foundations situated on 28 Lilly St. - Florence - Robert Ross Inspection of Plumbing—Rough provided that the person accepting this permit shall in every respect Inspectio?i of Plumbing—Finish conform to the terms of the application on file in this office, and to the Gas Inspection provisions of the Statutes and the Ordinances relating to the Construction, Maintenance and Inspection of Buildings in the City of Northampton. Inspectjon of Wiring—Rough Any violation of any of the terms above noted is an immediate revocation Inspection of Wiring—Finish of this permit.Expires six months from dnte of issuance,if not started. Building Inspection—Rough Note:A certificate of occupancy will be issued by this office upon return Insulation Inspection of this card signed by the Plumbing,Wiring and Building Inspectors. Building Inspection Finish ** Install per Manufacturer's information: windows, vinyl siding, roofs and woodstoves Smoke Detectors (Fire Department) Other THIS CARD 4BEISP Y D IN A CON$PJCVO P ACE O H PREMISES Certificate of Occupancy Building Inspec