29-421 (5) t PERMIT APPLICATION CHECK LIST Page"& Plot
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Address : 3 a9 _ ,4G� Gc�la lv5/Q
'`` Yes No Date
1 . Zoning Form Application fs /
2. Permit Application l�
3. omeowne statement if a licable Li if not b1_1 [�
4. sets of olans
5. Curb cut ---.-----
6. Water Department
7. Permit fee - h
$ Special Permit required with deed
9 Under section 127 -
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Grlt� of Xort4ampton 1z
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' DEPARTMENT OF BUILDIXG INSPECTIONS
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INSPECTOR 212 Main Street ' Municipal Building
Northampton, Mass. 01060
AS A HOMEOWNER I UNDERSTAND THAT I MAY APPLY FOR AND RECEIVE
A BUILDING PERMIT FOR A HOME OR ADDITION I INTEND TO LIVE IN.
I ALSO UNDERSTAND THAT I AM RESPONSIBLE FOR KNOWING THE STATE
BUILDING CODE AND ZONING ORDINANCE OF THE CITY OF NORTHAMPTON.
BEING A HOMEOWNER AND NOT A PROFESSIONAL CONTRACTOR IN NO WAY
ABSOLVES ME OF ANY RESPONSIBILITY TO INSURE THAT ALL FACETS
OF THE RULES AND REGULATIONS ARE COMPLIED WITH.
Signature a
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BETTER BUILT
BUILT- ON SITE
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SIZES 8l PRICES : ON COMPLETE BUILDING
6x6 $635 10x10 $ 995
6x8 $730 10x12 $ 1,125
600, $795 1004 $ 1,255
602 $910 10x18 $ 1,675
ADD MA. SALES TAX
S
8x8 $ 795 1202 $ 1,255'
8x40 $(""g 1 012x14 $ 1,485
8x12 $ 995 12x16 $ 1,675
8x14 $ 1,125 12x20 $ 2,350
NOT RESPONSIBLE FOR BUILDING PERMITS
PRICES AND SPECIFICATIONS ARE SUBJECT TO CHANGE WITHOUT NOTICE
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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. -ya(� Alterations
ioatTOti NORTHAMPTON, MASS. 19 Additions
APPLICATION FOR PERMIT TO ALTER Repair
Garage
1. Location f � d✓ �'�? �L P W C ZF- lr4o, Lot No.
/► 7r
2. Owner's name /�'�/G� /�L�- � -� Address ;/"'t1h
3. Builder's name-d,- ` , E',, ;/T :/air —Address—('/- QRO-'>R'
Mass.Construction Supervisor's License No. Expiration Date
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:'
The undersigned certifies that the above state nts are true to the best of his, her
knowledge and belief.
Signatur of r p,onsXplappUcant
Remarks
•
PNINTnSHOP
• Date Filed File. No,
ZONING PERMIT APPLICATION (§10 . 2) -
1
Name ,-of Applieant:jll�/< �(--1_ �7
Address : ' �'o I'�'� �x2 . fi r . �, :f Telephone; L
2 , . Owner of Property;
Address : • Telephones
3 . - Status of Applicant:AOwner contract Purchaser
Lessee Other (explal—n: ),
4 , Parcel Identification: Zoning Map Sheet# : ' ,
Zoning District (s) (in.clude overlays) U /� v�'1,
Str.eet Address r
5 , cYuired
Existing Proposed Rt:
by {off in
Use of Structure/Property
(if. project 'is. only interior work, skip to 6)
Building height - /O
%15ldg . Coverage (Footprint) '
Setbacks - ,front i00 —
- s i d d - _ --- .
- rear
Lot-'size —_�
Fr.outage :.
Floor, Area Ratio
%0pe:n Space (Lot area 'minus
J ui,,l:ding and parking)
Parkinqj ,Spaces _.....___.
Loading " �-
Signs
Fill (vol ume & location) '._.•_
6 . Narrative Description- of Proposed Work/Pro j;ect: (Use additional .Fsheets
if
necessary) /0 L ✓�.
7 . ' Attached Plans : Sketch Plan Site P1'an
8 Certification: I' hereby certify that the information contains herein
is true and accurate to the best of my knowledge, /
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-Date., Applicant ' s Signature:
' -• —' —'rrHxB SECTION ron OPVICXAL USH ONLY! % w
• Approve•d as 'presented/based on inforittation' presented
Denied as presented
ea n-f ehial : .
S gna u a of B g nspe.ctor pate
NOTE: (sauanco of a zoning,pormit doca not rollcvo an applicant's burdon to comply wlUt all zoning roquiremonts and obtain all rvduircd ponrits
from tho Board•o(Hon)th, Conaarvation Commission, ()opautmont of Public Worka and oUior appiicablo ponnit gratUng authauillos. .
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