38B-229 (7) ' t
PERMIT APPLICATION CHECK LIST
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Yes No Date
1 . Zoning Form Application
2. Permit Application
3. Homeowner statement if a licable Lic , # if not
4, 2 sets of plans
5. Curb cut
6, Water Department memn
7. Permit fee - check ° �14 1' `'- v c-,c L--
$. Special Permit required with dged if
�9. Under section 127 10. F
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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations
a NORTHAMPTON, MASS. 19 Additions
Repair
APPLICATION FOR PERMIT TO ALTER Garage
1. Location 0 Lot No.
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2. Owner's name Address 6'- 4-,/ A/ '
3. Builder's name l�� �� 6 (e Addresses
Mass.Construction Supervi is License No. 00 6 Expiration Date
4. Addition
5. Alteration /i&f— Z�,- Lc,-'
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 statements are true to the best of his, her
knowledge and belief.
Signature of responsible applicant
Remarks
PR
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Date Filed File No. 9 5B -a-Z3
ZONING PERMIT APPLICATION (§10.2)
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1. Name of Applicapt: ':�L / G°'YsG
Address: l Telephone: -
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2 . Owner of Propert m
Address: (e Telephone:
3 . Status of Applicant: Owner Contract Purchaser
Lessee Other (expl in: )
4 . Parcel Identification: Zoning Map Sheet# 35'fi Parcel#:�';'-'l ,
Zoning District(s) (include overlays) c/ 1
Street Address
Required
5 . Existina Proposed by Zonin
Use of Structure/Property
(if project is only interior work, skip to #6)
Building height
%B1dg.Coverage (Footprint)
Setbacks - front
- side
- rear
Lot size
Frontage
Floor Area Ratio
%Open Space (Lot area minus
building and parking)
Parking Spaces
Loading
Signs
Fill (volume & location)
6. Narrative Description of Pr9posed Work/ rojec (Use it nal sheets
if neces ary 01-
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7. Attached Plans: Sketch Plan Site Plan
8 . Certification: I hereby certify that the information contained her in
is true and accurate to the best of my knowledge.
Date: , o2 Applicant' s Signature: j!
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THIS SECTION FOR OFFICIAL USE ONLY. '
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Approved as presented/based on information presented
Denied as presented
as n o)lr D nial:
S`ignat a of Bu ing Inspector Date
NOTE: Issuance 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
s 1 . Footings and Walls
BUILDING DEPARTMENT 2 . Structural Components in
Place
3 . Complete Building
No. 292 Office of the Building Inspector
Date May 21, 19 92
BUI DING P RMI
°' THIS MAY CERTIFY THAT Stephen Demski Insp. on Site — Foundations
rly
has permission to Build new sills on porch Insp. of Plumbing — Rough
i situated on 65 Fairview Ave. Insp. of Plumbing —Finish
provided that the person accepting this permit shall in every re- Insp. of Wiring — Rough
spect conform to the terms of the application on file in this office,
and to the provisions of the Statutes and the Ordinances relating Insp. of Wiring — Finish
to the Construction, Maintenance and Inspection of Buildings in Insp. of Health (Septic Tanks)
the City of Northampton. Any violation of any of the terms above
noted is an immediate revocation of this permit. Expires six Building Insp. — Rough
months from date of issuance, if not started. Building Insp. — Finish
Note:A certificate of occupancy will be issued by this office upon
return of this card signed by the Plumbing,Wiring and Building Smoke Detectors (Fire Dept.)
Inspectors. Gas Inspection
THIS CARD MUST BE DISPLAYED IN A CONS -ICUOUS,PL CE ON THE PREMISES
Certificate of Occupancy _
S�t r nspector