22D-070 (3) PERMIT APPLICATION CHECK IST
PAGE -)-Z DPLOT -70 ZONE � � �� YES NO DATE
1 . ZONING FORM APPLICATION
2 . PERMIT I TI
3 . OWN NOT
3 SETS OF PLAN
5 . NEW CONSTRUCTION
6 . CURB CUT
7 WATER T S
8 . RE 0 I IO
9 . ADDITION
10 . ACCESSORY UC
11 . SIGN / AWNING
2 . PERMIT FEE - C - MONEY ORDER i/
13 . SPECIAL PERMIT REQUIRED WITH DEED---IF APPLICABLE
14 . UNDER SECTION 127 - CMR 780
15 . FOR
16 . FILL
COMMENTS :
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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations
NORTHAMPTON, MASS. 19 Additions
APPLICATION FOR PERMIT TO ALTER Repair
a
Garage
01 1 Location Lot No.
2. Owner's name Address
3. Builder's name - Address
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
I ' Siding house
(14. stimated cost:-
The undersigned certifies that the above statements are true to the best of his, her
knowledge and belief.
Si to oJresponsible appican!
Remarks
/rag
r
Date Filed 0010, File No.
ZONING PERMIT APPLICATION (510.2)
I . Name of Applicant: -dAAkj ljuf 4
771; &Address: , Telephone:
2 . Owner of Property: .
Address: Telephone:
3 . Status of Applicant:_L,,, �wner Contract Purchaser
Lessee Other (explain: )
4 . Parcel Identification: Zoning Map Sheet# L2� Parcel#70 ,
Zoning District(s) (include o rlays)
Street Address ,
Required
5. Existing Pro nosed —by Zoning
Use of Structure/Property
(if project is only interior rk, ki pUto #61 U
Building height
%B1dg. Coverage (Footprint) -
Setbacks - front
- side L: R: L: R:
- 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 Proposed Work/Project: (Use additional sheets
if necessary)
1
7 . Attached Plans : Sketch Plan Site Plan
8 . Certification: I hereby certify that the information contained herein
is true and accurate to the best of my knowledge..,
Date: ,2, Applicant's Signature.
ZApproved THIS SECTION FOR OFFICIAL USE ONLY:
as presented/based on information presented
Denied as presented--Reason:
Special Permi and/or Site Plan Required:
'nd ' g Re I e variance Required:
Q� 2
gnatur uilding Ins nacvt or "" to
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,Dopartmont of Public Works and other applicable permit granting authorities.
City of Northampton REQUIRED INSPECTIONS
' 1. Footings and Walls
BUILDING DEPARTMENT
0 2. Structural Components in Place*
I Complete Building*
No. 280 Office of the Building Inspector
Zoning Form No. 002483 Date 4/22/94 Fee $40 Check# 138
page, 22D parcel 70 Zone URA Section 127 ❑ Yes ® No
BUI]LDINGPERMIT
*Plumbing and Electrical Inspections required
THIS CERTIFIES THAT Lawrence J. Jones before Building Inspections
Repair water damaged bathroom floor, portion of roof,
has permission to sheetrock and miscellaneous repairs. Inspection on Site—Foundations
situated on 86 Florence Road 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
Smoke Detectors(Fire Department)
Other
THIS CARD MUST BE DISPLAYED IN A CONSPIC S P ON THE PREMISES
Certificate of Occupancy
� g spector i p„�11 Sil�1