16A-020 Nil- PERMIT APPLICATION CHECK LIST
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PAGE PLOT �X ZONE uhf- alb 0 'Ia-i--k-g-rk‘' C DA' E
1. ZONING FORM APPLICATION I q3
2. PERMIT APPLICATION
3. OWNER OCCUPANT STATEMENT / LIC.# IF NOT L .--
4. 3 SETS OF PLANS /PLOT PLAN
5. NEW CONSTRUCTION
6. CURB CUT
7. WATER AVAILABILITY FORMS
8. REMODELING INTERIOR -
9. ADDITION -
10. ACCESSORY STRUCTURE
11. SIGN / AWNING
12. PERMIT FEE - CHECK ONLY - MONEY ORDER a 1 ti6
13. SPECIAL PERMIT REQUIRED WITH DEED IF APPLICABLE
14. UNDER SECTION 127 - CMR 780
15. FORM A
16. FILL
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HOME IMPROVEMENT
CONTRACTOR
REG. # 108447
W1 RruG, IT BE Doti by Su A ; Trk' -ICC aT►fy, F1r:'[TRrt. r44 CONSTRUCTION SUPERVISOR
LIC. # 058487
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Zoning
Miscellaneous Additions, Repairs, Alterations, etc. Tel. No. -5 q 6 Alterations
%r NORTHAMPTON, MASS. F[�i +��o' - , 19 ! Additions
t APPLICATION FOR PERMIT TO ALTER Repair
Garage
1. Location 3o2 f A1i1t„'AY VILLAGE L C77 S^ Lot No.
2. Owner's name PAMtc.rra /SH AA; .s nil 2 . Address 3t: 2 t= A s w 2 t 4 • ) A Y V t L L ACS L
v+-* At C IK.;c.
3. Builder's name R o ta=ts C. w i. r r E Address 3 ``' c r r c i &? try" r A pt N e s it
Mass. Construction Supervisor's License No. a 543-1 '7 Expiration Date f3 -[ ( -ce 6,
4. Addition N/ 4
5. Alteration :u i A r - t D i u i D FT? - 8 15&-a-x.l i C c e ti e.) 5 4`e A 1T7 A c
6. New Porch A/A
7. Is existing building to be demolished? A 0
8. Repair after the fire xi/A
9. Garage N%H No. of cars Size
10. Method of heating El 17—T IL c:.
11. Distance to lot lines will b ra
12. Type of roof rui.4
13. Siding house ,i "jj�
14. Estimated cost- t✓ ® 1/c> 3jr;
The undersigned certifies that the above statements are true to the best of his, her
\q)
knowledge and belief. ... ---
Signature of responsible appilcant
Remarks EL TR +CAL 15 i T, H (CA iTl{y • ELE� TP IC /AA) ( FAtw2 WAY VP- LA GC L1S')
•
Date Filed 2 - •2 - 95- . _ File No. .
ZONING PERMIT APPLICATION ( §10. .
1 ) Nam of : d i C. t..� ► c - iZ, v � n It Cc. <r i _ __ __ t G ! lil _ _ Address :Applicant sc S t�3 - �' � ,- ; , -IILt e Telephoe: _S C�.s 73
2.) Owner of Property: 1',4.T�C'i�4ICHt xi Si7 -� R;
Address : - 33c, 2_ FA i 4 Al. i7 I L L i c e , 1r - ts Telephone: 5`6- 4. _ 7,(;- 2 - ,
3. Status of Applicant: Owner L Contract Purchaser • .
Lessee Other (explain • )
4. Parcel Identification: Zoning Map Sheet/ AA' „, P reel# ,
Zoning District (s) (include over ys) ja. �,� 5 •
Street Address :30;71 , L.V.0.1( 4 .
t, Required
5. • Existing Proposed by Zoning
Use of Structure /Property
(if project is only interior work, skip to #6)
Building height
%Bldg.Coverage (Footprint)
Setbacks - front
- side L: R: L: R:
- rear •
• Lot size
Frontage.
Floor Area Ratio
%Open Space (Lot area minus
building and parking) 1
Parking Spaces
Loading
Signs •
Fill (volume & location
6. Narrative Description of Proposed Work /Project: (Use additional sheets
if necessary)
L /
!' 'I V Le. r ' _ . f ; $ LLI- , , c -1— ,
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: Applicant s Signature � ” �..2�
THIS SECTION FOR OFFICIAL USE ONLY: .
t4Approved as presented /based on information presented
Denied as presented -- Reason:
Sp- ial'Permit and /or Site Plan Required:
• r 49.. • Req red: Variance Required'
S'gnatu - of'Bui •__ ••- spector U2 to
NOTE: lssuonco 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.
/c"71_
..,9 ..4. Cit y Northampton of REQUIRED INSPECTIONS
g • I 1 e 1. F :=::enmP 1 ace * BUILDING DEPARTMENT 2. S
' z,�__ == 3. Complete Building*
No.
65 Office of the Building Inspector
Zoning Form No. 003849 Date 2/2/95 Fee $ Check # 1990
Page, 16 A Parcel 20 , Zone URA /wsp Section 127 ❑ Yes MI No
BUILDING PERMIT
* Plumbing and Electrical Inspections required
THIS CERTIFIES THAT Robert white before Building Inspections
has permission to Construct a wall to divide basement Inspection on Site— Foundations
situated on 302 Fairway village, Leeds 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 'ti ik
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 % -a ` 3'
of this permit. Expires six months f r o m date o f issuance, if not started. Building Inspection — Rough b I " % 61
/ 41 6
Note: A certificate of occupancy will be issued by this office upon return Insulation Inspection i
of this card signed by the Plumbing, Wiring and Building Inspectors. �►;�
Building Inspection— Finish 0 V e i
Smoke Detectors (Fire Department)
Other
THIS CARD S E D .P ' YED IN A CONSPICUO S PJAAC ON ` 1 PREMISES
,<- i //4-4-
ti_,,Aiiicate of Occupancy
L _But •'ng Inspector s -
cni' 1 1.. 1 ; 1 ! ,,1`)1 j