23B-015 (6) PERMIT APPLICATION CHECK LIST
a �7
PAGE .9166' PLOT 15- ZONE ��� YES NO DATE
1. ZONING FORM APPLICATION
/2
2. PERMIT APPLICATION
3. OWNER OCCUPANT STATEMENT / LIC.# IF NOT
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
1 2 . PERMIT FEE - ' ONLY - MONEY O R D E R /
13. SPECIAL PERMIT REQUIRED WITH DEED IF APPLICABLE
14. UNDER SECTION 127 - CMR 780
15. FORM A
16. FILL
COMMENTS: ,
-o .
v b o• r
a
cc zrrn
0 r
R xo
E n et Z
5 • -
rri
O
o C O M
\o
1
Zoning
Miscellaneous Additions, Repairs, Alterations, etc. Tel. No. Alterations
..+ NORTHAMPTON, MASS. OCk0 A D 1 9 q; Additions
� Repair
(.17.t.. ," A PPLICATION FOR PERMIT TO ALTER
+_ t 1� c,A Garage
1. Location 1 t `C t \'C,� �Nut,t"K �0 (\ Lot No.
2. Owner's name Vr W.s t 0 i TAO Pc. -a`t Address Selvvi 41. ll \ i ^ -
3. Builder's name Q w' (%OO( /r� to + S \. l� Address t,J"QST S'i ek.AY
Mass. Construction Supervisor's License No. [``) LC1 0 `i _ Expiration Dateq` / I*t"
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 514 "Ac �
i 0 t �v4 r O \∎ fob '
13. Siding house
14. Estimated cost: - $ j CA '15 6
The undersigned certifies that the above statements are true to the best of his, her
knowled and belief.
y 10 - 3 I. 6 L l....-e- , , J .. ..r.L.(4
Signature of responsible applicant
Remarks
rrMrrin W
•
4 U
i.� i.
i J
Date Filed c 3 r File No. OO1 ""''
�G� � ZON ING PERMIT APPLICATION ( §10.2)
1. Name of Applicant: �(DtV\ coO
Address: S (,Jas A ,45 o-✓l Telephone: �;) -3Gy,o
2. Owner of Property: _ sv t, OcAVLO Vec9-«S
Address: / (-4 -Q lc s 1 Telephone:
3. Status of Applicant: Owner Contract Purcl?aser
Lessee Other (explain: cyloc.`1 C ✓+-j -ON )
4. Parcel Identification: Zoning Map Sheet# A
C r Parcel# /5
Zoning District(s) (inc ude erlays)
Street Address Z . ' .eQ,�Q - 1
Required
5. Existing Proposed by Zoning
Use of Structure /Property 0 -94,�c ,uaJ�
(if project is only interior work, skip to #16)
Building height
%Bldg.Coverage (Footprint)
Setbacks - front
- side L: R: L: R:
- rear
Lot size
Frontage •
Floor Area Ratio
%pen Space (Lot area minus
building and parking)
Parking Spaces
Loading
Signs
Fill (volume & location)
6. Narrative Description of Proposed Work /Project: -0
ct: ,(Use additional s eets
if necessary) A..�,n. \, o� s \o.e. cA to 6) '( ;b1/4 -(.../k ern ' F 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: O i 3 Applicant's Si `^� ,, IAA
Z `d � pp nature: -
Signature:
l// THIS SECTION FOR OFFICIAL USE ONLY:
res
p A p as presented/based on information presented
Denied as presented -- Reason:
S•- cial'Perr't and /or Site Plan Required:
and' g R-.ui .d: Variance Required:
i�_.� � � • io< q 11
S •f Buildi •= nspector Dat
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.
esdnAHP2,.
City of Northampton REQUIRED INSPECTIONS
.-1-
k Alit ' * 1. Footings and Walls
'-'J'=� id •
B U LDING DEPARTMENT 2. Structural Components in Place*
`m''� =: =- 3. Complete Building*
No. 1039 Office of the Building Inspector
Zoning Form No. 001922 Date 11/12/93 Fee $20 Check # 1491
Page, 23 B Parcel 15 , Zone GI Section 127 ❑ Yes la No
BuILDING PERMI
* Plumbing and Electrical Inspections required
THIS CERTIFIES THAT Pepin Roofing before Building Inspections
has permission to Re shingle roof Inspection on Site—Foundations
situated on 6 Hatfield Street 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 retum 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 / • U P ', / ON THE PREMISES
Certificate of Occupancy / a % - -
Bu' : spector f,