17D-012 (15) PERMIT APPLICATION CHECK LIST
PAGE I PLOT l2 ZONE 1 4.'p6 YES NO DATE
1. ZONING FORM APPLICATION 6 0 f
2. PERMIT APPLICATION L�
3. OWNER OCCUPANT STATEMENT / LIC.# F NOT O 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& 237556 t..�'
13. SPECIAL PERMIT REQUIRED WITH DEED IF APPLICABLE
14. UNDER SECTION 127 - CMR 780
15. FORM A
16. FILL
COMMENTS:
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Zoning
Miscellaneous Additions, Repairs, Alterations, etc. Tel. No. Alterations t/
t"""° . NORTHAMPTON, MA SS . So') c ct (e 19 7 2_ Additions
" Repair
vo ..` APPLICATION FOR PERMIT TO ALTER Garage
1. Location 13 rt' cl a t RA.. Ili 0 r I a AA. p +-on m 1 • Lot No.
2. Owner's name Ill o r - 4 h 14 m P4 n /0 m e 41./ PS-Set, Address R ✓;1 t V. rue 4 f mp r6 4., M A. 610o 6
3. Builder's name h- to (( ,'Ctl�ci r h 4 Address 1) 44- it ew5 kJ. / C On;42 Asy en 9, 0/
Mass. Construction Supervisor's License No. 0 Y s F? Expiration Date � t /. / ?2
4. Addition
5. Alteration
6. New i' ,e)i tr —, Replace_
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 SCE ft
12. Type of roof
13. Siding house
14. Estimated cost:- ®U Q
' The undersigned certifies that the above statements are true to the best of his, her
j-40$ , knowledge and belief.
4 2( 4
Signature of responsible applicant
Remarks
PNINTiSHOP
Filed
'Date `'` File No.
ZONING PERMIT APPLICATION ( §10.2)
1. Name of Applicant: A./4.ti /C
Address: / , « , y ,( (Oro L.v Telephone: 34, 5 - ( 12 Z3
2. Owner of Property: 0 - cm, e • 4/0w irOL /C A5Soc ,
Address: g,.,‘_ t Act- m'.Telephone: Sy - 75 c
3. Status of Applicant: Owner contract Purchaser
Lessee Other (expla n
•
4. Parcel Identification: Zoning Map Sheet# /7.) Parcel# /z.,
Zoning Districts (include_oyerlays) v,Q t3 _
Street Address , rr 1 I "(�( •
� Required
5, Existing Proposed by Zoning
Use of Structure /Property
(if project is only interior work, skip to #6)
Building height 30'
%Bldg. Coverage (Footprint) 7 595
Setbacks - front yo'
- side gof
- rear
Lot size 626, g Acct.
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) Xepk,'f- ,gwd' ,'? /■ct ces
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: Ttug1C_ 2 4 Z Applicant's Signature :
THIS SECTION FOR OFFICIAL USE ONLY:
/
Approved as presented /based on information presented
Denied as presented
R -=s P fo
/ / 7,2_7
igna •r= of Buil .g - Spector 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 Heahh, ConsorvatiA Commission, Department of Public Works and other applicable permit granting authorities.
awls-, City of Northampton REQUIRED INSPECTIONS
J
' 1 . Footings and Walls
�J<. "`�' BUILDING 2 . Structural Components in
DEPARTMENT Place
3. Complete Building
rN No. 402 Office of the Building Inspector
Date June 30, 1992 19
BUILDING PERMIT
THIS MAY CERTIFY THAT Frank Kuzdeba /Meadowbrook Assoc. Insp. on Site — Foundations
has permission to Repair /replace decks at Meadowbrook Apts. Insp. of Plumbing — Rough
situated on Bridge Road 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 :IC OU. P, ACE ON THE PREMISES
Certificate of Occupancy .�., --- -- -'�° -��
7- -B.u-H Inspector
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