18D-004 (29) PERMIT APPLICATION CHECK LIST Page" &
L7)(21 Address: - �� �_
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Yes No Date
1. Zoning Form Application
2. Permit Application v
3. Homeowner statement if applicable /Lic. # if not
4. 2 sets of plans _ arc `c 1 ri •
5. Curb cut _ __ __ ..__._
Water Department mpmn -------
7. Permit fee - check only e . s' 1714 CIC)
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$. Special Permit required with deed if applicable
9. Under section 127 - (:MR 7Af
Q. Firm A
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Zoning
Miscellaneous Additions, Repairs, Alterations, etc. Tel. No. Alterations
+ . 0 ',„ ; „,,, ( N,, ,. NORTHAMPTON, MASS . 19 Additions
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SAO APPLICATION FOR PERMIT TO ALTER Garage e
1. Location /0 D,gmric- A d - ti 1i- /h A m/2 h4 /7 - Lot No. //
2. Owner's name W j!//' A �1 1 .o e /{ Address /06 1 / / h / �]'/9110.
3. Builder's name 7i1 4 ? 441kd t.4 -- -- Address
Mass. Construction Supervisor's License No. a// c: d f i1 Expiration Date 6 3 9 3
4. Addition _.__. - ,
5. Alteration V/(! 4.2. ,41.e.rGaC,)
6. New Porch
7. Is existing building to be demolished? X..)0
8. Repair after the fire X-#)
9. Garage it-/A" No. of cars Size
10. Method of heating fci/9'
11. Distance to lot lines A/4
12. Type of roof /r-l/4
13. Siding house Al/4
14. Estimated cost:-
i I C ®0 ` 00 The undersigned certifies that the above statements are true to the best of his, her
knowl1 d b lief.
7L �
r of Signature of responsible applicant
Remarks
PH YN, _TaSHOP
R ' A.' o c.A... 1
Data Pile ._ ''3(��9a, Fi1e. No,•. _T
• ZONING PERMIT APPLICATION (§ 10 , 2) '
1. Name ;of Applicant; /X) i LS Ch, .1./..___:•__________/ - .
, Addr.ess ; /A O RWI K-dL' .alt- /I�xc p � k21 it. Tslgphone I Y/3 2I` ,6�zot
2 c Owner of Property; , / . t L,___,fLq Ps ) 4 &
. " Address I )hl, d gvit „ ! ,,; , e •__p • Tel -phone; / r& 7
. • 3,,•,3tatus of Applicant; V6wner Contract Purohasex
Lessee other. (explain; • T T ,
4. Parcel Identification; Zoning ;dap Sheet# jc ?_P Parcely.4
. Zoninci District (s) (in.clude,, overlay,;a) . e .____.- __ -__,_-
Sty; e e t Ad d r e s s , ( .t. �� - Cc stir r� /',, . _ c ._..,...
. ' 1lucl.tivod ,
5. I;xist;incl ' Proposed . i?y �'�a.ying
Use of Structure/Property •
(if. project 'is only interior work, skip to #{6) ,
• ' • Building height • • • _
' kp1clg. Coverage (Footprint)
• . . S,ethacks - front ' ' ..,,_
- side ' �
. - rear . _ _
Lo't•'size _ • .: I''r.pntage '
. , . ' I Area Ratio
%Ct.p in Space (Lot Arod 'minus '
, l iai'.7ding And parking) . ' — _._. _,..:. _
1 Par }rind 'Spaces '
'Loading • ___..._•.
Sig _._...
• , I (volume & location) • • , •
6 Narrative Description' of Proposed Plork /Pro j (Use addi);iontil , F..,heets
rl F e s s a r y) /trA o6' as v� -i �. k .....___.
' .7 , • ' Attaohed Plans: % I. Sketch Plan Site Plan .
•
8, ' .: Certif ieation: •,I' hereby certify . that the information oonttainecl hG.t a in
a, ' i'i true and aecura a to the best of my knowledge. •
•
- .Date! 3J b 4 a- Applicant t•s Signature; I • 1, V7 -k— ^ •
" T '' THIS SECTION foil O F'I�'IOIJ L. USE ONLY I '.• • . I ' i.
. b"' Approved as 'liroseritod /based on inforlu.at'ion pre sented ' • , • • '
Deniecl as preseni:e,d. •
4wesorl : for 6ial
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Snatu of Bui lcl ' nspa.ctor
•
Data
NOTE: laauanoo of a zoning doaa not rollovo an appllount'a burdun to ow nph'w,.Jl1,a_J zott n rodulfamont and ob
btahl all ryqu4t'd ponniu
from the Board,of Flonith, Conoorvallon Cornmlaoion, Dopalmont of Publlo worlt a op 4p1r0ob*¢ j inl►.proiitInp atrthnrillua, •
. MAR Q
n .s MA1\ 2 8
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City of Northampton REQUIRED INSPECTIONS
1 . Footings and Walls
,,,,,.-,T.1".;,:
"��- �� :''.;
-.:
, ;. BUILDING DEPARTMENT 2' Structural Components in
- ' =1 '� Place
• • `. 3. Complete Building
No. 188 Office of the Building Inspector
Date April 10, 1992 19
\ . .
_,, BUILDING PE 1, ,' MIT
THIS MAY CERTIFY THAT William & Evelyn Mock Insp. on Site — Foundations
has permission to Renovate section of room - put up 2 walls Insp. of Plumbing — Roughar• it T ��
situated on 100 Damon Road Insp. of Plumbing — Finish ,,,- 9 "5
provided that the person accepting this permit shall in every re- ' Alkosolo
Insp. of Wiring — Rough
spect conform to the terms of the vpplication on file in this office, v/ C� '�
and to the provisions of the Statutes and the Ordinances relating Insp. of Wiring — Finish / t F„.r e . ii �' ,,„
to the Construction, Maintenance and Inspection of Buildings in I nsp. 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. — Fini gbv f 2
Note: A certificate of occupancy will be issued by this office upon Smoke Detectors (Fire Dept.)
return of this card signed by the Plumbing, Wiring and Building
Inspectors. Gas Inspection
WORK ONLY - NOT USE
THIS CARD MUST BE DISPLAYED IN A CONSP U 1 U ' L, CE ON THE PREMISES
Certificate of Occupancy . _. d
A Inspector
p 40540.