25C-072 (3) PERMIT APPLICATION CHECK LIST
PAGE . 6'�, PLOT 71-9) ZONE YES NO DATE'
ZONING FO ICATION w-W
2 . PERMIT I
3 . OWN # IF NO
4 . 3 SETS OF S PLAN
5 . NEW CONSTRUCTION
r
6 . CURB CUT
7 WATER S
8 . REMODELING
9 . ADDITION
10 . ACCESSORY STRUCTURE
11 , SIGN / AWNING
12 . PERMIT FEE - CHECK ONLY - MONEY ORDER '`fa '
13 . SPECIAL PERMIT REQUIRED WITH DEED IF APPLICABLE
14 . UNDER SECTION 27 - C R 780
15 , FORM
16 , FILL
COMMENTS :
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P`ERMIT APPLICATION CHECK LIST
PAGE 64WT 79 ZONE ES NO DATE
1 . ZONING FORM APPLTCATION
2 . PERMIT P I V
3 . OWNER OCCUPANT STATEMENT LIC. 0 IF NOT v
3 SET PLAN
NEW CONSTRUCTION -
6 , CURB OUT
7 WATER
8 . REMODELING
9 . ADDITION
0 , ACCESSORY
11 , SIGN / AWNING
2 , P ER MIT E - C - MONEY-OR MONEY-OR E
C�
13 , SPECIAL PERMIT REQUIRED WITH DEED IF APPLICABLE -
-14 . UNDER SE - C R 780
15 . FORM A
6 . 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
l Garage
1. Location aL-? Lot No.
2. Owner's name rJ r S I r Address 5-19 e.`
3. Builder's name lily/ Address Ll JUey.�tJ
Mass.Construction S upervisor's License No. /60 Expiration Date -S I Y-26
4. Addition /
5. Alteration -/c� y1.V�l Q/A C2zA0,e%.j- Lo l&)dow
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
13. Siding house
14. Estimated costa
The undersigned certifies that the above statements are true to the best of his, her
knowledge and belief.
2 c=
Signature responsible appicant
� r
Remarks
003433
1
Date Filed File No.
ZONING PERMIT APPLICATION (510.2)
1 ) Name of Applicant: Cekb"c/ ,T
Address: L( Ke-6z s5 -- 424c), Telephone:
L2- Owner of Property: t'Oy i CPXZ9
Address: Telephone: (c-/ S 7
3. Status of Applicant: Owner L-19�ntract Purchaser
Lessee Other (explain: )
4 . Parcel Identification: Zoning Map Sheet# Parcel#
Zoning District(s) (include ovfrla y s)
Street Address
Required
5. Existina P o osed by Zoning
Use of Structure/Property
(if project is only interior ork, ki to #6)
Building height \
%B1dg.Coverage (Footprint)
Setbacks - front
- side
- rear
Lot size
Frontage
Floor Area Ratio
%Open Space (Lot area minus
building and parking)
Parking Spaces
Loading
Signs
Fill (volume & location)
6. Narrative Descriptio of Proposed Work/Project: (Use additional sheets
if necessary)
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 knowl ge.
Date: le 21-9411 Applicant's Signatur
ZApproved— — — — — — — — — — — — — — — — — — — —THIS SECTION FOR OFFICI USE Y:
as presented/based on information presented
Denied as presented
s for D al
gnat e f Suildin ctor pfite
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 au tiorities.
City of Northampton REQUIRED INSPECTIONS
BUILDING DEPARTMENT
I. Footings and Walls
2. Structural Components in Place*
I Complete Building*
No.
1090 Office of the Building Inspector
Zoning Form No. 003488 Date 10/25/94 Fee 20 Check# 0403
Page, 25C Parcel 72 Zone uRB
Section 127 ❑ Yes ❑ No
BUI]LDINGPERNM
* Plumbing and Electrical Inspections required
THIS CERTIFIES THAT Edward Corbett Jr. before Building Inspections
has permission to Install replar ema Inspection on Site—Foundations
z nt_srindoTas P�
situated on 27 Day Ave. 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.
** Install per Manufacturers information: windows, vinyl siding, Building Inspection—Finish
roofs and woodstoves. Smoke Detectors(Fine Department)
Other
THIS CARD MUST BE DISPLAYED IN A CONSP ICUOUSJPLA O PREMISES
Certificate of Occupancy
Buil pector ��_