25C-072 (5) PERMIT APPLICATION CHECK LIST
PAGE Q,5C PLOT ZONE U �-' (��� �/� , YES NO DATE
1 . ZONING FORM APPLICATION
2 . PERMIT APPLICATION
3 . OWNER OCCUPANT STATEMENT LIC . # IF NOT �io ,7 4-----
4 . 3 SETS OF PLANS LOT PLAN
5 . NEW CONSTRUCTION
6 . CURB CU
7 . WATER AVAILABILITY FORMS
8 . REMODELING INTERIOR
9 . ADDITION
10 . ACCESSORY STRUCTURE
11 . SIG N / AWNING
C 7C '
12 . PERMIT FEE - CHECK ONLY - MONEY ORDER 0
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. � � /�y s 7 Alterations
NORTHAMPTON, MASS. 19 Additions
APPLICATION FOR PERMIT TO ALTER Repair
Garage
1. Location 1�(XL4 A.V 2 um Lot No.
2. Owner's name Address n-7
3. Buildei s name (;,)�ngJ e. ct Address 17 t
Mass.Construction Supervisor's License No. Expiration Date 6 /3- /2 3
4. Addition , 1 , -
nn
5. Alteration 1� mev� �t s1r'r Fronn V�x ��5 -_.n 5u -- to-,AT- 's y-12 C
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 cost:-A,� 0, U
The undersigned certifies that the above statements are true to the best of his, her
knowledge and lief.
24, 4
Signature of responsible app,icani
Remarks Kt-W�U4?- Uk-5tcy- -IASuItI 10 C.t,'R4L k e -e i: Im-c�
�t PT
Date Filed 23-`j2 File No. ;D 5C- 0-7
ZONING PERMIT APPLICATION (§10.2)
1. Name of Applicant:
Address: p Telephone:-_%4q 7,17ft 3
2 . Owner of Property: -
Address: x Telephone:;
3 . Status of Applicant: Owner ,Contract Purchaser
Lessee Other (explain: )
4 . Parcel Identification: Zoning Map Sheet# 'a 5 Parcel# c 7 2_,
Zoning District(s) (include overlays) C�
Street Address ac► Dn 4 Av&
Required
5 • EXistina Proposed bv Zoning
Use of Structure/Property
(if project is only interior work, skip to #6)
Building height
%B1dg.Coverage (Footprint)
Setbacks - front
- side R L R
- rear
Lot size
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)
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: %%-23 °-�'2 Applicant' s Signature: 4,2 ad Z
�V
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
THIS SECTION FOR OFFICIAL USE ONLY:
NOV 2 31992
_!fApproved as presented/based on information presented
Denied as presented
a for D i 1
/ 2-5"' Z
ignat r Building nspector at
NOTE: Issuance of a zoning permit does not relieve an applicant's burden to comply with ail zoning requirements and obtain all required permits
from tie Board of Heatth, Conservation Commission, Department of Public Works and other applicable permit granting authorities.
7/92 FXAS
City of Northampton REQURED INSPECTONS
A
BUILDING DEPARTMENT 1. Footings and Walls *
2. Structural Components in Place
3. Complete Building*
No. 753 Office of the Building Inspector
Zoning Form No. None
Date 11-23-92Fee$40.00 Check# 768
Page, 25C Parcel 072 ,Zone URB Section 127 ❑ Yes ® No
BUILDINGPERMIT
* Plumbing and Electrical Inspections required
THIS CERTIFIES THAT Louise Carrier before Building Inspections
has permission to Reriove Plaster, Insulate & Sheetrock Inspection on Site—Foundations
situated on 29 Day Avenue 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.Expi res 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.
Building Inspection—Finish
Smoke Detectors(Fire Department)
Other
THIS.CARD MUST BE DISPLAYED IN A CONSPICUOUS PLACE ON THE PREMISES
Certificate of Occupancy —z-
Buildin for ���
o4im+^Kgo
City of Northampton REQuwxD INSPECTIONS
e BUILDING DEPARTMENT 2. Struccttme Components in Place*
3. Complete Building*
No. 753 Office of the Building Inspector
Zoning Form No. None .
Date 11-23-92Fee$40.00 Aleck# 768
Page, 25C parcel 072 ,Zone URB Section 127 ❑ Yes ® No
BUI]LDINGPERMIT
* Plumbing and Electrical Inspections required
THIS CERTIFIES THAT Louise Carrier before Building Inspections
has permission to Remove Plaster, Insulate & Sheetrock Inspection on Site—Foundations
situated on 29 Day Avenue Inspection of Plumbing—Rough
provided that the person accepting this permit shall in every respect Inspection of Plumbing—Famish
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.
Building Inspection—Finish
Smoke Detectors(Fire Department)
Other
THIS-CARD MUST BE DISPLAYED IN A CONSPICUOUS PLACE ON THE PREMISES
Certificate of Occupancy Zz--
-Jiuildin for
� �1 GL1
"Of pol
M City of Northampton TI REQUIRED INSPECONS
A a r I. Footings and Walls
" BU/DIN DEPA RTM /N .i!� 2. Structural Components in Place*
3. Complete Building*
No. 753 Office of the Building Inspector
Zoning Form No. clone Date 11-23-92Fee$40.00 Check# 768
Page, 25C Parcel 072
g ,Zone URB Section 127 Yes U1 No
BUI]LDINGPER.MIT
* Plumbing and Electrical Inspections required
THIS CERTIFIES THAT Louise Carrier before Building Inspections
has permission to Remove Plaster, Insulate & Sheetrock Inspection on Site—Foundations
situated on 29 Day Avenue Inspection of Plumbing—Rough
provided that the person accepting this permit shall in every respect Inspection of Plumbing—Finish
conform to the terrns of the application on file in this office, and to the Gas Inspection
provisions of the Statutes and the Ordinances relating to the Construction, Inslxction 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.
BLAding Inspection—Finish-
Smoke Detectors(Fire Department)
Other
THIS CARD MUST BE DISPLAYED IN A CONSPICUOUS PLACE ON THE PREMISES
Certificate of Occupancy
__Building-Inspector
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