25C-088 (5) PERMIT APPLICATION CHECK LIST
PAGE ��CPLOT �77 ZONE . 66k� Z Z � �e Y DAT
1 . ZONING 0 131-71 q�
2 . PERM T APPLICATION
3 . OWNER OCCUPANT STATEMENT C.# IF NOT
4 . 3 SETS OF PLAN
5 . NEW CONSTRUCTION
6 . CURB CUT
7 . WATER FORMS
8 . REMODELING INTERIOR
9 . ADDITION
10 . ACCESSORY
11 . SIGN / AWNING
2 PERMIT a 7OQ v
13 . SPECIAL -PERMIT REQUIRED WITH DEED IF APPLICABLE
14 . UNDER SECTION 127- CMR 780
15 . FORM
16 . FILL
COMMENTS :
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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations
NORTHAMPTON, MASS. 19_�a4l Additions
APPLICATION FOR PERMIT TO ALTER Repair
- Garage
1. Location Lot No.
2. Owner's name i rr; l B�t iN r Address Zlly c:;llel
3. Builder's name f1/�/� Wit,! r `�� = w �'' Address
Mass.Construction Supervisor's License No. '- 6-6aX Expiration Date
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
13. Siding house 11114-�c'/a j/C�' f,2,1iAXkI— f�',.1'�%�� /"Z/��; ��/�•(� �tf�i ,,Ts lG� '
14. Estimated cost-
A
The undersigned certifies that the above statements are true to the best of his, her
knowledge and belieff
Signalure of responsible app icani
Remarks
Date Filed % 0 0 2 9 2-1
File No.
ZONING PERMIT APPLICATION (510, 2)
1. Name of A1"'L60'licant: NI c//%�j G ,� �h•�Gr.� �Z
Address: ,(/ Telephone: S=
2 . Owner of Property:_ L7;�IblZ' ,��j,ytle'
Address : ova ZrtiwY Telephone: ,5-gam , �7
3 . Status of Applicant: Owner Contract Purchaser
Lessee Other (explain : )
4 . Parcel Identification: Zoning Map Sheet# 5 C- Parcel# 5 ,
Zoning District(s) (include over ays) �,t. 11
Street Address
Required
5. Existinq Pro nosed by Zoning
Use of Structure/Property
(if project is only interior work, skip to #6)
Building height
%B1dg. Coverage (Footprint)
Setbacks - front
- side 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:. Applicant's Signature:_ �tt
THIS SECTION FOR OFFICIAL USE ONLY:
' Approved as presented/based on information presented
Denied as presented--Reason:
Special' Permit and/or Site Plan Required:
F. ding Requir Variance Required* '
na ure ing Inspect �3� ate,
NOTE: Issuance of a zoning permit does not relieve an applicant's burden to comply with all zoning roquiroments and obtain all required permits
from the Board of Health,Conservation commission,Dopaitmont of Public Works and other applicable permit granting authorilios.
City of Northampton REQUIRED INSPECTIONS
e BUILDING DEPARTMENT 1. Footings and Walls
2. Structural Components in Place*
3. Complete Building*
No. 637 Office of the Building Inspector
Zoning Form No. 002921 Date ]_(7/94 Fee $20 Check# 0708
Page, 25C Parcel 88 ,Zone URB Section 127 ❑ Yes ® No
BUI]LDINGPERMI r I
* Plumbing and Electrical Inspections required
THIS CERTIFIES THAT United siding & window Co. before Building Inspections
has permission to Install vinyl siding & windows Inspection on Site—Foundations
situated on 22 Lincoln Ave. Inspection of Plumbing—Rough
provided that the person accepting this pen-nit 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(Fire Department)
Other
THIS CARD MUST BE DISPLAYED IN A CONSP?1CU PL � ON THE PREMISES
Certificate of Occupancy
Building Inspector��_