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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. . Alterations
NORTHAMPTON, MASS. W_, 19 Additions
APPLICATION FOR PERMIT TO ALTER Repair
a
Garage
1. Location Lot No.
2. Owner's name Address
3. Builder's name
Mass.Conswction Su rvisor's License No. �� s �� Expiration Date
4. Addition
5. Alteration t,&
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- ) /
j The undersigned certifies that the above statements are true to the best of his, her
1 knowledge and belief.
S 'nature of esponseble a icanl
Remarks °
7 'i='
�. fl M 00253;
q�
Date Filed � ` File No.
ZONING PERMIT APP ICATION (510. 2)
1 . Name of Applica9t: �.
Address: , (I 7V Telephone:
2 . Owner of Property: C i Address: Telephone:
3 . Status of Applicant: Owner Contract Purc�aser
Lessee L /Other (explain:
4 . Parcel Identification: Zoning Map Sheet# ysG arcel#
Zoning District(s) (include o�,}{er1 ys) GL�
Street Address 3 G1
Required
5. Existina Pro osed bv Zoning
Use of Structure/Property U`N'"
(if project is only interior work, skip to #6)
Building height
%B1dg. Coverage (Footprint)
Setbacks - front
- side L: R3 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)
L)
y
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: �% Ly Applicant' s Signature
� � THIS SECTION FOR OFFICIAL USE ONLY:
Z Approved as presented/based on information presented
Denied as presented--Reason:
special.' Permit and/or Site Plan Required:
di e ired: variance Required: —
4ISiq4n a of Bu ng Inspector ��q at
NOTE: Issuance of a zoning permit does not relieve an applicant's burden to comply with all zoning requiroments and obtain all required permits
from the Board of Health,Conservation Commission, Department of Public Works and other applicable permit granting aulhoritios.
1701-
City of Northampton REQUIRED INSPECTIONS A
BUILDING DEPARTMENT I. Footings and Walls
e 2. Structural Components in Place*
I Complete Building*
No.
319 Office of the Building Inspector
Zoning Form No.
002534 Date 4/29/94 Fee $20 Check# 001793
Page, 25C Parcel 139 ,Zone URB Section 127 ❑ Yes ® No
BUI]LDINGPERNM
i
* Plumbing and Electrical Inspections required
THIS CERTIFIES THAT Larry Jubb before Building Inspections
has permission to Install replacement windows & some siding Inspection on Site--Foundations
situated on 173 North Street 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 pemut.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 CONSPIC S PL ON THE PREMISES
Certificate of Occupancy
g Inspector
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