25C-196 (3) PERMIT APPLI�C/A�TION CHECK LIST
PAGE ESL PLOT ZONE , ', S NO DATE
ZONING O
2 . -PERMIT
3 . OWNER OCCUPANT O C�-
SETS LAN
5 . NEW CONSTRUCTION
6 CURB- CUT
7 . WATER
8 , REMODELI
9 . ADDITION
ACCESSORY C
1-1 . SIG
12 , PERMIT FEE CHECK ONLY 'F
MONEY ORDE
13 . SPECIAL U D WITH DEED IF APPLICA8LE
4 . UNDER SECTION - CMR 780
5 FORM A
6 . FILL
COMMENTS : 1
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COMMONWEALTH 6EPA4TMENT OF PUBLIC SAFETY pal/arstopossafsBdi�fl�At
OF ONE ASHBORTON PLACE, M1
All AO
MA3SAC?NI�I:TTS ,i BosTON,MA 02108 G�D�tts
LICENSE oftblsNcosso.
ExplRarloN DATE - C O N S T R. SUPERVISOR CAUTION
v,
04/11/1996 EFFECTIVE DATE LIC-NO. FOR PROTECTION AGAINST `k
RESTRICTIONS THEFT, PUT RIGHT THUMB
NONE 06/30/1993. 005269 PRINT IN APPROPRIATE
BOX ON LICENSE.
BENOIT J GAULIN
182 COUNTY RD #
SS # '004-36-8307. � SOUTHAMPTO MA 01073 BLASTING OPERATORS
MU� �lC,�,�,DE PHaTI�:
PHOTO(BLASTING OPR ONLY) F •00 ,[ij� f,
.I NOT VALID UNTIL SIGNED BY LICENSEE AND OFFICIALLY
HEIGHT: STAMPED OR SIGNATURE OF THE COMMISSIONER JUL 1
04/17/193
THIS DOCUMENT MUST SIGN NAMEDA"ATURE LINE
CARRIEDONTHE PER30N SIG RE OF LICENSEE
- THE HOLDER WHEN E Il/jj
OTHERS-RIGHT THUMB PRINT GAGED INTH13pCCUPATION ER
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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations
NORTHAMPTON, MASS. 19 Additions
APPLICATION FOR PERMIT TO ALTER Repair
a
Garage
1. Location A v g- Lot No.
2. Owner's name 666 ,i a n-1 AC44,c v 5 Address
3. Builder's name 12E,ey 6AL ,)v .21t.C . Address Si 110/v
Mass.Construction Supervisor's License Nom 21370 Expiration Date
4. Addition
5. Alteration
6. New Porch f/,2&/t
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 V s 0 / > T/Nva 54v 77tZ/1S '`.S10rAA 640P '
14. Estimated COSL-
/J you
n The undersigned certifies that the above statements are true to the best of his, her
knowledge and belief.
Signature of responsible app,icani
Remarks T Ked NG A c t a T fGS�S 7`0
r
Date Filed �///L 1
/�y File No.
ZONING PERMIT APPLICATION (510. 2)
1 . Name of Applicant: .UCN G4�t,i. ,rrc
Address: /$' DLL.44r 57 7 y�L Telephone: �,?y- y4
2 . Owner of Property: �,,, ibtir�sts
Address :_ 3&6 u Telephone:
3 . Status of Applicant: Owner x Contract Purchaser
Lessee Other (explain : )
4 . Parcel Identification: Zoning Map Sheet# 2SC Parcel#Iq ,
Zoning District (s) (include overlays)
Street Address ,
Required
5 • Existinq Proposed by Zoning
Use of Structure/Property
(if project is only interior work', ski# o #6)
Building height
%B1dg. Coverage (Footprin
Setbacks - front
- side L: 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:_ K1167 �Z Applicant' s Signature:
`— THIS SECTION FOR OFFICIAL USE ONLY:
proved as presented/based on information presented
Denied as presented--Reason:
S ecial'. Permit d/or Site Plan Required:
din ?Requ ' ed• Variance Required:
S natur Building In f or at
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 authorities.
el _
City of Northampton REQUIRED INSPECTIONS
g 1. Footings and Walls
BUILDING DEPARTMENT - 2. Structural Components in Place*
3. Complete Building*
Nom 543 Office of the Building Inspector
Zoning Fonn No. 002809 Date 6/20/94 Fee $20 Check# Money Order
Page, 25C Parcel 196 ,Zone URC Section 127 ❑ Yes ® No
BUI]LDINGPERMI r-I
* Plumbing and Electrical Inspections required
THIS CERTIFIES THAT Ben Gaulin Inc. before Building Inspections
has permission to Install vinyl siding, trim & doors Inspection on Sites--Foundations
situated on 5-7 Highland 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. Building Inspection—Finish
** Install per Manufacturers information: windows, vinyl siding,
roofs and woodstoves. Smoke Detectors(Fire Department)
Other
THIS CARD MUST BE DISPLAYED IN A CONSPIgV LA O THE PREMISES
Certificate of Occupancy --
Building Ins for IMF