25C-191 (4) PERMIT APPLICATION CHECK LIST
PAGE PLOT 111 ZONE ' 4 YES NO DA j�E
1 . ZONING FORM APPLICATION
2 . PERMIT APPLICATION
3 . OWNER OCCUPANT STATEMENT iI `A IF NOT
4 . 3 SETS OF PLANS OT PLAN
5 . NEW CONSTRUCTION
6 . CURB CU
7 . WATER AVAILABILITY FORMS
8 . REMODELING INTERIOR
9 . ADDITION
10 . ACCESSORY STRUCTURE
11 . SIGN AWNING
12 . PERMIT FEE - EC` ' ONLY - MONEY ORDER �
13 . SPECIAL PERMI EQUIRED WITH DEED IF APPLICABLE
14 . UNDER SECTION 127 - CMR 780
15 . FORM A
16 . FILL
COMMENTS :
C A.
C
� J tr1
� a
oLn
CA O r
z
z d -3
y
o o �
Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations
a NORTHAMPTON, MASS. 19 Additions
APPLICATION FOR PERMIT TO ALTER Repair
Garage
1. Location 'f -�• /lam Lot No.
2. Owners name au 4.1 rcj Address 2 d 4,,---,
3. Builder's name /�`✓••� �� �T Address 3i� p. 1%c Si /�,.-, �e/s�
Mass.Construction Supervisor's License No. o G 6 d 2 a Expiration Date 9'-A br-- 9rce
4. Addition
5. Alteration
6. New Porch
7. Is existing building to be demolished?
8. Repair after the fire
9. Garage U/i s1GQ.41 No.of cars Size
10. Method of heating
11. Distance to lot lines
12. Type of roof
13. Siding house UvIv St�n a ✓ �, �r �C
14. Estimated cost:-
The undersigned certifies that the above statements are true to the best of his, her
knowledge and belief.
/ Signature of responsible appicant J��, ==-4e�
.
X _J
Remarks
u
� 4tiiV+. rY
Date Filed 0013 3 ::) File No.
ZONING PERMIT APPLICATION (910 . 2 )
1 . Name of Applicant: /f�-11" C1.. 1(1
Address : -31 �i /J..,, c S'/-- x,,, Ac's V —Telephone:
2 . Owner of Property: �� -J4-1 50,E
Address : a. -1 ( 1 Telephone :
3 . Status of Applicant : Owner e---� Contract Purchaser
Lessee Other (explain., )
4 . Parcel Identification: Zoning Map Sheet# Parcel#
Zoning District (s) (include ov ' lq)
Street Address ,
R equired
5. Existincr Proposed 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: L: R:
- rear
Lot size
Frontage
Floor Area Ratio
%Open Space (Lot area mi
building and parking)
Parking Spaces
Loading
Signs
Fill (volume & location)
6 . Narrative Descript ' on 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 : Z�0.1 ,, 30 /15'3 Applicant' s Signature :
- - - - - - 7—
ZApproved THIS SECTION FOR OFFICIAL USE ONLY:as presented/based on information presented
Denied as presented--Reason :
special' Permit and/or Site Plan Required :
i in R uired: _ Variance Required:
r� � l
igna re ding Inspector �Tl ate
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.
ii T)-
t+n�
�20� �oye City Northampton REQUIRED INSPECTIONS74
• 1. Footings and Walls
BUILDING DEPARTMENT 2. Structural Components in Place*
3. Complete Building*
No.
527 Office of the Building Inspector
Zoning Form No. 001339 Date 6/30/93 Fee 20 Check x# 0729
Page, 25C Parcel 191,Zone URC Section 127 ❑ Yes L.1 No
BUI]LDINGPERMI r I
* Plumbing and Electrical Inspections required
THIS CERTIFIES THAT Kevin Gale/Judy Johnson before Building Inspections
has permission to Install vinyl siding Inspection on Sit—Foundations
situated on 29 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
Smoke Detectors(Fire Department)
Other
THIS CARD MUST BE DISPLAYED IN A CONSPICU US LA ON THE PREMISES
Certificate of Occupancy
ng nspector