25C-234 (6) PERMIT APPLICATION CHECK LIST
PAGE SLOT ZONE YES NO DATE
1 . ZONING FORM APPLICATION
2 . PERMIT APPLICATION
3 . OWNER OCCUPANT STATEMENT ILICA IF NOT
4 . 3 SETS OF PLANS PLOT PLAN
5 . NEW CONSTRUCTION
6 . CURB CUT
7 . WATER AVAILABILITY FORMS
8. REMODELING INTERIOR
9 . ADDITION
10 . ACCESSORY STRUCTURE
11 . SIGN AWNING
12 . PERMIT FEE - CHECK ONLY - MONEY ORDER
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. Alterations
so NORTHAMPTON, MASS. �,Uy'l� \\(0 11Additions
Repair
APPLICATION FOR PERMIT TO ALTER Garage
1. Location Lot No.
2. Owner's name 'fit L�'��`4 �`��� Address \ `\ �L��C'ti9" \\�
3. Builder's name ��r+ \. ��� \ � Address 3 t-)
Mass.Construction Supervisor's License No. �� ��, Expiration ate_ 10 Z32 _
4. Addition 1 \
5. Alteration s -7.-�: S�IsS �L1��� 04LQ 5 ''x»1_ y1r�FrY+�lc'y� G�f .ac`v �5�c1 �°�r»►w.
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:-
COOO The undersigned certifies that the abQve s me true to the best of his, her
knowledge and belief.
� r
ignature of responsible applicant
Remarks
PNIN, _T�SHOP
.y
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Date Filed File No.
ZONING PERMIT APPLICATION (§10 . 2 )
1 . Name of Applicant : ��\„�, \. +��►�
Address :'3�1 �A� � !�'� �� �\v Telephone: to r6 g
2 . Owner of Property:
Address : Vii.. XX) - \�n,,,,,,o Telephone:
3 . Status of Applicant : Owner Contract Purchaser
Lessee N, Other (explain:
4 . Parcel Identification: Zoning Map Sheet# )..SL Pa c l# 23L/ ,
Zoning District (s) (incluXe overl
Street Address Ac
Required
5 . Existincr Proposed by Zoning
Use of Structure/Property
(if project is only interior work, skip to #6)
Building height
tB1dg. Coverage (Footprint)
Setbacks - front
- side
- 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/Pxoject: (Use additional sheets
if necessary) o►-LS Ar I ouS C v �v �2
V
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 knowled
Date : G / Applicant Is Signature: a
— _ -' THIS SECTION FOR OFFICIAL U8E Y:
�� Approved as presented/based on information presented
Denied as presented
Reason for nial:
ignatu f Bud, rng Inspector Date
NOTE: Issuance of a zoning permit does not relieve an applloanVe burden to comply with all zoning requirements and obtain all required porTnhs
from the Board of HeaM, Consorvation Commission, Department of Public Works and other applicable permit grunting authorities.
City of Northampton REQUIRED INSPECTIONS
1 . Footings and Walls
BUILDINGDEPARTMENT 2. Structural Components in
Place
3. Complete Building
No. 358 Office of the Building Inspector
t�1 Date June 19, 1992 19
B U1 DING P RMI
THIS MAY CERTIFY THAT John Giblin/Bernie Golob Insp. on Site — Foundations
Replace/repair walls and sills damaged UYT
has permission to water and insects Insp. of Plumbing — Rough
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situated on 177 Bridge Street Insp. of Plumbing --Finish
provided that the person accepting this permit shall in every re- Insp. of Wiring — Rough
spect conform to the terms of the application on file in this office,
and to the provisions of the Statutes and the Ordinances relating Insp. of Wiring — Finish
to the Construction,Maintenance and Inspection of Buildings in Insp. of Health (Septic Tanks)
the City of Northampton.Any violation of any of the terms above
noted is an immediate revocation of this permit. Expires six Building Insp. — Rough
months from date of issuance, if not started. Building Insp. — Finish
Note: A certificate of occupancy will be issued by this office upon
return of this card signed by the Plumbing,Wiring and Building Smoke Detectors (Fire Dept.)
Inspectors. Gas Inspection
r THIS CARD MUST BE DISPLAYED IN A CONSP CUO P ACE ON THE PREMISES
`Certificate of Occupancy -
- —Building Inspector
t