32A-249 PERMIT APPLICATION CHECK LIST
PAGE 3 PLOT � q ZONE vF.q KIr) nATr:
1 .
ZONING FORM APPLICATION
C/
tR
2 .
PERMIT APPLICATION
3 .
OWNER OCCUPANT ST
MENT
LIC . # IF NOT
I/
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 -- CHECK
ONLY - MONEY ORDER * a�'t�ry
13 .
SPECIAL PERMIT REQUIRED WITH
DEED IF APPLICABLE
14 .
UNDER SECTION 127 -
CMR 780
15 .
FORM A
16 .
FILL
COMMENTS :
�p > o
n.
a
cn O
X Z � m
Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations
NORTHAMPTON, MASS. %� 1� Additions
• Repair
• APPLICATION FOR PERMIT TO ALTER
,,� Garage
1. Location �}� ��� /y1 xfTy✓✓%i;'%'� 1'� Lot No.
2. Owner's namy �, ', '�! >'P,-,Address
3. Builder's name ��' � � � ddress
Mass.Construction Supervisor's License No. Expiration Date
4. Addition
5. Alteration IP
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-,�
The undersigned certifies that the above statements are true to the best of his, her
knowledge and belief.
vv
J
nature of responsible appucan!
Remarks
.riVr.. r
'v
Date Filed File No.
r.,
ZONING PERMIT APPLICATION
1 . Name of
Address: j � � � • �r�,rj , �' Telephone: s`Y!' ^�
2 . Owner of Property: 614,Z A5
Address: , Telephone:
3 . Status of Applicant: Owner contract Purchaser
Lessee Other (explain )
4 . Parcel Identification: Zoning Map Sheet# 3<�,4 Parcel# . ,
zoning District(s) (include overlays) GC.t�
Street Address
Required
5 , EXistin cr Proposed'
by Zoning
Use of Structure/Property
(if project is only interior work, skip to ##6)
Building height
%Bldg. Coverage (Footprint)
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)
73 ltyy�_
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:`
THIS SECTION FOR OFFICIAL USE ONLY:
I/Approved as presented/based on information presented
Denied as presented--Reason:
pecial" Per ,�-t and/or Site Plan Required:
in ing R idi d: Variance. Require :
1
gnat o Buz t -- r ectar � ate
NOTE: tssuance of a zoning permit does not relieve an applicant's burden to comply Willi all zoning requirements and obtain alt required permits
from the Board of Hoaith,Conservation Commission, Doparlmont of Public Works and otlior applicable permit granting authori(tes.
g�0 °tip City Of Northampton REQUIRED INSPECTIONS
BUILDING DEPARTMENT 2. Structural Components in Place*`
3. Complete Building*
No.
Office of the Building Inspector
Zoning Form No. 003777 Date 1/24/9 Fee $20 Check# 27826
Page, 32A Parcel 249 ,Zone URA Section 127 ❑ Yes No
BUI]LDINGPERMIT
* Plumbing and Electrical Inspections required
THIS CERTIFIES THAT Joseph Jasinski before Building Inspections
has permission to Install a 51x5' replacement window Inspection on Site—Foundations
situated on Fairgrounds - 191 Br;dgP St_ 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.
** 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 CONSPICUOU LA O PREMISES
Certificate of Occupancy
Buildin �®r