28-002 (3) i
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UP.PAR'!'MI NT O!+ 13U11.D1,N0 INSP13GYNONS
INSP6C1'OR 212 Main Stroot ' hsunie(pal 33ulldhng
Northnmpton, Mnss, 01000
AS A HOMANER I UNDERSTAND THAT I MAY APPLY FOR AND RECEIVE
A BUILDING PERMIT FOR A HOME OR ADDITION I INTEND TO LIVE IN ,
I ALSO UNDERSTAND THAT I AM RESPONSIBLE: FOR KNOWING THE STATE.
BUILDING CODE AND ZONING ORDINANCE OF THE CI'T'Y OF NORTHAMPTON,
BEING A,HOM50NNER AND NOT A PROFESSIONAL CONTRACTOR IN NO WAY
ABSOLVES ME OF ANY RESPONSIBILITY TO INSURE THAT ALL FACFTS-
OF THE RULES AND REGULATIONS ARE COMPLIED WITH,
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Zoning 1
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. ln i f Alterations
a NORTHAMPTON, MASS. 7,),, a t 19 Additions APPLICATION FOR PERMIT TO ALTER Repair
1. Location Lot No.
2. Owner's name Address
3. Builder's name Address
Mass.Construction Supervisor's License No. Expiration Date
4. Addition
5. Alteration
6. New Porch
7. Is existing building to be demolished?
8. Repair after the fire
9. C95ge x No.of cars Size
10. Method of heating
11. Distance to lot lines
12. Type of roof
13. Siding house
14. Estimated cost:- ,)[t`W)
The undersigned certifies that the above statements are true to the best of his, her
knowledge and belief.
Signa e of responsible applicant
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Remarks �' � i '� 1 f�(�� �'r' ,`�' CJ
PHIN,yTa�SH�OP
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r ` Date Filed File No',
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Zoning orclinance Bobti.on 10 , 7
1 , Name of Apa- i.eant k4
Addr. ess ; T ^ Telephone
X2 . Owner. of Pr. n er. t i
Address :
`Telephone 1
3 , S't.�atus of AZ�n1 i,c<a �i. ; �O�Inc r C'on'tract Purchaser
Lessee Other (G;;l�la n— )
q , Parcel Identi.f .icat. o ni.ny map Sheet,�"�)
Zoning Districts )
Street Address
5 , f-
--OW li.ai ce' with to .i.nc ; ),x i.3 Proposed
Use of Structure7property tom.
Size of Structure (su , ft.
Building height
0
}wilding coverage
Setbacks -
front
Side
IVO - rear '
y
Lot Size
Frontage _
Floor Area Ratio
Open Space
Parking Spaces
Loading Spaces
Siyns
Till ((volume & location)
6., Description o 'Pr. nosed Work—/Pr—_o ect ; ( use ,
additi,dnal sheets if neces ary)
7 , ,Attached Plans ; Sketch Plan Site Plan hl k
8 , Certj,fica�,ton ; x hereby cartify that Lila 'ihn grmat.ion, contained
herein is true and accurate to the best off' my know edge ,
c s 9/ Applicant ' s Signature :
Date 1
THTS SUcTT5N`F3R—oTr CYA USE' 3lgTy i
'Approved as presented
Denied as presented
Reason for Denial ;
Signature of BLUIding Inspector. • Da{:a,
o�� pro City r o Northamntn REQUIRED INSPECTIONS
1 . Footings and Walls
t BUILDING DEPARTMENT 2 . Placetural C:>mponents in
3 . Complete Building
No. 264 Office of the Building Inspector
Date JUNE 4 19 91
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BUI DING P RMIT
THIS MAY CERTIFY THAT GARY DEYO Insp. on Site — Foundations
has permission to REPLACE A 8 'X8 ' STORAGE SHED Insp. of Plumbing — Rough
situated on 404 SYLVESTER ROAD 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 riot 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
THIS CARD MUST BE DISPLAYED IN A CONSPICUOUS PLACE N THE PREMISES
Certificate of Occupancy
Building Inspec
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