38B-229 (6) PERMIT APPLICATION CHECK LIST
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Yes No Date
1 . Zoning Form Application
2. Permit Application
3. Homeowner statement `-f a licable Lic . # if not C�
4. 2 sets of plans
5. Curb cut
6. Water Department. memn 11
7. Permit fee - check-only - - ('.9 �( C�
�. Special Permit required with deed if
9. Under section 127 - CMR 780
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DEPARTMENT OF BUILDING INSPECTIONS
212 Main Street ' Municipal Building
INSPECTOR NTorthampton, Mass. 01060
AS A HOMEOWNER 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 CITY OF NORTHAMPTON.
BEING A HOMEOWNER AND NOT A PROFESSIONAL CONTRACTOR IN NO WAY
ABSOLVES ME OF ANY RESPONSIBILITY TO INSURE THAT ALL FACETS
OF THE RULES AND REGULATIONS ARE COMPLIED WITH.
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Signature & Date
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c{ Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. S� `� �i�' Alterations
go NORTHAMPTON, MASS. MP"1 I 19� " Repair
Additions
APPLICATION FOR PERMIT TO ALTER Garage
1. Location (0 FF} l(u i E A y cri 0 Lot No.
2. Owners name &TEPkird I' CW(tU 7,Vf- P `)EM Sim I Address 6S r-nt2U eyj AVc tyoa-7, oeme ru
3. Builder's name S ,, F Address
Mass.Construction Supervisor's License No. Expiration Date
4. Addition
5. Alteration 2 E-j o yn TE. eoc`to r\1 or (-sA x Ens►Evr i ro!t rpm aq ac om
6. New Porch
7. Is existing building to be demolished? NO
8. Repair after the fire N10
9. Garage _ No.of cars Size
10. Method of heating r\) I'
11. Distance to lot lines N 1
12. Type of roof N I
13. Siding house NI 1r
14. Estimated cost:-
�t p40.
The undersigned certifies that the above statements are true to the best of his, her
knowledge and belief.
J�, Signature o responsible applicant
Remarks
PHINyTiSH/OP
1r • t `/
Date Filed File No.
ZONING PERMIT APPLICATION (510.2)
1. Name of Applicant: STE.P"6^1 Q6 -J K- J
Address: 1L -vr Noarwwnorud Telephone:
2 . Owner of Property: CHRIJitNr P Q CM1 10
Address: foS FAlagjfw r-wf- nroRrupur,,orv4-1 Telephone: Q?-4 -6a4!4
3 . Status of Applicant: r° owner Contract Purchaser
Lessee Other (explai.n )
4 . Parcel Identification: Zoning Map Sheet# f�i, Parcel# ,
Zoning District(s) (include overlays) _ t /�
Street Address S 6 F4v E•v y F,
Required
5 .
Existing Pro nosed o
Use of Structure/Property
(if project is only interior work, skip to 6)
Building height
%B1dg. 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/Project: (Use additional sheets
if necessary) rNQJRTf- PoartarJ OF iF_rnF.�rT Fa!L
F/-�t'YI l�-�-••- t2o�M �P A�,;� l 2��c 2 y,r
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 } ! ,sledge.
Date: [Y �� _ Applicant ' s Signature:
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
THIS SECTION FOR OFFICIAL USE ONLY:
Approved as presented/based on information presented
Denied as pr •sented
son for a ial :
Srighatut-e--Vf Bui.ldi Lnspector ate
NOTE: bsuance o Wing permit does not rolleve 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,
City of Northampton REQUIRED INSPECTIONS
s 1 . Footings and Walls
BUILDINGDEPARTMENT 2 . Structural Components in
Place
6— 3 . Complete Building
V No. 276 Office of the Building Inspector
\ Date May 18, 1992 19
BUI DING P RMI
THIS MAY CERTIFY THAT—Stephen Stephen Demjki Insp. on Site — Foundations
Renovate portion of basement for family room
has permission to approximately 121x24' with *Condition Insp. of Plumbing — Rough
situated on 65 Fairview Ave. 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 theapplication 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. *CONDITION: Ceiling height must be the regulation Gas Inspection
7'3"
THIS CARD MUST BE DISPLAYED IN A CONS ICU , US P IAGE ON THE PREMISES
Certificate of Occupancy
u lding Inspector