12C-087 (6) PERMIT APPLICATION CHECK LIST
URA
PAGE i 'Q C PLOT ZONE WSP '7
hick- Dr.
YES NO DATE
1 . ZONING FORM APPLICATION 4 - C- 93
2 . PERMIT APPLICATION L--
3 . OWNER OCCUPANT STATEMENT LIC . # IF NOT �--
4 . 3 SETS OF PLANS PLOT PLAN
5 . NEW CONSTRUCTION
6 . CURB CU
7 . WATER AVAILABILITY FORMS
8 . REMODELING INTERIOR
9 . ADDITION
10 . ACCESSORY STRUCTURE
11 . SIGN / AWNING
12 PERMI FE - CHECK O - MONEY ORDER )5r a G. O 0
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.'y` ' _9 3 Alterations
NORTHAMPTON, MASS. 19 Additions
APPLICso ATION FOR PERMIT TO ALTER Repair
/ Garage
1. Location ,Q /G %' /C Lot No.
2. Owner's name 'J '`' �C /f S v^-1� Address 1'"S
3. Builder's named C, Address 72 Cj
Mass.Construction Supervisor's License No Expiration Date
4. Addition
5. Iteration 7G �, / -` I�> O�� -1 %,Z xi4
-Alt..
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:-
j The undersigned certifies that the above statements are true to the best of his, her
\ knowledge and belief.
Signature of responsible applicant
Remarks
• eiW''r�.T,�
`A 0000 6 t
Date Filed e), " / -3 File No. I 'D-C - OR 7
ZONING PERMIT APPLICATION (§10 . 2) U R Aq Ws P
1. Name of Applicant: (�W111 4-6
Address : 32L OL v(s` ,. _Telephone:
2 . Owner of Property: 4a.,� f/j
Address: 10 ,7 'w c 71,h Telephone: 11 e . ci;? i
3 . Status of Applicant: Owner Contra t P rchaser
Lessee �0'ther (explain: �p,�;��&� / )
4 . Parcel Identif icatio Zoning et//...j_,@ _C Parcel# 097 ,
Zoning District (include overlays)
Street Address
Required
Existing Pro o by Zoning
interior work, skip to #6)
,otprint)
,ont
.de L: R: L: R:
:ar
area minus
I ng)
ration)
6. Narrative e =pZion of Proposed Work/ roject/: (Use additional sheets
if necessary) �, / c' SS We-C, /c
QL ,,4,1 )%rl
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: '-1-6 'J 3 Applicant' s Signature:
i C
THIS SECTION FOR OFFICIAL USE ONL
ZApproved as presented/based on information presented } APR � 6
Denied as presented--Reason:
cial P rmit and/or Site Plan Required: C.
ing u ' ed: Variance Required _ 1f
7�
an, of>uild ' . s pector NOTE: Issuance of a zoning permit oes 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.
City of Northampton' REQUIRED INSPECTIONS
e
BUIULDIMG DEPARTMENT 1. Footings and Walls
2. Structural Components in Place*
3. Complete Building*
No. 169 Office of the Building Inspector
Zoning Form No. 000868 Date 4/7/9 3 Fee $20 Check# 2520
Page, 12C Parcel 87 ,Zone URA Section 127 ❑ Yes ® No
BUI]LDINGPERMIT
*Plumbing and Electrical Inspections required
THIS CERTIFIES THAT Valley Home Improvements before Building Inspections
has permission to Install slider and vinyl floor Inspection on Site--Foundations
situated on 28 Rick Drive 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 CONSPIC S ACE ON THE PREMISES
Certificate of Occupancy
uilding Inspector � �-
;1�, EI S�