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12C-079 it 4 ZRMIT APPLICATION CHECK LIST J ' PAGE YES NO DATE 1 . ZONING FORM APPLICATION �'' pat 2 . PERMIT APPLI I 3 , OWN IF NO v 4 . 3 SETS OF PLANS PLAN 5 , NEW CONSTRUCTION 6 . CURB CUT 7 WATER S B . REMODELINQ 9 . ADDITION 10 , ACCESSORY STRUCTURE 11 , SIGN / AWNING 2 PERMIT FEE - C - MONEY ORDER C0 t3 �D L 13 , SPECIAL PERMIT REQUIRED WITH DEED IF APPLICABLE 14 . UNDER SECTION 2 - C R 780 15 . FORM 16 . FILL COMMENTS : T n„ D CA �I 3 Z r O Z cn O f � rn . ry Zoning Miscellaneous Additions,Repairs,Alterations,etc. Tel.No.�� '' ` Alterations NORTHAMPTON, MASS. 19 Additions APPLICa ATION FOR PERMIT TO ALTER Repair / ( Garage 1. Location �� l b�C!r Irk ' _. Lot No. 2. Owner's name A9w/r Ief 1 Address 3. Builder's name �► c^ Address %T Y'- Mass.Construction Supervisor's License No. �L� r3 1ST Expiration Date �® 17 Mass. 4. Addition 5. Alteration few 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. Esti ted cost:- The undersigned certifies that the above statements are true to the best of his, her know d d belie . ko,j _,1�0 V signaturlof respon app,icant Remarks Fz 1 003494 Date Filed File No. ZONING PERMIT APPLICATION (510.2) 1 Name of Applicant: O✓L�S wC Address: 1 Telephone: (2)- Owner of Propert��: l , V/J of llll�-1 Address: 2 U"la�C C v C Telephone: Status of Applicant: Owner L- IC"ontract Purchaser Lessee Other (explain: ) 4. Parcel Identification: Zoning Map Sheet# j ��} Parcel# Zoning District(s) (include overla W Street Address melLk-11; Required 5. Existina Proposed bv Zoning 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 C6) Fill (volume & loc ion) Narrative Description of Pro osed Work/Project: (Use additional sheets if necessary) Jew ,e YJ 1,,C ?f 4",eA- 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: �C' �� Applicant's Signature: - - - - - - - - - - - - - - - - - THIS SECTION FOR OFFICIAL USE ONLY: Approved as presented/based on information presented De ied as presented Zas 'for ni igna� o-f Build m9pector X�` ` ate NOTE: Issuance of a zoning permit does 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 audxxities. City of Northampton REQUIRED INSPECTIONS 1.BUILDING DEPARTMENT 2. Structural Components in Place* 3. Complete Building* No. 1093 Office of the Building Inspector Zoning Form No. 003494 Date 10/25/94Fee 20 Check# 1013 Page, 12C Parcel 79 ,Zone URA Section 127 ❑ Yes © No BUI]LDINGPERMI r-I * Plumbing and Electrical Inspections required THIS CERTIFIES THAT C.&T. Construction before Building Inspections has permission to Install replacement windows Inspection on Site—Foundations situated on 20 Marc Circle 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 CONSPICUO L E O PREMISES Certificate of Occupancy -- Buil torn rI_ `� l