17C-042 (7) PERMIT APPLICATION CHECK LIST
PLOT . ° ' ZONE G(-�� : ^'YES NO DAT
EQEIM APPLXOAMQV.,U loved
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3 . OWNER OCCUPANT STATEMENT # 'IF NOT
4 . 3 SETS OF PLANS OT PLAN
5 . NEW CONSTRUCTION
6 . CURB CUT
7 , WATER AVAILABILITY FORMS
8 . REMODELING INTERIOR
9 . ADDITIO
10 . ACCESSORY STRUCTURE
11 . SIGN / AWNI
1 2 . PERMIT FEE . ONLY — MONEY ORDE s; . .Y
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. Alterations
a NORTHAMPTON, MASS. 19 Additions
APPLICATION FOR PERMIT TO ALTER Repair
Garage
v , v
1. Location _ Lot No.
2. Owner's name - Address__ c /
3. Builder's name Address_ sc'
Mass.Construction Supervisor's License No. � �/S� _Expiration Date
4. Addition _
5. Alteration
6. New Porch
7. Is existing building to be demolis ed? _.
8. Repair after the fire _
9. Garage No.of cars Size
10. Method of heating
11. Distance to lot lines
12. Type of roof 014 Y 11
13. Siding house
14. Estimated cost:49 370
1
The undersign e rti s that the aV�te��s rents are true to the best of his, her
knowledg d be f
Signa[uWojresponsible app,ican!
Remarks —
Date Filed � r� ��► File No.
ZONING PERMIT, PLICATION (§10 . 2)
1 . Name of Applicant:
Address : j Telephone: 2
2 . Owner of Property: Z-1 �.
Address Telephone : 5 -
3 . Status of Applicant, C wner Contract Purchaser
Lessee Other (explain: )
4 . Parcel Identification: Zoning Map Sheet#-fl-!�_ Parcel# _Z- ,
Zoning District (s) (include overl s) U_k6
Street Address <j S ,
UU Required
5 . Existinq Proposed by Zoning
Use of Structure/Property
(if project is only interior work, skip to #6)
Building height
%B1dg. 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 Propose A Work/Project : (Use additional sheets
if necessary)
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 r - Applicant' s Signature: �7
THIS SECTION FOR OFFICIAL USE ONLY:
Approved as presented/based on information presented
Denied as presented--Reason:
Special' Permit and/or Site Plan Required:
F 'hdi r12 Requ ' ed: _ Varia ce Requivr�ed`
S gnature f Aate
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 authorities.
iC'71-
City of Northampton REQUIRED INSPECTIONS
• 1. Footings and Walls
e e BUILDING DEPARTMENT 2. Structural Components in Place*
3. Complete Building*
No. 835 Office of the Building Inspector
Zoning Form No. 001736 Date 9/15/93 Fee $20 Check# 3630
Page, 17C Parcel 42 ,Zone URB Section 127 ❑ Yes ® No
BUI]LDING PERNM
* Plumbing and Electrical Inspections required
THIS CERTIFIES THAT Bob Thibodo before Building Inspections
has permission to Re-shingle roof Inspection on Site--Foundations
situated on 55 Sheffield Lane Inspection of Plumbing—Rough
provided that the person accepting this pen-nit 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 pen-nit.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
F
THIS CARD MUST BE DISPLAYED IN A CONSPICUOUS PL CE ON THE PREMISES
Certificate of Occupancy
Building In for
City of Northampton REQUHZED INSPECTIONS
$ ; 1. Footings and Walls
• BUILDING DEPARTMENT 2. Structural Components in Place*
3. Complete Building*
Nom 835 Office of the Building Inspector
Zoning Form No. 001736 Date 9/15/93 Fee 20 Check# 3630
Page, 17C Parcel 42 ,Zone URB Section 127 ❑ Yes ® No
BUI]LDINGPERMIT
*Plumbing and Electrical Inspections required
THIS CERTIFIES THAT Bob Thibodo _ before Building Inspections
has permission to Re-shingle roof _ Inspection on Site�—Foundations
situated on 55 Sheffield Lane 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 Northamptoa.
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 CONSPICUOUS PL CE ON THE PREMISES
Certificate of Occupancy
Building In for