17C-035 (4) PERMIT APPLICATION CHEQK LIST
PAGE 17C PLOT ZONE U/'L4A - � O A
1 . ZONING FORM APPLICATION
2 . PERMIT P I �-'
3 . OWNER OCCUPANT STATEMENT LIC # IF NOT
4 . 3 SETS OF PLANS ZPLOT PLAN
5 . NEW CONSTRUCTION
6 . CURB CU
7 . WATER V I FORMS
8 . REMODELING INTERIOR
9 . ADDITIO
10 . ACCESSORY STRUCTURE
11 . SIGN / AWNING
2 . PERMIT -FEE - CHECK ONLY - MONEY OR D ��
13 . SPECIAL PERMIT-REQUIRED WITH DEED IF APPLICABL
14 . UNDER SECTION 127 - C R 780
15 . FORM A
16 . FILL
COMMENTS:
.. a
70 'v
_ 3 a
CA Z
� o
X
Z ^' m
-3
a
Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations
NORTHAMPTON, MASS. Z_Z 199' Additions
APPLICATION F PERMIT TO ALTER Repair
// Garage
1. Location /,q ? &Ja1`�i )-ntr& Lot No.
2. Owner's name y �4 '<a IV a,4 G-n<0, Address
3. Builder's name U e ,C e e Address /tGOZ? �
Mass.Construction Supervisor's License No. (� Expiration Date
4. Addition
5. Alteration /l +'�t �r( 8�� C Q � '-cJ r erc-c lvl' /1� i1r�•��1��_ C'���,� t�cn57<•4i�S
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 t"'
0.
The undersigned certifies that the above statements are true to the best of his, her
knowledge and beli
Signature of responsible appic n!
Remarks
002841
Date Filed �a �/ File No.
2 NING PERMIT APPLICATION (510.2)
1 . Name of Applicant: ,�c� �y� ��� - cZ•_ �• '
Address : hjo;e �. °Ce7"/�--� Telephone:
2 . Owner of Property: �4� o �A-Cv-/V0 if
Address : s F /1 Q,k ti, 02?v- S Telephone: 5-e v-, S-o a
3 . Status of Applicant: Owner Contract Purchaser
Lessee Other (explain : )
4 . Parcel Identification: Zoning Map Sheet# Parcel# 3!-�; ,
Zoning District(s) (include o erlays)
Street Address O ?
Required
5 . Existinq Proposed by Zo in
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 Proposed Work/Project: (Use additional sheets
if necessary)
2�t3 �'c' t°� b d� �ec-.� C ;0 w/•u' cpz-cl--
e a X- L 0Z
'r
7 . Attached Plans: Sketch Plan Site Plan
8 . Certification: I hereby certify that the information contained herein
is t ue and accurate to the best of my knowledg .
Date - 2 Applicant's Signature: - -),
THIS SECTION FOR OFFICIAL US NLY: - - r r -
Approved as presented/based on information presented
Denied as presented--Reason:
Al' Per and/or Site Plan Required:
g Re u' variance Required: —
of or 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,Dopaitmont of Public Works and other applicable permit granting authorities.
i c' l_
qty of ort ampton REQUIRED INSPECTIONS
BUILDING DEPARTMENT 1. Footings and Walls
a e 2. Structural Components in Place*
3. Complete Building*
No. 556 Office of the Building Inspector -
Zoning Form No. 002841 Date 6/23/94 Fee $20 Check# 1158
Page, 17C Parcel 35 ,Zone URA Section 127 ❑ Yes ® No
BuiiLDiNGPERmir
* Plumbing and Electrical Inspections required
THIS CERTIFIES THAT Tc)hn Trask before Building Inspections
has permission to Hang new kitchen door, new cellar window & handrail Inspection on Site-Foundations
situated on 109 North Maple Street Inspection of Plumbing—Rough
provided that the person accepting this pemiit 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 CONSPICU US PL N THE PREMISES
Certificate of Occupancy --
Building for IMF