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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations
NORTHAMPTON, MASS. 19 Additions
APPLICATION FOR PERMIT TO ALTER Repair
Garage
1. Location rf Lot No.
2. Owner's name ! o Address
3. Builder's name Address
Mass.Construction Supervisor's License No. ';2� Ta _ Expiration Date f'
4. Addition
5. Alteration
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:-
The undersigned certifies that the above statements ge true to the best of his, her
knowledge and be��? A r> ✓r
t� Signature of rrsp�onsib(e app icani
Remarks �J`
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Date Filed U /��y, ` File No.
Z NING PERMIT P I ATION (510. 2)
1 . Name of ApplicaVOAddress : Telephone:
2 . owner of Property: 1
Address : - _ Telephone:
3 . Status of Applicant: owner Contra Pu haser
Lessee Other (explain :
4 . Parcel Identification: Zoning Map/ Sheet#_/7 4 Parcel# �3 ,
Zoning District (s) (include verla s)
Street Address
Required
5. Existing 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 Proposed Work/Project : (Use additional sheets
if necessary)
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7 . Attached Plans : Sketch Plan Site Plan
8 . Certification: I hereby certify that the informatio contained herein
is true nd accurate to the best of my knowledge
Date: Applicant' s Signature:
�� -� THIS SECTION FOR OFFICIAL USE ONLY:
Approved as presented/based on information presented
Denied as presented--Reason:
Sp ial' Permit and/or Site Plan Required :
Wd ' Requ ' e Variance Required:
gnaturL Bu ldi specto a
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.
4io- City of Northampton REQUIRED INSPECTIONS
BUILDING DEPARTMENT 2. Structtural and Components in Place*
3. Complete Building*
No. 372 Office of the Building Inspector
Zoning Form No. 002591 Date 5 f] /g4 Fee $2n Check# Money Order
Page, 17A Parcel 73 ,Zone URA Section 127 ❑ Yes No
BUI]LDINGPERMIT
* Plumbing and Electrical Inspections required
THIS CERTIFIES THAT Bob Thibodo before Building Inspections
has permission to Replace face layer of shingles Inspection on Site—Foundations
situated on 17 Mountain Road Inspection of Plumbing—Rough
provided that the person accepting this permit shall in every respect Inspection of Plumbing—Famish
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 perit.Expires six months from date of issuance,ifnot 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 PL THE PREMISES
Certificate of Occupancy
B spector
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