17A-064 (2) PERMIT APPLICATION CHECK LIST
PAGE / PLOT � ZONE °'e lZ j 7 t� YES NO DATE
1 . ZONING FORM APPLICATION T Z
2 . PERMIT APPLICATION
3 . OWNER OCCUPANT STATEMENT LIC . # IF NOT
4 . 3 SETS OF PLANS OT PLAN
5 . NEW CONSTRUCTION
6 . CURB CU
7 . WATER AVAILABILITY FORMS
8 . REMODELING INTERIOR
9 . ADDITIO
10 . ACCESSORY STRUCTURE
11 . SIGN / AWNI
1 2 . PERMIT FE - CHECK ONLY - MONEY ORD
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. � C� Alterations
NORTHAMPTON, MASS. 7 Z 19 Additions
Repair
APPLICATION FOR PERMIT TO ALTER
Garage
1. Location V, /d�, `>�- - Lot No.
2. Owner's name �C7t�1�`r1`-� ` �h$,�V,� Address__ /^
3. Builder's name • N' '6�x `�SUtp Address �'�`� �ec�5r, 1Y Yi �C1O I
Mass.Construction Supervisor's License No. ---Expiration Date
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 QjtD vg-'r V;*.j
14. Estimated cost:Ap3b 0 C)
The undersigned certifies that the above statements are true to the best of his, her
knowledge and belief.
I � R1�,
Signature of responsible app,icant
Remarks �1r,a 1-��t� _ S� )C)A.- 1V4 'Qj 7jn�p _
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Date 1� 0 014 J f}
Filed 3' �,� File No.
ZOOMING PERMIT APPLICATION (§10 . 2)
1 . Name of Applican-: w-c— , , 4fN,C�
Address : Y.� _ r�,� 0 telephone:
2 . Owner of Property:� �r�r�V
Address : Telephone :
3 . Status of Applicant :Owner Contract Purchaser
Lessee Other (explain: )
4 . Parcel Identification : Zoning Map Sheet#_/'7/- Parcel# r
Zoning District(s) (include overlays) G-'1-1713 r
Street Address
Required
5 . ExistilIG5 Pro nosed by Zoning
Use of Structure/Property ,�/ �_t �yJ
(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
oopen 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)l Coop �aoc
h
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: '� '.�31t*�,� Applicant' s Signature._
THIS SECTION I'OR OFFICIAL USE ONLY:
Approved as presented/based on information presented
Denied as presented--Reason:
S ci l' Permit and/or Site Plan Required :
n g Re it d: _ Variance Required :
S nat e of Build ' r 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 authorities.
iCT)-
City of Northampton REQUIRED INSPECTIONS
BUILDINGDEPARTMENT 2. Footings and Walls Components in Place*
3. Complete Building*
No.
632 Office of the Building Inspector
Zoning Form No. 001450 Date 7/22/93 Fee $20 Check# M0
Page, 17A Parcel 64 ,Zone URB Section 127 ❑ Yes U No
BUIULDING PERINM
*Plumbing and Electrical Inspections required
THIS CERTIFIES THAT Michael Hebert before Building Inspections
has permission to Install vinyl siding Inspection on Sites-Foundations
situated on 257 Bridge Road 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 per 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
M THIS CARD MUST BE DISPLAYED IN A CONSPIC U PL ON THE PREMISES
Certificate of Occupancy
g Inspector -
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