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11C-029 (4)
PERMIT APPLICATION CHECK LIST PAGE l`�� PLOT '� �� ZONE �� YES NO DATE 1 . ZONING FORM APPLICATION 2 . PERMIT IC T 0 3 . OWNER OCCUPANT IF NO 4 . 3 SET S PLAN 5 . NEW CONSTRUCTION 6 CURB CUT 7 . WATER S r 8 . REMODELING I 9 . ADDITION 10 . ACCESSORY UC 11 . SIGN / AWNING 2 . P E R I E - CHECK ONLY - MONEY OR ER IL 13 . SPECIAL PERMIT REQUIRED WITH DEED IF APPLICABLE 14 . UNDER SECTION 127 - C R 780 15 , FORM 16 . FILL COMMENTS : 1 � � z a � zm > ., z - 1 z Zoning Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations NORTHAMPTON, MASS. 19 Additions APPLICa ATION FOR PERMIT TO ALTER Repair Garage 1. Location Lot No. 2. Owner's name Address 3. Builder's name Address �7 Mass.Construction Supervisor's License No. eco 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 14. Estimated cost:- �'C.C�1 cC10 The unde gn d certifies that the above statements are we to the best of his, her knowle a lief. Signature of responsible appicant Remarks t�A oz —1(-P-4- — �lJI �iVfA. l 0©468.' Date Filed File No. ZONIN E IT PLICA I N (510.2) 1. Name of Applicant: C�� Address: Telephone: 2 . owner of Property: . Address: Telephone: _ tip 3 . Status of Applicant: Owner Contract., Pu9chasqr Lessee Other (explain w ubc_._+ ) 4 . Parcel Identification: Zoning Map Sheet# Parcel# , Zoning District(s) (include overlays) Street Address Required 5• Existincr 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 Pr posed Wor /Proj t: (use additiona heets if essary ; Glv Y 7 . Attached Plans: Sketch Plan Site Plan 8 . Certification: I hereby certify that the information contained herein is tr a and accurate to the best of my knowled Date: Applicant's Signature: .�. THIS SECTION FOR OFFICIAL USE ONLY. Approved as presented based on information presented / p d Denied as presented--Reason: special.' Pe 't and/or Site Plan Required: oFin ng R it Variance Required, 7/,.77' t gna of Building n � ctor Patef NOTE: Issuance of a zoning permit does not relieve an appiicanCs burden to comply with all zoning requirements and obtain all required'permffs from the Board of Health,Conservation Commission,Department of Public Works and olhor applicable permit granting authorities. i e?*)- v City of Northampton REQUIRED INSPECTIONS BUILDING DEPARTMENT 1. Footings and Walls 2. Structural Components in Place* I Complete Building* No. 483 Office of the Building Inspector Zoning Foam No 002682 Date 6/7/94 Fee -$2o — Check# 2139 Page, 11C pal 29 ,Zone URA Section 127 ❑ Yes ® No BUI]LDINGPERMI-71 *Plumbing and Electrical Inspections required THIS CERTIFIES THAT Paul McCutheon before Building Inspections has permission to Strip & reshing.le roof, install 4 replacement windows Inspection on Site—Foundations situated on 140 Florence Street, Leeds Inspection of Plumbing—Rough provided that the person accepting this pemnit 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 B DIS A D IN A CONSPICUO S P ACE PREMISES Certificate of Occupancy -- Building In or ri-