17A-206 (5) . PERMIT APPLICATION CHECK LIST
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YES NO DATE
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1 ZONING FORM APPLICATION
2 . P4IT APPLICATION
3 . OWNER OCCUPANT STATEMENT # IF NOT
4 . 3 SETS OF PLANS PLAN,
5 . NEW CONSTRUCTION
6 . CURB CU
7 . WATER AVAILABILITY FORMS
8 .
9 . ADDITIO
10 . ACCESSORY STRUCTURE
11 . SIGN AWNING
1 2 . PERMIT FE -- ONLY - MONEY ORDER
13 . SPECIAL PERMIT REQUIRED WITH DEED IF APPLICABLE
14 . UNDER SECTION 127 - CMR 780
15 . FORM
16 . FILL
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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations
a NORTHAMPTON, MASS. 19 Additions
APPLICATION FOR PERMIT TO ALTER Repair
I Garage
1. Location i `7 n - tl1`1 c e p'Flo .. Lot No.
2. Owner's name a". k -Tex5%VtSKi Address_ 7-10
3. Builder's name Zu h na itS Lot Address S (-Iexl d 5 .
Mass.Construction Supervisor's License No. �� 4�S _Expiration Date a`6 4 U
4. Addition
5. Alteration
6. New Porch 0 1L
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:-
J�(1 G,�u�a 46 4 Lc, fur^ �)5 o uc.�. CL)
v r.: v e The undersigned certifies that the above statements are true to the best of his, her
tcu Z ` knowledge and beli
v c
1,-
Signature of responsible appiican!
Remarks
si\Yti V
i . UOl ,.,8
I� .�
Date Filed File No.
ZONING PERMIT APPLICATION (510 . 2)
1 . Name of Applicant:
Address : k -Y l���c Telephone: 5s-�:�
2 . Owner of Property:_ 0�4.r jc_ 7c s►xS ki
Address : -� A_ (W,gp a S . Telephone : y-341 Ca3
3 . Status of Applicant: Owner L.�Contract Purchaser
Lessee Other (explain: )
4 . Parcel Identification: Zoning Map Sheet# 114_ Parcel# 916(4 ,
Zoning District (s) (include o rlay_ )
Street Address
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 t v' t5 �ttj
- side L: R: C)" L: ), R: val + t _l
rear ROW� I O , r
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) oC4 c(% S LA11
-�---
1
7 . Attached Plans : ketch Plan Site Plan
8 . Certification: I hereby certify that the information contained herein
is true and accurate to the best of my knowledge.
Date : CJ 3 Applicant' s Signature :
THIS SECTION FOR OFFICIAL USE O Y:
Approved as presented/based on information presented
Denied as presented--Reason:
Special' Permit and/or Site Plan Required :
F ' n ' ng q i d: Variance Required:—
S gna u e of Buil Insctor �' at
NOTE: Issuance of a zoning permit does not reliove 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.
City of Northampton REQUIRED INSPECTIONS
• 1. Footings and Walls
BUILDING DEPARTMENT 2. Structural Components in Place*
3. Complete Building*
881 Office of the Building Inspector
No. VUJ
Zoning Form No. 001783 Date 9/30/93 Fee $ 80 Check# 1323
Page, 17A Parcel 206 ,Zone URB Section 127 ❑ Yes ZI No
BUI]LDINGPERMII
* Plumbing and Electrical Inspections required
THIS CERTW IES THAT John Punska before Building Inspections
has permission to Add 2 decks, remodel bedroom & install new door Inspection on Site,--Foundations
situated on 137 North Maple Street 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 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 CONSPICU. U PLA ON THE PREMISES
Certificate of Occupancy
ding Inspector -
(Fp�t J 11!511(7