17A-051 (5) PERMIT APPLICATION CHECK LIS
PLOD':, 0 '2 „ 7e` =
ONE 4 �' ' � YES NO DATE
1 . y. ZONING FORM APPLICATION
2 . PERMIT APPLICATION
3 . OWNER OCCUPANT E IF NO
4 . 3 SETS OF NS ZELOT PLAN
5 . NEW CO ST UC IO
6 . CURB CU
7 . WATER AVAILABILITY S
8 . REMODELING INTERIOR
9 . ADDITION
10 . ACCESSORY STRUCTURE
11 . SIGNJ AWNING
12 . PERMIT FEE — ,jVM ONLY — MONEY ORDER-
13 . SPECIA PE MIT REQUIRED WITH DEED IF APPLICABLE
14 . UNDER SECTION 127 — CMR 780
15 , FORM
16 , FILL
COMMENTS :
a � a
T A
3 0 �
> � o
Z
^� m
•D
Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations
NORTHAMPTON, MASS. �i �" x'? 19 5 Additions
APPLICa ATION FOR PERMIT TO ALTER Repair
Garage
1. Location /,ZA-� 3 )? )''► ��' zyi►Q /�i/a `�) c. y^� rl- Lot No.
2. Owners name ���L TE I lP f 10 Z."!� Address _S �ir!r�tt 4 � �>rt,, /���
3. Builder's name �1 Address 771 S el 42e, �'_� A�-,7L oA
Mass.Construction Supervisor's License do. oae-f.Y1 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 ez)41C h'► 'tip-j' 1 tJ�lJ�
14. Estimated cost:- /4� p C-)n
The undersigned certifies that the above statements are true to the best of his, her
knowledge and belief.
$l Lure of responsible app,lcanl
Remarks
Date Filed File No.
ZONING PERMIT APPLICATION
I . Name of Applicant: �'
Address: - ,Q, -.
C 3 Telephone: SG �y/
2 . Owner of Property:Address : ;-/a 3 `x3 /v. �.��. Telephone:
3 . Status of Applicant: Owner �ontract Purchaser
Lessee Other (explain: )
4 . Parcel Identification: Zoning Map Sheet#{ arcel# (. ,
Zoning District(s) (include ove lays)
Street Address 191
Required
5 . Existing Proposed by Zonin
Use of Structure/Property 'a- mn
(if project is only interior work skip to #6)
Building height
!Bldg. Coverage (Footprint)
Setbacks - front
- side L: R: L: ,r R:
- rear !'
Lot size
Frontage.
Floor Area Ratio
oOpen Space (Lot area minus
building and parking)
Parking Spaces r
Loading
Signs
Fill (volume & location)
6 . Narrative Description of Proposed Work/Project: (Use additional sheets
if necessary)
' aJ
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: /I J c�,
i � Applicant' s Signature: .��,�z.�-- •/����
THIS SECTION FOR OFFICIAL USE ONLY:
ZApproved as presented/based on information presented
Denied as presented--Reason:
S cial' Permit and/or Site Plan Required:
i ding quired: variance Required,
�%
gna u e -of Build Ipspector Da
NOTE: tssuance of a zoning permit does not rellave an applicant's burden to comply vft all zoning requirements and obtain all required permits
from tho Board of Hoaith,Conservation commission, Dopattmont of Public Works and othor applicablo permit granting authoritlos.
r
tU►H
City of ort ampton REQUIRED INSPECTIONS
• 1. Footings and Walls
LBADING DEPARTMENT 2. Structural Components in Place*
3. Complete Building*
No. 16
Office of the Building Inspector
Zoning Form No. 003784 Date 1/11/95 Fee $40 Check# 14269
Page, 17A Parcel 51 ,Zone URB Section 127 ❑ Yes ® No
BUIULDING PERmi r
*Plumbing and Electrical Inspections required
THIS CERTIFIES THAT B.&R. Siding Spec. / Inc. before Building Inspections
has permission to Install replacement windows & vinyl siding Inspection on Site--Foundations
situated on 121-123 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 Constriction, Inspection of Wiring—Rough
Maintenance and Inspection of Buildings in the City of Northampton.
Any violation of any of the terns 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 CONSPICUOU PL CE N THE PREMISES
Certificate of Occupancy
Building In r
51100