17A-117 (2) PERMIT APPLICATION CHECK LIST
p -YES NO DATE
2 .
s OWNER OCCUPANT STATEMEN NOT
3 SETS QF PLANS ZPLOI PLAN
NEW CONSTRUCTION
6 CURB CUI
7 WATER
8 . REMODELTNG INTERIOR
9 . ADDITION
0 . ACCESSOBY STRUCTURE
1 . SIGN / AWNING
2 PERMIT
3 , SPECIAL UI RED WITH DEED IF APPLICABLE
4 , UNDER SE - C R 780
5 . FORM A
6 , FIL
COMMENTS:
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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. -52-7 - 34 6 1� Alterations
NORTHAMPTON, MASS. 19,y�, Additions
APPLICATION FOR PERMIT TO ALTER Repair
a
Garage
1. Location ZZ- c-LA i y- - Av t�- Lot No.
2. Owner's name W( PAT fTI 1A=L2-Q- Address Z2— G(Amt� e/(�
3. Builder's name cS Address 2-6b M�J
Mass.Construction Supervisor's Lic se No. d Expiration Date_t
4. Addition
5. Alteration
tfJ
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 a rZ5777 he best of his, her
knowledge and li
Signaiure of responsible app ica ni
Remarks
I?
'v
Date Filed File No.
ZONING PERMIT APPLICATION (510. 2)
I . Name of Applicant: SLC.-V
Address: Z`n16 L X t Telephone: 2-
2 . Owner of Property:
Address: 'z2 Yf n Telephone: T8
3 . Status of Applicant: Owner VContract Purchaser
Lessee Other (explain: )
4 . Parcel Identification: Zoning Map Sheet# JrnI lP Parcel#
Zoning District(s) (include o lay ) ujZ6t/
Street Address
Required
5 . Existincr Proposed by Zoning
Use of Structure/Property
(if project is only interior work, skip to #6)
Building height
%Bldg. Coverage (Footprint)
Setbacks - front
- side L: R: L: R:
- rear
Lot size U
Frontage.
Floor Area Ratio
%Open Space (Lot area minus e`
building and parking)
Parking Spaces
Loading
Signs
Fill (volume & location)
6. Narrative Description of Proposed Work/Project: Use additional sheets
if necessary)
�(C C.d-6 CJ`s L
7. Attached Plans: Sketch Plan Site Plan
S . Certification: I hereby certify that the information contained herein
is true and accurate to the best of my knowle e.
Date:_ Applicant's Signature:
r/ THIS SECTION FOR OFFICIAL USE ONLY: r
Approved as presented/based on information presented
Denied as presented--Reason:
S cial' Per it and/or Site Plan Required:
ing R it d: Variance Required:
9s
S. gnat re of Buil spector
NOTE: issuance of a zoning permit does not relieve an applicant's burden to comply WiUt all zoning roquiroments and obtain all required pormus
from tho Board of Health,Conservation commission, Dopattmont of Public Works and other applicable permit granting authorithos.
/c 9)
City of Northampton REQUIRED INSPECTIONS
e 1. Footings and Walls
BMI)ING D 2. Structural Components in Place*
3. Complete Building*
N Office of tPe Building Inspector
, Qi.� ' 356
Zoning Form No. 004257 Date 5/11/95 Fee $88 Check# 3451
page, 17P. Parcel 117 ,Zone URA Section 127 ❑ Yes ❑ No
BUU."1JD1NTG PER?!vHT
*Plumbing and Electrical Inspections required
THIS CERTIFIES THAT Sackrey Construction _ before Building Inspections
has permission to Remodel kitchen inspection on Site—Foundations
situated on 22 Claire Ave. Inspection of Plumbing—Rough
provided that the person accepting this permit shall in every respect Inspection of Plumbing--k iiiish v
conform to tl�e terms of the application or,..file in this office, and to the Gas Inspection
provisions of theStatutes and the Ordinances relating to the Construction, Inspecti m of Wiring—Rough
Mainter a and Inspection of Buildings in the City of Northampton. f
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—;sough
Note,Acertificate of occupancy will be issued by this office upon return Insulation Inspection
of this card signed by the Plumbing,Wiring and Budding Inspectors. �
Building Inspection—Finish
Smoke Detectors(Fire Department)
Other
THIS CARD NILE ST BE Da SPLAYS & A CONSPIC CJ U PT � Olv THE PREMISES Ce:t',ficate of Occupancy