17A-271 (3) a
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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations
NORTHAMPTON, MASS. ��/ oZ� 199 Additions
APPLICATION FOR PERMIT TO ALTER Repair
_ Garage
1. Location l 2 n R � S is �L�=� •n /ham -1 t�/n ? Lot No.
2. Owner's name Sofa•7 r Address__ /, CUs ,S'% ��! �► '�
3. Builder's name S c &1c'1')e-,1.1,f Address
Mass.Construction Supervisor's License No. CD t4-O 7 Expiration Date l/a-
4. Addition sew "� ��e�✓� �'
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 �� l . �� i •� l �� !E2 e-
13. Siding house
14. Estimated cost �7®CD .
The undersigned certifies that the above statements are true to the best of his, her
Cknowledge and belief.
Signamure of responsible appican!
Remarks
Date Filed Z r O O l �l 4 C File No.
ZONING PERMIT APPLICATION //(§10 . 2)
1 . Name of Applicant: ys 13
e S .- f;/c 4 (X—
Address : ) G, .,. �„ -, Telephone: 57.,
2 . owner of Property: /t�� U%7�,� Z__
• ✓� �3 S�) -,2C_
Address:., ; J pg 5r Telephone:
3 . Status of Applicant: Owner r%` Contract Purchaser
Lessee Other (explain: )
4 . Parcel Identification: Zoning Map SheetJ /Y,q_ arcel# o 7/ r
zoning District(s) (include o erlays)
Street Address
Required
5 . Existina 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
Frontage.
Floor Area Ratio
.Open Space (Lot area minus
building and parking)
Parking Spaces
Loading
Signs
Fill (volume & location)
6. Narrative Description of Pro osed Work/Project: (Use additional sheets
if necessary) 0 Ue
o! / 7' SLi n -
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: l - -z A, y Applicant's Signature: rr d ��
THIS SECTION FOR OFFICIAL USE ONLY: -
'flApproved as presented/based on information presented
Denied as presented--Reason:
pecial' ermit and/or Site Plan Required:
in fired: variance Required, r
rl
gn e of Bu pector d I ate
NOTE: issuance of a zoning potmit does not relieve an appliconrs burden to comply Willi all zoning roquiroments and obtain all required permits
from the Board of Hoalth,Conservation commission,Dopattmont of Public Works and other applicable permit granting authorities.
le7*)-
PERMIT APPLICATION CHECK LIST
PAGE (' PLOT a�� ZONE ES NO DATE
ZONING FORM L IO
2 . PERMIT I
3 . OWNER OCCUPANT STATEMENT LICA IF NOT
3 SETS
5 . NEW CONSTRUCTION
6 . CURB CUT
7 WATER
8 . REMODELTNG
9 . ADDITION
0 , ACCESSORY U
11 . SIGN / AWNING
2 , PERMIT FEE - CHECK ONLY - MONEY ORDER /j
13 . SPECIAL PERMIT REQUIRED WITH DEED IF APPLICABLE
4 . UNDER SEC - CMR 780
15 , FORM A
6 . FILL
COMMENTS : J7 �
City of Northampton REQUIRED INSPECTIONS
g a 1. Footings and Walls
BUILDINGDEPARTMENT 2. Structural Components in Place*
3. Complete Building*
No. 1201 Office of the Building Inspector
Zoning Form No. 003646 Date 11/22/9 Fee $20 Check# 14522
Page, 17A parcel 271 ,Zone URB Section 127 ❑ Yes ❑ No
BUI]LDINGPERMTI
* Plumbing and Electrical Inspections required
THIS CERTIFIES THAT Emerson Batchelder before Building Inspections
has permission to Reshingle roof Inspection on Site—Foundations
situated on 126 oak 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
** Install per Manufacturers information: windows, vinyl siding,
roofs and woodstoves. Smoke Detectors(Fire Department)
Other
THIS CARD MUST BE DISPLAYED IN A CONSPICU011ir PL CE N PREMISES
Certificate of Occupancy --
Bu' nspector �i-