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06-017 (12) . PERMIT APPLICATION CHECK LIST P {)7 Z©tdE E NO .DATE 1 . 49NING FORM- APPLICATION 2 . PERMIT APPLICATIO 3 . OWNER OCCUPANT STATEMENT IF NOT 4 . 3 SETS QF PLANS O P 5 . NEW CONSTRUCTION 6 . CURB CU 7 . WATER AVAILABILITY FORMS 8 . REMODELING INTERIOR 9 . ADDITIO 10 . ACCESSORY STRUCTURE 11 . SIGN Z AWNING 12 . PERMIT FEE #O LY — MONEY ORD R 13 . SPECIAL PERMIT REQUIRED WITH DEED IF APPLICABLE 14 , UNDER SECTION 127 — CMR 780 15 , FORM A 16 . FILL COMMENTS : y > o `° Ts v b o• rro- r Z r � � a• -s �• O Z m y Zoning Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations a NORTHAMPTON, MASS. /� tfr 19� Additions APPLICATION FOR PERMIT TO ALTER Repair Garage 1. Location Pg v," �c� Lot No. 2. Owners name i a--t �s� u h ____ Address__3 S-7 `/a r n v/ad 3. Builder's name Address Mass.Construction Supervisor's License No. / D �1(! 3 0 --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 Co �o t, u/ f`� n, /��e n& 14. Estimated cost:- 0 0 u c, The undersigned certifies that the above statements are true to the best of his, her ! knowledge and beli Signature of responsible app,icant Remarks -- a u si�Yn, !L Date Filed 16 File No. - ZONING PERMIT APPLICATION (§10 . 2) 1 . Name of Applicant: Address : QY �� a Telephone: 5 5 2 . Owner of Property: Address : 3 S 7 f l;� [( �� Telephone :.. S-spy 3 . Status of Applicant: Owner Contract Purchaser Lessee Other (explain : C o r-, i~iq g c=fv vz ) 4 . Parcel Identification: Zoning Map Sheet# �' 7 Parcel# � , Zoning District (s) (include overl ) `J Street Address ' _ Required 5. Existina 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 Proposed Work/Project : (Use additional sheets if necessary) / de4/ac rvr� b nT w`VJ° LPL(1 '� 'r 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 Applicant' s Signature: THIS SECTION FOR OFFICIAL USE ONLY: Approved as presented/based on information presented Denied as presented--Reason: Special' Permit and/or Site Plan Required : Finding Required: Variance Required: Signature of Building Inspector Date NOTE: Issuance of a zoning permit does not relieve 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. %t,T)_ City of Northampton REQUIRED INSPECTIONS 1. Footings and Walls BUILDING DEPARTMENT 2. Structural Components in Place* 3. Complete Building* No. 958 Office of the Building Inspector Zoning Form No. E Date j 0/i9/93 Fee $20 Check# 551 Page, 6 Parcel 17 ,Zone SR Section 127 ❑ Yes 0 No BUI]LDINGPERMIT * Plumbing and Electrical Inspections required THIS CERTIFIES THAT Denni-s Labato before Building Inspections has permission to Install replacement windows Inspection on Site—Foundations situated on 357 Haydenvil`i.e Road; Leeds 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 4- of this card signed by the Plumbing,Wiring and Building Inspectors. Building Inspection—Finishc° Smoke Detectors(Fire Department) Other THIS CARD ST E DISPLAYED IN A CONSPIC US.PLA( O THE PREMISES Certificate of Occupancy - Building Inspector