17C-177 (7) '?ERMIT APPLICATION CHECK LIST
PAGE PLOT /2 2zoNE 61,e 6 tr` i uG -' ES NO DATE
j , ZONING FORM APPLICATION
2 . PERMIT APPLICATION
3 . OWNER OCCUPANT IF NOT
4 . 3 SeTS OF S P
5 . NEW CONSTRUCTION
6 , CURB CUT
7 , WATER A S
8 . REMODELING
9 , ADDITION
10 , ACCESSORY STRUCTURE
11 SIGN
12 . PERMIT FE - CHECK ONLY - MONEY 0 DE �IIo 7 /
13 . SPECIAL PERMIT REQUIRED WITH DEED IF APPLICABLE
14 . UNDER SECTION 127 - C R 780
15 . FORM
16 . FILL
COMMENTS :
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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. n Tel.No. .�r9 7 11'/` 2 7`f 3 Alterations
at"""Pro� NORTHAMPTON, MASS. �/l9 1.2 19 . Additions
APPLICATION FOR PERMIT TO ALTER Repair
Garage
1. Location �Vm� AI�C _ Lot No.
dr
2. Owner's name P 0 A �n �� Address_
,ft MA
3. Builder's name r7. T�j�L L Rnn- j���4o _Address_ )`7 1� S
Mass.Construction Supervisor's License No. _ __Expiration Date _09�✓
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 es a Aoki
13. Siding house
14. Estimated cost:-7
The undersigned certifies that the above statements are true to the best of his, her
knowledge and belief.
Signature of responsible appicant
Remarks
00 580
Date Filed cai�)3 File No.
ZONING PERMIT APPLICATION (§10 . 2)
1 . Name of Applicant: �' O
Address : E�Ah elephone:
2 . Owner of Property:
Address : jQ Telephone:
3 . Status of Applicant: Owner Contract Purchaser
Lessee Other (explain: )
4 . Parcel Identification: Zoning Map Sheet# / 7C.- Parcel# /7 71
Zoning District (s) (include overlays) oRA
Street Address
Required
5. Existinq Pro osed —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)
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: 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 :
ndi Req red: variance Required:
�� /
S nature Buil i n g I o q ate
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, Depaitmont of Public Works and other applicable permit granting authorities.
%i 71-
City of Northampton REQUIRED INSPECTONS,
_
e BUILDING DEPARTMENT 2. Footings and Components in Place*
3. Complete Building*
No. 733 Office of the Building Inspector
Zoning Form No. 001580 Date8/17/93 Fee $20 Check# MO
Page, 17C Parcel 177 ,Zone URB Section 127 ❑ Yes U No
BUI]LDINGPERMIT
* Plumbing and Electrical Inspections required
THIS CERTIFIES THAT George Thibodo before Building Inspections
has permission to Re-cover roof with shingles Inspection on Site—Foundations
situated on 29 Plymouth Ave. 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 CONSPICUOUS PLACE ON THE PREMISES
Certificate of Occupancy
Bu' _spector -�