17C-172 (9) PERMIT APPLICATION CHECK LIST
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PAGE Oe PLOT /2-7 ZONE UX6 2- 7 �-� YES NO - DATE
1 . ZONING FO ICATJON � l
2 . PERMIT APPLICATION
3 . OWNER OCCUPANT NOT �1
4 . 3 SETS OF PLANS
5 , NEW CONSTRUCTION
6 . CURB CU
7 , WATER S
8 . REMODELING
9 . ADDITION
10 , ACCESSORY
11 , SIGN
12 , PERMIT FEE - CHECK ONLY - MONEy ORpEg :j- ,-3<-
13 , SPECIAL EERMIT REQUIRED WITH DEED IF APPLICABLE
14 , UNDER SECTION - C R 780
15 . FORM
16 . FILL
COMMENTS :
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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations
a /1�NORTHAMPTON, MASS. 19 Additions
APPLICATION FOR PERMIT TO ALTER Repair
, f Garage
1. Location 27 � �'��� —�'` Lot No.
2. Owner's name � Address
3. Builder's name f (, c k Address____T����
Mass.Construction S upervis 's License No. o 5-- "Z 7 __.__Expiration D ea
4. Addition
5. Alteration � ly
6. New Porch Gr`LA
7. Is existing building to be demolished? A
C C
S. Repair after the fire
9. Garage f cars Size
10. Method of heating
11. Distance to lot lines
12. Type of roof
13. Siding house
14. Estimated cost:-
The undersigned certifies that the above statements are true to the best of his, her
knowledge and belief.
e of responsible app scan!
Remarks __.
l
Date Filed -/ 0 01 J ( `
File No.
ZONING PERMIT APPLICATIO (§10 . 2)
1 . Name of Applicant:
Address : Telephone:
2 . Owner of Property: t7
Address : 2 y Telephone :
3 . Status of Applicant: Owner V Contract Purchaser
Lessee Other (explain: )
4 . Parcel Identification: Zoning Map Sheet# l7� Parcel# 17-7,
Zoning District(s) (include overla s)
Street Address Z7 _ ,
Required
5. Existing Proposed _ by Zonin
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/Pro ect: (Use addition 4l sheets
if n
7 cessary) al, 0� QC P
G� r
j
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: p �� Applicant's Signature:
THIS SECTION FOR OFFICIAL USE ONLY:
ZApproved as presented/based on information presented
Denied as presented--Reason:
ecial' Permit and/or Site Plan Required:
i ing red: Variance Requi reed*
� U
1gn t e e Bu ' or Date/
NOTE: I 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.
4io Cit y of Northampton REQUIRED INSPECTIONS 1. Footings and Walls
BUELDING DEPARTMENT 2. Structural Components in Place*
3. Complete Building*
No. 725 Office of the Building Inspector
Zoning Form No. 001578 Date 8/13/93 Fee $20 Check# 135
Page, 17C Parcel 172 ,Zone UR8 Section 127 0 Yes ® No
BUI]LDING PERmi r
* Plumbing and Electrical Inspections required
THIS CERTIFIES THAT Gerry Shattuck before Building Inspections
has pemmi ssion to Remove & replace steps & landing with new temporary onMspection on Site—Foundations
situated on 27 Fairfield 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 CONSPIC US LAC N PREMISES
Certificate of Occupancy
Building Inspector �,--
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