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17C-162 PERMIT APPLICATION CHECK LIST PAGE - PLOT ZONE � � YES NO DATE ZONING-FO ZONING -FORM APPLICAT ION 2 .___ PERMIT APPLICATION 3 . OWNER OCCUPANT STATEMENT /,.-L I C , # I F NOT 3 SETS OF S PLAN 5 NEW CONSTRUCTION 6 CURB -CUT - WATER AVAILADILITY FORMS 8 . REMODELING - INTERIOR 9 . ADDITION-- 10 , ACCESSORY STRUCTURE 11 . SIGN Z -AWNING 12 . PERMIT FEE - CHEQK ONLY - MONEY ORDER 3 . SPECIAL PE T REQUIRED WITH DEED IF APPLICABLE 4 . UNDER SECTION 27 - CMR 780 15 . FORM A 16 , FILL COMMENTS : � K� Kd` �YY�.R.�'T' �%.Ali.�w� � 4�� '�':Y'.F�.?;�+.Ni`A�f.: .. j .i �f. ,. V 7h `C o Z y z o .01 " d y Zoning Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations t ti NORTHAMPTON, MASS. �� ( � 19 Addit' ns i a APPLICATION FOR PERMIT TO ALTER epa lL Garage 1. Location �� 1 0, 1 7A�C v Go k w C.e Lot No. 2. Owner's name Address . o3"/J F"JILL 3. Builder's name _ — — Address V^ 0-; Mass.Construction Supervisor s License No. 1 '' 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 Distance to lot lines 12. ype of roofQ yj n Siding house 14. Estimated cost:--,�;z, th°ti' f The undersigned certifies that the above statements are true to the best of his, her knowledge and belief. � r~ Signature of responsible app,ican! Remarks (;Vel si�r.� •6 000631 e Dat Filed File No. I'7 C - 1 (7 -'- ZONING PERMIT APPLICATION (§10. 2) Name of Applicant: Address : Telephone: Owner of Property: \ Address : Telephone: 3 . Status of Applicant: Owner Contract Purchaser Lessee Other (explain: ) 4 . Parcel Identification: Zoning Map Sheet# 11L Parcel# Iw A , Zoning District(s) (include over Street Address Required 5 . Existinq 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 Descr ' tion 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:,�f v � Applicant's Signature: — — — — — — — — — — THIS SECTION FOR OFFICIAL USE ONLY: s Approved as b Jr;i 1 9 pp presented/based on information presented k Denied as presented--Reason: Special Permit and/or Site Plan Required: - M171Ns Finding Required: Variance Required: iv�NTliNVPafJ Na+�IG�L? Signature of Building Inspector `� Date NOTE: Issuance of a zoning permit does not rolieve an applicant's burden to comply with all zoning requirements and obtain all required permits from the Hoard of Health, Conservation Commission, Department of Public Works and other applicable permit granting authorities. i e 71- City of Northampton R UIRED INPECTONS e 1. Footings and Walls BUILDING DEPARTMENT 2. Structural Components in Place* 3. Complete Building* No. 3 Office of the Building Inspector Zoning Form No. 000634 Date 1/21/9 3Fee $20 Check#M.0. Page, 17 C Parcel 16 2 ,Zone u R B Section 127 ❑ Yes © No BUI]LDINGPERMIT * Plumbing and Electrical Inspections required THIS CERTIFIES THAT George ^h i b o d o before Building Inspections has rmission to Re-roof Pe Inspection on Site--Foundations situated on 67 Chestnut street Inspection of Plumbing—Rough provided that the person accepting this pen-nit 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—Finisk 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 t THIS CARD MUST BE DISPLAYED IN A-CONSPICUOUS PLACE ON REMISES Certificate of Occupancy L'_/Bui1ding Inspector .