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DESIGN & CONSTRUCTION
PERMIT APPLICATION CHECK LIST
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YES NO DATE
2 . OIL
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3 . OWNER OCCUPANT STATEMENT
NOTE
4.4 . I
4 . 3 SETS OF OT PLAN
5 . NEW CONSTRUCTION
6 . CURB CUT
7 . WATER VAIL BI TY FORMS
8 . REMODELING INTERIOR
9 . ADDITION
10 . ACCESSORY STRUCTURE
11 . SIG AWNING
12 . PERMI E - CHECK O L .
13 . SPECIAL PERMIT RE UI ED WITH DEED IF APPLICABLE
14 . UNDER SECTION 127 - CMR 780
15 . FORM
16 . FILL
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Zoning U A13
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No.-594- N006 Alterations )e
a NORTHAMPTON, MASS. 12- A Pei L 19� Additions
APPLICATION FOR PERMIT TO ALTER Repair_X
Garage
1. Location to ST -t-_T FL.A,a -AjCE MA Lot No. 89
2. Owner's name MAL ff." I-AWRL=uOle Address b/ ST RX EldiZE-Neg
3. Builder's name Wm S TL2Rzr,-%s AA Address 31n, %ax 141 L zos. MA O1C15g
Mass.Construction Supervisor's License No. o o o Si S Expiration Date X0016
4. Addition
5. Alteration����-4,=11;�T�►� of fQ9 w RjT"&=t*-, cw—motlfloA 6t: x15f/Pt1G 8'aniftem 2 asoaw/m
6. New Porch
7. Is existing building to be demolished?b L o
8. Repair after the fire He
9. Garage Y t:-C, No.of cars Z Size
10. Method of heating 9,43 S22%4A
11. Distance to lot lines
12. Type of roof AS&AAL+ SHIPJA/A<
13. Siding house W Dorm CI np Inuft"ejol
14. Estimated cost:- 1y 10oo
The undersigned certifies that the above statements are true to the best of his, her
knowledge and belief.
Signature of responsible app,ican!
Remarks
Date Filed 119y .1 00243 1 File No.
ZONING PERMIT APPLICATION
I. Name of Applicant: 411111ate, T lt��¢os�e�c�,4 D /L.y 2-0.
Address:_ );7,0 lox /42 Fn< _A W oLoS'A Telephone: f,/f3 A-A .
2 . Owner of Property: . Q4,4 ,ow Al ZA&&gAFA. C
Address:_ IE&U- ��� Telephone: Shy
3 . Status of Applicant: Owner Contract Purchaser
Lessee Other (explain
4 . Parcel Identification: Zoning Map Sheet# , ' L Parcel# ,
Zoning District(s) (include. overlays) Gl�
Street Address - ,
Required
5 . Existinqcr Proposed —by Zoning
Use of Structure/Property S a /Z,�
(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)prw&ja "Is?rA;a :2",, /42Q
_azQ;g rJ X52 AWA2 4o3ZU AW , Aloz " u a 2 SA42"41 A/W zZ ArWAW=5
JL,Srr/�oTg ias�,ell Blue's!«���e� 5/,�s+►.�ile� t-J.o �.r�a/ L��/�_.�f
.y
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: le, 46k Applicant's Signature: 42
ZApproved- F E THIS SECTION FOR OFICIAL US ONLY:as presented/based on information presented
Denied as presented--Reason:
special* Permi and/or Site Plan Required:
in ng Required: Variance Required:
S gnatur m BIU ding -tor {- to
NOTE: Issuance of a zoning permit does not relieve an applicant's burden to comply with all zoning requirements and obtain all roquirad permits
from lho Board of Health,Consorvalion commission, Dopartmont of Public Works and other applicable permit granting authorities.
City of Northampton REQUIRED INSPECTIONS
e 1. Footings and Walls
BUILDING DEPARTMENT 2. Structural Components in Place*
3. Complete Building*
Na 232 Office of the Building Inspector
Zoning Form No. 002431 Date 4/14/94 Fee $52 Check# Money Order
page, 17C parcel 85 ,Zone URB Section 127 ❑ Yes ® No
BUI]LDINGPERMIT
*Plumbing and Electrical Inspections required
THIS CERTIFIES THAT William Turomsha before Building Inspections
has permission to Demolish exisitng bathroom, construct new improved Inspection on Site--Foundations
version
situated on 67 High 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
Smoke Detectors(Fire Department)
Other
THIS CARD MUST BE DISPLAYED IN A CONSPI 118 PL N THE PREMISES
Certificate of Occupancy
' g Inspector