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7 CIDER MILL ROAD•HAYDENVILLE.MA 01039 (413)268-3121
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FINE CONSTRUCTION
7 CIDER MILL ROAD•HAYDENVILLE.MA 01039 (413)268-3121
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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. � y -2— Alterations
pQ'S� pTO NORTHAMPTON, MASS. � 19 Additions
g g
Repair
e APPLICATION FOR PERMIT TO ALTER p
Garage
1. Location Lot No.
2. Owner's name ,;%tom/�• �r / i9r11& Address /yr/�QZ/ ! /lJi ?<�z*-,
3. Builder's name .4E �f'�� Address
Mass.Construction Supervisor's License No._�J�/�� ✓� Expiration Date
4. Addition
5. Alteration � /�i�rU� �
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
14. Estimated cost' C) .
i
The undersigned certifies that the above statements are true to the best of his, her
knowledge and belief.
A Signature of responsible applicant
Remarks-/'"/,k/ ter/, /D /lq�'� ��r E"�'�' mac? Gf//q��.�r D z`'�i��•;'�a5
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Date Filed 2 File No.
ZONING PERMIT APPLICATION (510.2)
1. Name of Applicant: �C
Address: Telephone: ,
2 . Owner of Property:
Address: G F Telephone: '
3 . Status of Applicant: Owner Contract Purchaser
Lessee Other (explain:
4 . Parcel Identification: Zoning Map Sheet# Parcel# J,
Zoning District(s) (include v rl s) LI-6
Street Address & 3 'M ttvti
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
- 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) /rr.�'��.9�-� o� w;T �rJ ��l�/��P/�T�, ��'X//i✓�
7. Attached Plans: y 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:
L Approved as presented/based on information presented
Denied as presented
Be son or Denial:
Sign e of Buildi 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 auttwritkm
PERMIT APPLICATION CHECK LIST Page•& Plot
Address: ` gam
Yes No Date
1.. Zoning Form Application V
2. Permit Application
3. Homeowner statement- if api)licable/Lic. H V not
4. 2 sets of plans
5 Curb cut
6 Water Department mQmn _
7. Permit fee - check
�. S ecial Permit required with deed
9. Under section 127 Form A
Cit y of Northampton REQUIRED INSPECTIONS
a
1 . Footings and Walls
BUILDING DEPARTMENT 2. Structural Components in
Place
3. Complete Building
No. 233 Office of the Building Inspector
Date May 5, 1992 19
B U1 DING P. RMIT
THIS MAY CERTIFY THAT Richard P. Dec Insp. on Site — Foundations \
has permission to Install doorway within footprint - create airlock Insp. of Plumbing — Rough
63 Main Street, Florence Ins of Plumbing Finish
situated on P• g —� �
provided that the person accepting this permit shall in every re- Insp. of Wiring — Rough
spect conform to the terms of the application on file in this office,
and to the provisions of the Statutes and the Ordinances relating Insp. of Wiring — Finish
to the Construction,Maintenance and Inspection of Buildings in Insp. of Health (Septic Tanks)
the City of Northampton.Any violation of any of the terms above
noted is an immediate revocation of this permit. Expires six Building Insp. — Rough
months from date of issuance, if not started.
Building Insp. — Finish
Note:A certificate of occupancy will be issued by this office upon
return of this card signed by the Plumbing,Wiring and Building Smoke Detectors (Fire Dept.)
Inspectors. Gas Inspection
L
y
THIS CARD MUST BE DISPLAYED IN A`CO U L CE ON THE PREMISES
Certificate of Occupancy
Bui ector
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