17C-276 (3) PERMIT APPLICATION CHECK LIST
7
PAGE /�C. PLOT �7( ZONE U`<6 13 YES NO DATE
1 . ZONING FORM APPLICATION
2 , PERMIT APPLICATION
3 . OWNER OCCUPANT STATEMENT LIC . # IF NOT
4 . 3 SETS 0 _ /PLOT PLAN
5 . NEW CONSTRUCTION
6 . CURB CU
7 . WATER AVAILABILITY FORMS
8 . REMODELING INTERIOR
9 , ADDITIO
10 . ACCESSORY STRUCTURE
11 . SIGN / AWNING
12 . PERMIT FEE - CHECK ONLY - MONEY ORD R :� elq q
13 . SPECIAL PERMIT REQUIRED WITH DEED IF APPLICABLE
14 . UNDER SECTION 127 - CMR 780
15 . FORM A
16 . FILL
COMMENTS :
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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No._C2 Alterations
a NORTHAMPTON, MASS. � C_ 19q3 Additions
APPLICATION FOR PERMIT TO ALTER Repair
Garage
1. Location 11 1 �`1 � C3►r'�Q,�1�� Lot No.
2. Owners name i017+.tn � _�.�c,� Address___
3. Builder's name Address
Mass.Construction Supervisor's License No. .__Expiration Date
4. Addition
5. Alteration C— s n GU �['d ' —�1w.vso,i d 'a
6. New Porch
7. Is existing building to be demolished? _
8. Repair after the fire 4�u
9. Garage_, 41 Y, No.of cars Size
10. Method of heating A.4.1
11. Distance to lot lines I // 4i f°A
12. Type of roof /a M o •
13. Siding house
14. Estimated cost: O
The undersTanbel if) abo e statements are true to the best of his, her
knowledge
7__,�Signa1j1e`qf,e,ponsib1e appicanl
Remarks —
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Date Filed 12- --7- 93 00r) ,) 6
Date I File No.
ZONING PERMIT APPLICATION (510 . 2 )
I. Name of Applicant: W h
Address : ► D�,Ictx elephone: 5-,'6 -Sr-2_
2 . Owner of Property: s� i 1-, &4,1
Address : 3 �, GL c� /,��h _ Telephone :
3 . Status of Applicant: Owner Contract Pu has r
Lessee p,( Other (explain: _ )
4 . Parcel Identification: Zoning Map Sheet# Parcel# 7:2--
Zoning District(s) (include overlays) 6
Street Address j?,
Required
5. Existing Proposed 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 additi na1 shee s
if necessary) IA,( . C. JA &JQ _ R• o i L- ha �
lez ti,c. Al /!mss
7
7 . Attached Plans : �TSketch Plan Site Plan
8 . Certification : I hereby certify that the information contained herein
is true and accurate to the best of my knowJlede
Date:- Z - ] 3 Applicant r s Signature :
THIS SECTION FOR OFFICIAL US
ZAroved as presented/based on information presented
Denied as presented--Reason:
S ecial' Permit and/or Site Plan Required:
ng u ' red: Variance Required:—/
lgnat e ulldin f spector \�?j 6 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, Department of Public Works and other applicable permit granting authorities.
it'9")_
Cit y Northampton TIof REQUIRED INSPECTIONS
$ e 1. Footings and Walls
BUILDING DEPARTMENT 2. Structural Components in Place*
3. Complete Building*
No.
1134 Office of the Building Inspector
Zoning Form No. 002061 Date 12/8/93 Fee $88 Check# 8199
Page, 17C Parcel 276 ,Zone URB Section 127 ❑ Yes ® No
BUI]LDING PERNM
*Plumbing and Electrical Inspections required
THIS CERTIFIES THAT Wright Builders before Building Inspections
has permission to Renovate 1 bath, add 2 bath, replace 6 windows Inspection on Site—Foundations
situated on 13 Lilly street Inspection of Plumbing—Rough
provided that the person accepting this peanut shall in every respect Inspection of Plumbing—Finish
conform to the terms of the application on file in this office, and to the i 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 teens 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 PL N THE PREMISES
Cer"tificate of Occupancy
Building Inspector
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