17D-028 (5) PERMIT APPLICATION CHECK LIST
OE PLOT ZOME ., . , .
S NO DATE
3 OW
4 . 3 SET PLAN
5 . NEW CONSTRUCTION
6 . CURB OUT
7 . WATER S
8 . REMODELING
9 . ADDITION
0 , ACCESSORY STRUCTURE
11 , SIGN Z AWNING
2 E R M I T F E E 0 N L Y - M 0
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3 . SPECIAL D WITH DEED IF APPLICABLE
4 . UNDER SECTION - CMR 780
5 FORM A
6 . FILL 1
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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations
NORTHAMPTON, MASS. 19 Additions
APPLICATION FOR PERMIT TO ALTER Repair
l / Garage
1. Location U ��`�l��v ✓S�//vim 15-1� iw
r-e el'le // Lot No.
2. Owner's name Cep, CO"G-2e.17- Address
3. Builder's name,l�t�yr�l �l°l r�llrei?S // Address
Mass.Construction Supervisor's License No. �y'�6 Expiration Date
4. Addition Ve
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
11. Distance to lot lines
12. Type of roof
13. Siding house
14. Estimated cost- 1�1 Ll do
The undersigned certifies that,0i above stateme are ue to the best of his, her
knowledge and belief. �*4 d
6 Sign pure ofr ponsible appicant
Remarks
I�IH
002"t 33
Date Filed File No.
ZONING PERMIT APPLICATION (910". 2)
1 . Name of Applicant:
Address :- q6 , / Telephone: -;?6e
2 . Owner of Property:
Address : f�� P Telephone:
3 . Status of Applicant: Owner Contract Purchaser
Lessee Other (explain: )
4 . Parcel Identification: Zoning Map Sheet# 17t2 Parcel#
Zoning District(s) (include over a s)
Street Address - 3
Required
5 . Existing Pro nosed —by Z nin
Use of Structure/Property A.c- c-c:-
(if project is only interior work, s)fip t co #6)
Building height
%B1dg. Coverage (Footprint)
Setbacks - front 3
- side L: a"7' R: `� L: .9,'71R: 6 1 .
- rear ( a
Lot size p► t
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)__ lq �Xld ' cc,E
7 . Attached Plans : Sketch Plan / Site Plan
8 . Certification: I hereby certify that the informa ion contain herein
is true and accurate to the best of my knowled
Date: A p p 1 i c a n t I s Signature:
THIS SECTION FOR OFFICIAL USE ONLY:
Approved as presented/based on information presented
Denied as presented--Reason:
S cial' Permit and/or Site Plan Required:
i Req d: Variance Required:
�1 40
gnatur 1 ding InspActor at
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 tho Board of Health,Conservation commission, Dapaitmont of Public Works and other applicable permit granting authorities.
iell-
City of Northampton , REQUIRED INSPECTIONS
• 1. Footings and Walls •
BUILDING DEPARTMENT 2. Structural Components in Place*
3. Complete Building*
No. 517 Office of the Building Inspector
Zoning Form No. 002789 Date 6/13/94 Fee $40 check# 1701
page, 17D parcel 28 Zone URB Section 127 ❑ Yes 0 No
BUILDINGPERmir
*Plumbing and Electrical Inspections required
THIS CERTIFIES THAT Douglas Seamans before Building Inspections
has permission to Construct a deck 141x161 Inspection on Site—Foundations
situated on QZ slj : AYenue z,`: 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 CONSPICUO L O PREMISES
Certificate of Occupancy
B ' spector
Go1�