17D-073 (8) PERMIT APPLICATION CHECK LIST
Yes No Date
1 . Zoning Form Application v
2. Permit Application
3. Homeowner statement if a licable Lic. # if not
4. 2 sets of plans
5. Curb cut
6 Water Department memo
7. Permit fee - check Q-4- # c/`3-7- '40,oc v
§. Special Permit required with de if applicable
9 Under section-127 - CMR 780
W. Form A
O�TIiAMp�O ��
Gl ff� of Xort4a pion
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DEPARTMENT OF BUILDING INSPECTIONS
INSPECTOR 212 Main Street ' Municipal Building
Northampton, Mass. 01060
AS A HOMEOWNER I UNDERSTAND THAT I MAY APPLY FOR AND RECEIVE
A BUILDING PERMIT FOR A HOME OR ADDITION I INTEND TO LIVE IN.
I ALSO UNDERSTAND THAT I AM RESPONSIBLE FOR KNOWING THE STATE
BUILDING. CODE AND ZONING ORDINANCE OF THE CITY OF NORTHAMPTON.
BEING A HOMEOWINER AND NOT A PROFESSIONAL CONTRACTOR IN NO WAY
ABSOLVES ME OF ANY RESPONSIBILITY TO INSURE THAT ALL FACETS
OF THE RULES AND REGULATIONS ARE COMPLIED WITH.
Signature & Date
Addendum to Building Permit Application:
Property Address : 30 High Street, Florence, MA 01060
Owner : Theodore R. and Anne L. Deppe
We are requesting a permit to put a bathroom in the basement
of our house. We presently have one small bathroom on the
second floor which has proved inconvenient for a family of
two adults and three teenagers.
We want to build an 8 x 10 bathroom which will include a
commode , sink, and fiberglass shower . We will frame it in,
sheetrock it , and paint the walls, and add a drop ceiling
and door . Plumbing to be installed by O 'Connell Oil
Associates with water pipes of type L copper .
Dan Whiteley , electrician, will provide a vented fan, light
fixtures, and outlets . DES roofing to provide vent flashing
at roof .
LAYOUT APPROXIMATE
NOT TO SCALE
DIMENSIONS ROUNDED
F C
P 1 1
6 C{
Fl
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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No.
5 � �� 7 7 Alterations
/rGc� '7 2 Additions
a NORTHAMPTON MASS. � 19 Repair
APPLICATION FOR PERMIT TO ALTER
Garage
1. Location 3 O � ` S+ F (0 re,C.e Lot No.
2. Owners name s A�% � , �Q f Address l o t�`�^ S fi ��° re, ce
3. Builder's name ' Ore Address 30 lt„ �4 10 rf, UV
Mass.Construction Supervisor's License No. Expiration Date
4. Addition
5. Alteration G A Cpl
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:- 3, occ O p
The undersigned certifies that the above statements are true to the best of his, her
knowledge and belief.l
Signature of responsible applicant
Remarks
PRIN� HOP
Y,
Date riled ol __. _..�_.
202gxNG PEJUJI P APPLICATION (510 - 2 )
I , Nama ;of A plicant: t n --
' A d d x,�s s I ,�"3�i /-1 l��( ST G U�E ti��•-- 7.'a].g p h o a t ���7!.Ca_7 _
2 , owner of Proper y t �1 eG G Gr-e hex, %'e
Address ) _
Pe1ephonpt ---.7 ."7.
31 ,•At+al:us 'off Applicani: l 'Owner contract: Pu,rchase, *
Lessee Other. (explaT7n '
4 , Parcel Tdenti.�ic&t:i011 : 7,011incj Hap S ept/_�;
Zoning DJ.s�rict: (s) ( in;o� ude over
Street Address 6 d,,CH Sr
5 , uNx ,sti UC. Pro Poaocl
Use of, St:ruct:ure/Propert'y
(ig• project; 'is only intoviox work, Sk h t o G )
Building height: ' ' __.__...
f I Cover age (Footpri��t)
8,a4.,t)acka - front.
- *side
-• rear
Lol_- size
1 Fx.ontacje
plour, Area Ratio
kapean space (Lot tires 'nl.inus
1:vt ::I.ding and unrk.ing)
•Par}tin(U Spaces -
-
J.Jqad inch _
Bigne —
'• • I`i.L;ti (vol.untQ & locai:zon) _, r ....
6 , Narrr.ttive Description- of Proposed Work/l)r.o�act.. (Use add iLi ! :s
if 1=05sary)
1 •
7 . Attached Plains ; Skatch l�lan ' Site Plan
8 . ; Cartiticationt ,I' hereby certify that the ini'ormaLlon obnt ai,: 1 1' :-c3 in
' fi true and acourat.e to Cite best of my knowledge ,
Da�,a t j �. �� �Z Applicant; t•s Signat.ure t .
•.• '' •• _. •.» —,CH:B 8>aOTI6N P'01t Or'll fODAL UBB Ong I
ZD prove-cl ats '13 eserited/based oat .ittfoxttiaL- .on presented Il.iad AS presenteld ,
rl, r peli,f al I
>1. �0.2_
'
qna re, o;C By ng ' xnspe•ctor a ,Q
NOTM (aauancu o(a zonln0,porm(l dour not►ollwo an appllcunt's bumfun IQ compty whit off zonho mqul(urnontl and
(torn tho Uard,o(Honlltt, Conamatlon Ommloolon, popnrtniont of Publlo lftko and Qdm o r>llcablo p or dT r
r t
MAR 2 IF`
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I.l J
City of Northampton REQUIRED INSPECTIONS
1 . Footings and Walls
• _1,T)ING
z Structural Components in
�
3 . Complete Building
No. 108 Office of the Building Inspector
Date March 4, 19 92
BUI DING P RMIT
THIS MAY CERTIFY THAT Theodore Deppe Insp. on Site — Foundations
Install an 8 x 10 bathroom - Framing,
has permission to sheet rocking, paint and installing a ceiling Insp. of Plumbing — Rough
I situated on -�Q High St- , Florence, MA. Insp. of Plumbing —Finish
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
THIS CARD MUST BE DISPLAYED IN A CONSP CUOUS PLACE ON THE PREMISES
Certificate of Occupancy
-Building Inspector
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