31D-142 - SPLIT OFF FROM 31D-141 (2) PERMIT APPLICATION CHECK LIST Li5:171
YES NO DAT _
1 . ZONING FORM APPLICATION #7/(?�
2 . PERMIT APPLICATION
3 . OWNER OCCUPANT STATEMENT / LIC . ft IF NOT
4 . 3 SETS OF PLANS /PLOT PLAN 1110
5 . NEW CONSTRUCTION
6 . CURB CUT
7 . WATER AVAILABILITY FORMS
8 . REMODELING INTERIOR
9 . ADDITION
10 . ACCESSORY STRUCTURE
11 . SIGN / AWNING
12 . PERMIT FEE — CHECK ONLY — MONEY ORDER �.
13 . SPECIAL PERMIT REQUIRED WITH DEED IF APPLICABLE
14 . UNDER SECTION 127 — CMR 780
15 . FORM A
16 . FILL
:247
COMMENTS . g '' :t�.:..4` i., ao e
°�d `4� Cityof Northampton REQUIRED INSPECTIONS
DEPARTMENT I. Footings and Wallst AN BUILDING"- ..' 2. Structural Components in Place*
+=5�
�" 3. Complete Building*
Office of the Building Inspector
No. 57
Zonin.! Form No
000655 Date 2/2/93 Fee $380 Check# 13326
;;,-.�r,;,
.. Section 127 a Yes ❑ No
BUILDING PERMIT
* Plumbing and Electrical Inspections required
THIS CERTIFIES THAT Adams & Ruxton Construction Co. before Building Inspections _
has permission to Renovate interior & install handicap ramp Inspection on Site—Foundations
situated on 175 Main 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—Fmish
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 OUS P ON THE PREMISES
Certificate of Occ r=ncy
for
I'1 U 210l1
00065; .
Date Filed I ,4C'I 11 File No.
I
ZONING PERMIT APPLICATION (§10 . 2)
.41 1. Name of Applica t: C o Lam _A-- 0-0 _
Address: �' C. / � 7O �. DIO'7OTelephone: / •3(/- a / 8
2 . Owner of Property: , ( ,. .
Address : Telephone:
3 . Status of Applicant: Owner L--- Contract Purchaser
Lessee Other (explain: )
4 . Parcel Identification: Zoning Map Sheet# -SIO ,,, Parcel# /' -.; r
Zoning District(s) (include ov lay C-C)
Street Address ilrj Mom,. ,� _
Required
5 . Existing Proposed by Zoning
Use of Structure/Property
(if project is only interior work, skip to #6)
Building height
%Bldg. Coverage (Footprin't
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) •
•
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.L. gDate: uy� , ,_ C,
�I �(O �3 Applicant's Signat / e: wrc,..
�/ THIS SECTION FOR OFFICIAL USE ONLY:
y Approved as presented/based on information presented
Denied as presented--Reason:
Special Permit and/or Site Plan Required:
nd . ng uired: Variance Required:
gna r of uildi nspector 4:7 b Date v
NOTE: Issuance of a zoning permit does not relieve an applicanfs.lzurden to comply veth 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.
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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No.13 4 —2 13 8 Alterations
ikri NORTHAMPTON, MASS.
t �ANUA�/ Zo 19�6 Additions
'' APPLICATION FOR PERMIT TO ALTER Repair
Garage
1. Location 1143 /il/N t N �1- Lot No.
2. Owner's name 'WO I1a 11E11) I j j t*' FO Q,SAUI J Address 144( ht/PIN 51- 51')FL D , /AA
3. Buil(---der's name ,/�+1J P✓/l IZ►JXTO 1�1 Address 600 UN.)(O f-) 5-- W. SPFLJ , /A A
Mass.Construction Supervisor's License No. 0 S88o Expiration Date 6/3°793
4. Ado►t►on
5. Alteration r r P\ R /A t 1v j /N.D.t-r
6. New Porch
7. Is existing building to be demolished? N 0
8. Repair after the fire
9. Garage N O No.of cars Size
10. Method of heating C7P;C1 /)T Al
11. Distance to lot lines
12. Type of roof
13. Siding house
14. Estimated cost:- 1g5,000,OO
The undersigned certifies that the above statements are true i the best of his, her
knowledge and lflie .
-11-' /fr)(\6‘62,,,LA-r:Al i (22_,izt,i.._-f-;- t, .
lip Signature respo s' a appicant
v
Remarks F- s✓ AFr yC C=0!? 1-"' 1 .1.0V AL eY2Ps-p nr,Is max«`--/IV
O EFkCP /,e i Fell?. -It I►)S A I l AT •)1.1 (D1 NAN)DIC./kP
ir_.per"P Trn '_=xT to V. 1-›-t.rrpA1.1( -
COMMONWEALTH DEPARTMENT OF PUBLIC SAFETY
OF 1010 COMMONWEALTH AYE.
MASSACHUSETTS BOSTON,MASS.02215
ENCLOSE CHECK OR MONEY ORDER
LICENSE FOR REQUIRED FEE,
EXPIRATION DATE �(��. CONSTR. SUPERVISOR
pb/3Q/ 1993 ��` �=- o MADE PAYABLE TO
RESTRICTIONS EFFECTIVE DATE LIC-NO.
NONE iO6/30/1991 025880 "COMMISSIONER OF PUBLIC SAFETY"
mENRICG J OLIVERI (DO NOT SEND CASH).
17 SAINT JOSEPH DR �""
SS Ii 025-24-2069 E LONGMEAD MA C1028 PLEASE hC+TFLfEE INCREASE
•
PHOTO(BLASTING OPR ONLY) FEE:
100.00 EFFEC4-1 F4A._J1 , 1985
• HEIGHT: NOT VALID UNTIL SIGNED BY LICENSEE AND OFFICIALLY
STAMPED-OR-SIGNATURE OF THE COMMISSIONER
DOB: ,r7
10/02/1932 en,lx-c C/��'v�txenc. D04O.T DE"1AA LICENSE STUB
THIS DOCUMENT MUST BE SIGN NAME IN FULL-ABOVE SIGNATURE LINE
CARRIED E THE PERSON ENG OF �� �URE OF LICENSEE
THE HOLDER WHEN PATIO•
� C
OTHERS RIGHT THUMB PRINT ED IN THIS OCCUPATION f,�/� COMMISSIONER
200M-2-87.81429
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