36-004 (2) pQ.'tHMtp�o
� � �Iussachusetts W
s. DEPARTMENT OF BUILDING INSPECTIONS
a
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 HOMEOWNER 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 & to
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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations
a NORTHAMPTON, MASS. 1 g Additions
APPLICATION FOR PERMIT TO ALTER Repair
Garage
1. Location Lot No.
2. Owners name Address Z z „��
3. Builder's name Aj Address
Mass.Cons Supervisor's License No. Expiration Date
4. AAdai0q
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:- / 7 o o
The undersigned certifies that the above statements are true to the best of his, her
knowl ge and bell
Signature o sponsible applicant
Remarks J'
PRIN.T�SHOP
•Y P+
Date Piled File. No.
ZONING PE 7T APPLICATION (510 . 2) .--
1. Name off' Appicant:
Address : 70) a
Telephone.
2 , Owner of Property: _-
Address ,, . Telephone:
w
3 . Status of Applicant: X owner Contract Purchaser
Lessee Other (expla n: ),
4 . Parcel Identification: Zoning Map Sheet# Parcel y ,
Zoning District (s) (include overlays) URA
Street Address
' 12�cYttiL ed ,
S • I;xistin� Proposed by_ china
Use of Structure/Property '
(if prof eot 'is only interior work, skip to //6)
Building heig /ht • �. _
kpldg. Coverage (Foot;priht;)
t Setbacks - front
- s i d d
- rear
Lo.t 'size 'M-
Frontage ----------
• Floor, Area Ratio
%ope,n Space (Lot; area minus
bull.dinq and parking) _ ..._
Parkinc[ ,Space's
Loading
Signs _ ..
Fill (volume & location)
6 . Narrative Description of Proposed WorkJProj,ect; (Use additional �slZeets
if riFcessary) _.
7 . ' Attached Plans : Sketch Plan Site Plan
8 . Certification: •1 ' hereby certify that the information contained herein
i•s true and accurate to the best of my knowledge.
Date: /�1j f / CYi Applicant' s Signature: v
-• •• - .• -'Ifx-: B SECTION FOR OFFICIAL USE ONLYt j -
`` Approved as presented/based on information presented
Denied as presented
Reason for Deiiia'l : .
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'Signature. of Building inspector Date '-"
NOTE: Wuanco of a zoning pormit does not(ollavo an applicant's burdon to comply wigs all zoning roqulromonts and obtain ah'rvquhud ponrlu
from tho Board.o(f-lonhh, conoorvation Commission, Dopatmont of Public Works and odior applicablo ponnit granting authcuitiva.
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