25C-038 (4) PERMIT APPLICATION CHECK LIST
PAGE 2S G PLOT 3T ZONE �� � � YES NO DATE
ZONING FORM APPLICATION
2 . PERMIT APPLI
3 . OWNER OCCUPANT STATEMENT NOT �.
3 SETS OF PLANS- ZELOT PLAN
NEW CONSTRUCTION
6 CURB CUT
WATER
8 , REMODELTNG
9 . ADDITION
0 , ACCESSORY
11 , SIGN / AWNING
2 , PERMIT FEE - l/
3 . SPEC IRED WITH DEED IF APP IC B
4 . UNDER SECTION 127 - CMR 780
15 FORM A
6 , FILL
COMMENTS :
a
T a`
o
Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations
NORTHAMPTON, MASS. UTU���- Z 19 Additions
APPLICATION FOR PERMIT TO ALTER Repair
�7 {,, �i Garage
1. Location // ����/f�%/�� ,�l�� �1��/�//1j9�`�i/ h� ��J'f Lot No.
2. Owner's name /rJ 19 77-- ��.� Address
3. Builder's name /�' ��/ ✓� `� W/ " G� Address `� y GldfT�� /� l�✓�� /�/ C7/�'6v
Mass.Construction Supervisor's License No.��QS fin/ Expiration Date_ 1-1116
4. Addition
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. S;rnrtse
14. Estimated cost:- 9 Ov
The undersigned certifies that the above statements are true to the best of his, her
knowledge and belief.
Signature of responsible appucan!
Remarks
Date Filed to I' _ File No.
ZONING PERMIT APPLICATION (§ib*. 2)
1 . Name of Applicant: IAll f� Ileli� 6 '� k114&e'1�
Address: (,fir �� Telephone:
2 . Owner of Property:
Address: Telephone: S F1- YYW
3 . Status of Applicant: Owner Contract Purchaser
Lessee Other (explain )
4 . Parcel Identification: Zoning Map Sheet#_2 ,r'G Parcel#3� .. ,
Zoning District(s) (include lave ys) 6J
Street Address tk,44 r
Required
5 , Existing Proposed by Zonin
Use of Structure/Property
(if project is only' interior work, skip to #6)
Building height
oBldg. 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 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.'_
X w
Date App 1 icant s S ignature: e ce
THIS SECTION FOR OFFICIAL USE ONLY: _ — — r r — _
V/Approved as presented/based on information presented
Denied as presented--Reason:
Special* Permit and/or Site Plan Required:
ing Requ' ed,:, Variance Required
K gnatiar Building Ixmpfactor
NOTE: Issuance of a zoning permit does not relieve an applicant's burden to comply Witit all zoning requirements and obtain all required pormits
from the Board of Hoalth,Conservation Commission,Dapaitmant of Public Works and oUtor appiicabio permit granting authorltios.
City of Northampton REQUIRED INSPECTIONS
I. Footings and Walls
BUILDING DEPARTMENT
2. Structural Components in Place*
3. Complete Building*
No. 450 Office of the Building Inspector
Zoning Form No. 004355 Date 6/8/95 Fee $20 aleck#Money Order
Page, 25c Parcel 38 Zone URB Section 127 ❑ Yes ® No
BUI]LDINGPERMIT
*Plumbing and Electrical Inspections required
THIS CERTIFIES THAT United Siding & windows before Building Inspections
has permission to Install replacement windows Inspection on Site—Foundations
situated on 11 Northern Ave. 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 teams 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 - S PLA THE PREMISES
Certificate of Occupancy
Buildin
�optt'``t 1.1;1!51149