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25C-186 (6) PERMIT APPLICATION CHECK LIST ES DATE 3 , OWNER 3 SETS OF PLANS /PLOT PLAN NEW S 6 , CURB CUT 7 WATER 8 . REMODELING 9 , ADDITION 0 , ACCESSORY C 11 , SIGN / AWNING 2 , PERMIT FEE,&jdWW - MONEY npDERAiUMOM 13 . SPECIALRERMIT REQUIRED IF APP IC B 4 . UNDER S - CMR 780 5 , FORM A 6 , FILL COMMENTS : ,a Z, T r► v � 3 c Zrn �! > � o r Z X o � Zoning OR t?— Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations NORTHAMPTON, MASS. —+;3 19 Additions ~, Repair APPLICATION FOR PERMIT TO ALTER Garage 1. Location 11 F l"Y Lot No. 2. Owner's name Address M� 3. Builder's name .fir fH Addressaj Lt"Zjm f;e-)A" W27 Mass.Construction Supervisor's License No. tj j (�� + Expiration Date (; / 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. Siding house 14. Estimated cost- 'Vey The undersigned certifies that the above statements are true to the best of his, her knowledge and belief. e Signaru oj:resp nstbte appicane Remarks Date Filed File No. ZONING PERMIT APPLICATION I . Name of Appli ant: a, Address: 1 ,�, { , Telephone: � 2 . owner of Property: ' ? , e14 vn-10 Address: ���� j�;j/ 1, r� 1� -�: l Telephone: 3 . Status of Applicant: Owner .Contract Purchaser Lessee Other (explain: ) 4 . Parcel Identification: Zoning Map Sheet# Parcel I8(o ZoningDistrict(s) (include_ ov ys). r Wy ..e S tr eet Address 1 Required 5 • Exist�n Proposed by Zoning Use of Structure/Property (if project is only, interior w k, 4iP to #6) Building height °sB1dg. Coverage (Footprint) Setbacks - front - side L: R: L: R: - rear Lot size Frontage. Floor Area Ratio oOpen 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. 4 Date:. lv ,, Applicant's Signature:, THIS SECTION FOR OFFICIAL USE ONLY: YApproved as presented/based on information presented Denied as_ presented--Reason: S cial'&e ' nd/or Site Plan Required: g Variance Required: gnatu 'of Bu�.ldina In actor D e 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 the Board of Hoallh,Conservation commission, Dopartmont of Public Works and otlior appiicablo permit granting authoritios. C ity of Northampton REQUIRED INSPECTIONS b BUILDINGDEPARTMENT 1. F ootings and Walls *2. Structural Components in Place 3. Complete Building* No. 426 Office of the Building Inspector Zoning Form No. 004324 Date 5/30/95 Fee $20 Check#582 Page, 25C Parcel 186 ,Zone URC Section 127 ❑ Yes Q No BUI]LDINGPERINM * Plumbing and Electrical Inspections required THIS CERTIFIES THAT William Mazuch before Building Inspections has permission to Replace front & rear doors Inspection on Site —Foundations situated on 22 Highland 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 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. ** Install per Manufacturers information: windows, vinyl siding, Building Inspection—Finish roofs and woodstoves. Smoke Detectors(Fire Department) Other THIS CARD MUST BE DISPLAYED IN A CONSPICUOUS PLACE ON rME P Certificate of Occupancy '` B ding Inspector