25C-186 (7) a
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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations
NORTHAMPTON, MASS. 19 Additions
APPLICATION FOR PERMIT TO ALTER Repair
�J Garage
1. Location Lot No.
2. Owner's name Ad ess
3. Builder's name `(ag jlCI c � Address
Mass.Construction Supervisor's LiceNonse . a r~ � 1 Expiration Date
X
4. Addition of
5. Alteration _
6. New Porch
7. Is existing building to be demolished? 1
8. Repair after the fire wd
9. Garage Y2( No.of cars Size
10. Method of heating f444,1
11. Distance to lot lines
12. Type of roof
13. Siding house
14. Estimated cost- C31 6V-tJ
The undersigned certifies that the above statemcnts are true to the best of his, her
knowledge and belief.
t/
Si nature ojresponsible appucant
Remarks c
S
0039 07
,..Date Filed File No.
ZONING /PERMIT APPLICATION (S10.2)
1. Name of Applicant: / l
Address: Telephone:) 17
2 . Owner of Property:
Address: Telephone:
3 . Status of Applicant: Owner Contract Purchaser
Lessee Other (explain: )
4 . Parcel Identification: Zoning Map Sheet#<3-s"C- Parcel#
Zoning District(s) (include overlays)
Street Address
Required
Existin Proposed b Zonin
Use of Structure/Property
(if project is only interior work, skip to #6)
Building height
%Bldg.Coverage (Footprint)
Setbacks - front
- side
- 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.
Date: - � Applicant's Signature:
THIS SECTION FOR OFFICIAL USE ONLY:
_L-Approved as presented/based on information presented
Denied as presented
's f or i 1:
'ignatu o Build' pector Date
NOTE: Issuance of a zoning permit does not relieve an appikanfs burden to comply with all zoning requirements and obtain all required permits
from the Board of Health,Conservation Commission,Department of Public Works and other applicable permit granting audxmdes.
PERMIT APPLICATION CHECK LIST
PAGES L PLOT ZONE ��'� 3- -,�`� �L YES NO DATE
ZONING FORM APPLICATION
2 . PERMIT I "
3 . OWN '" IF NO
3 SETS OF PLANS PLAN
5 . NEW CONSTRUCTION
6 . CURB CUT
7 WATER S
8 , REMODELING
9 . ADDITION
10 , ACCESSORY STRUCTURE
11 , SIGN / AWNING
2 , PERMIT F E E - - MONEY ORDER]jt-,��-//' Y�
13 , SPECIAL PERMIT REQUIRED WITH DEED IF APPLICABLE
14 . UNDER SECTION 127 - C R 780
15 . FORM
16 , FILL
COMMENTS :
-
City of Northampton REQUIRED INSPECTIONS
BUILDING DEPARTMENT 2. S�rccttugral Walls Components in Place*
3. Complete Building*
NO. 1023 Office of the Building Inspector
Zoning Form No. 003407 Date 10/12/94 Fee 40 Check# 239
Page, 25C Parcel 186 ,Zone URC Section 127 ❑ Yes 0 No
BUI]LDINGPERNM
* Plumbing and Electrical Inspections required
THIS CERTIFIES THAT William Mazuck before Building Inspections
has permission to Install 3 doors, sheetrock, new cabinet with sink 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.
Building Inspection—Finish
Smoke Detectors(Fire Department)
Other
THIS CARD MUST BE DISPLAYED IN A CONSPICUOUS PLACE ON THE PREMISES
Certificate of Occupancy
Building Inspector