17A-302 (5) 4
PERMIT APPLICATION CHECK LIST
P
3 0 0
3 SETS OF PLAN� /PLOT P AN
NEW CONSTRUCTION
6 CURB CUT
7 WATER
8 , REMODEUNG INTERIOR
9 . ADDITION
0 , ACCESSQRX STRUCTURE
1 , SIGN
2 , PERMIT FEE - CHECK ONLY -
13 . SPECIAL RERMIT REQUIRED WITH DEED IF APPLICABLE
14 . UNDER 8
5 , FORM A
6 . FILL
COMMENTS:
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70 "d
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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. q; ?�`S GL� Alterations
��`1-�' 19 f Additions
NORTHAMPTON, MASS.-�
Repair
APPLICATION FOR PERMIT TO ALTER
Garage
1. Location !�s / �te1`Jf �'���e Lot No.
2. Owner's name Q'ti� j�rt,�r/( Address ;S ✓ il�.c°5 7 �'c�C
3. Builder's name Address
Mass.Construction Supervisor's License No. Od 6_ 7h3 Expiration Date rd�✓�'i��r
4. Addition
5. Alteration
6. New Porch
7. Is existing building to be demolished?
S. 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:- S60
The undersigned certifies that the above statements are we to the best of his, her
knowledge and belief.
Signature of responsible app icant
Remarks 11.2
t
Date Filed 4� s� / / °� 00306 '1'
r7�� r � File No.
ONING PERMIT APPLICATION (Si0. 2)
I. Name of Applicant:
Address : /�� 3"� ,zt Telephone:
2 . Owner of Property: u1 t„c,ve-
Address : 1,, s <�%2�sJ- <�t Telephone:
3 . Status of Applicant: Owner tract Purchaser
Lessee Other (explai.n )
4 . Parcel Identification: Zoning Map Sheet# 1 4 Parcel# 30
Zoning District(s) (include o er ays)
Street Address its
Required
5. ExistincT Pro osed by Zonin
Use of Structure/Property -suet--Tit
(if project is only interior work, skip to #6)
Building height
%B1dg. Coverage (Footprint)
Setbacks - front
- side L: R: L: R:
- rear
Lot size Z�$
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) /-rl C,�r zC> :; = 6,.,-/�
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:--���f/ Py" Applicant's Signature:
THIS SECTION FOR OFFICIAL USE ONLY:
/Approved as presented/based on information presented
Denied as presented--Reason:
S ecial'• Per it and/or Site Plan Required:
4crna ng Re it d: Variance Required•rte- of Building ate
NOTE: Issuance of a zo g permit does not rcliave an applicant's burden to comply Willi all zoning requirements and obtain all requirod permits
from the Board of Health,Conservation commission, Dopartmont of Public Works and other applicable pormh granting authoritlos.
City of Northampton REQUIRED INSPECTIONS
1. Footings and Walls
BUILDING DEPARTMENT 2. Structural Components in Place*
3. Complete Building*
No. 742 Office of the Building Inspector
Zoning Form No. 003067 Date-8/8/94 Fee $2o Check# 6981
Page, 17A Parcel 302 ,Zone_LmA Section 127 ❑ Yes No
BUI]LDINGPERMI r-I-I
*Plumbing and Electrical Inspections required
THIS CERTIFIES THAT Roy Omasta before Building Inspections
has permission to strip & reshingle roof Inspection on Site--Foundations
situated on 115 Hillcrest Drive 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 CONSPICUOU A O PREMISES
k
Certificate of Occupancy --
Buil p!Pctor F