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17C-042 (7) PERMIT APPLICATION CHECK LIST PLOT . ° ' ZONE G(-�� : ^'YES NO DAT EQEIM APPLXOAMQV.,U­ loved 1N z 3 . OWNER OCCUPANT STATEMENT # 'IF NOT 4 . 3 SETS OF PLANS OT PLAN 5 . NEW CONSTRUCTION 6 . CURB CUT 7 , WATER AVAILABILITY FORMS 8 . REMODELING INTERIOR 9 . ADDITIO 10 . ACCESSORY STRUCTURE 11 . SIGN / AWNI 1 2 . PERMIT FEE . ONLY — MONEY ORDE s; . .Y 13 . SPECIAL PERMIT REQUIRED WITH DEED IF APPLICABLE 14 . UNDER SECTION 127 - CMR 780 15 . FORM A 16 . FILL COMMENTS : y b > o 70 `C < n- C 7 "'' O O r m 1 xo z � o Zoning Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations a NORTHAMPTON, MASS. 19 Additions APPLICATION FOR PERMIT TO ALTER Repair Garage v , v 1. Location _ Lot No. 2. Owner's name - Address__ c / 3. Builder's name Address_ sc' Mass.Construction Supervisor's License No. � �/S� _Expiration Date 4. Addition _ 5. Alteration 6. New Porch 7. Is existing building to be demolis ed? _. 8. Repair after the fire _ 9. Garage No.of cars Size 10. Method of heating 11. Distance to lot lines 12. Type of roof 014 Y 11 13. Siding house 14. Estimated cost:49 370 1 The undersign e rti s that the aV�te��s rents are true to the best of his, her knowledg d be f Signa[uWojresponsible app,ican! Remarks — Date Filed � r� ��► File No. ZONING PERMIT, PLICATION (§10 . 2) 1 . Name of Applicant: Address : j Telephone: 2 2 . Owner of Property: Z-1 �. Address Telephone : 5 - 3 . Status of Applicant, C wner Contract Purchaser Lessee Other (explain: ) 4 . Parcel Identification: Zoning Map Sheet#-fl-!�_­ Parcel# _Z- , Zoning District (s) (include overl s) U_k6 Street Address <j S , UU Required 5 . Existinq Proposed by Zoning Use of Structure/Property (if project is only interior work, skip to #6) Building height %B1dg. 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 Propose A 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 r - Applicant' s Signature: �7 THIS SECTION FOR OFFICIAL USE ONLY: Approved as presented/based on information presented Denied as presented--Reason: Special' Permit and/or Site Plan Required: F 'hdi r12 Requ ' ed: _ Varia ce Requivr�ed` S gnature f Aate 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 Health, Conservation Commission, Department of Public Works and other applicable permit granting authorities. iC'71- City of Northampton REQUIRED INSPECTIONS • 1. Footings and Walls e e BUILDING DEPARTMENT 2. Structural Components in Place* 3. Complete Building* No. 835 Office of the Building Inspector Zoning Form No. 001736 Date 9/15/93 Fee $20 Check# 3630 Page, 17C Parcel 42 ,Zone URB Section 127 ❑ Yes ® No BUI]LDING PERNM * Plumbing and Electrical Inspections required THIS CERTIFIES THAT Bob Thibodo before Building Inspections has permission to Re-shingle roof Inspection on Site--Foundations situated on 55 Sheffield Lane Inspection of Plumbing—Rough provided that the person accepting this pen-nit 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 pen-nit.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 F THIS CARD MUST BE DISPLAYED IN A CONSPICUOUS PL CE ON THE PREMISES Certificate of Occupancy Building In for City of Northampton REQUHZED INSPECTIONS $ ; 1. Footings and Walls • BUILDING DEPARTMENT 2. Structural Components in Place* 3. Complete Building* Nom 835 Office of the Building Inspector Zoning Form No. 001736 Date 9/15/93 Fee 20 Check# 3630 Page, 17C Parcel 42 ,Zone URB Section 127 ❑ Yes ® No BUI]LDINGPERMIT *Plumbing and Electrical Inspections required THIS CERTIFIES THAT Bob Thibodo _ before Building Inspections has permission to Re-shingle roof _ Inspection on Site�—Foundations situated on 55 Sheffield Lane 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 Northamptoa. 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 PL CE ON THE PREMISES Certificate of Occupancy Building In for