03-009 (2) PERMIT APPLICATION CHECK LIST
PAGE PLOT "l ZONE � ' \ i 1-���� NO DATE
1 ZONING '
2 . PERMIT
3 . OWNER OCCUPANT S OT
4 . 3 SETS OF- PLANS L ?
5 . NEW CONSTRUCTION
6 . CURB CU
7 WATER V 0 S
8 . REMODELING IO
9 . ADDITION
10 . ACCESSORY STRUCTURE
SIG t
2 . PERMIT L - MONEY O D
13 . SPECIAL PERMIT REQUIRED WITH DEED IF APPLICABL
14 . UNDER SECTION 127 - CMR 780
15 . FORM
16 . FILL
COMMENTS :
u-0 _ , ,
>
Z rn
Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations
NORTHAMPTON, MASS. 19— Additions
APPLICATION FOR PERMIT TO ALTER Repair
Garage
1. Location 6ty,1),C,-L Lot No.
I Cf Address
2. Owner's name
Address J Mz 515 t 15 /yV 1)�11-e y 7 14"
3. Builder's name-U
Mass.Construction Supervisor's License No. �i 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 COSL-
The undersigned certifies that the above statements are true to the best of his. her
41 knowledge and belief.
Signature of responsible app icani
Remarks
002810
Date Filed File No.
ZONING PERMIT APPLICATION (910. 2)
1. Name of Applicant:
Address : Telephone:
2 . owner of Property:
Address : ;2 ,;
Telep o e:
3 . Status of Applicant: Owner 1-�Contract Purchaser
Lessee Other (explain: )
4 . Parcel Identification: Zoning Map Sheet# Parcel# ,
Zoning District(s) (incl e ovr� l� a�ys)
Street Address 4P ( !IDC d!u9-- I
5 . Required
Existinq Proposed bv Zo in
Use of Structure/Property �--
(if project is only interior work s 'p to 6)
Building height
%Bldg. Coverage (Footprint)
Setbacks - front
- side L: R: L: R:
- rear
Lot size
Frontage
Floor Area Ratio
%open Space (Lot area mien S
building and parking)
Parking Spaces
Loading
Signs
Fill (volume & location)
6. Narrative Description of Proposed Work/Project: (Use additional sheets
if necessary)
'r
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:_(p 97, Applicant's Signature:
/ THIS SECTION FOR OFFICIAL USE ONLY:
�/Approved as presented/based on information presented
Denied as presented--Reason:
Special' Permit and/or Site Plan Required:
di Requ ' d: Variance Required:
gna u -- ul ding Inspec r � D e
_._. _ .
NOTE: issuance of a zoning pdWCdow 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 authontlos.
ie 11-
tV W
City Q Northampton REQUIRED INSPECTIONS
• 1. Footings and Walls
e BUILDING DEPARTMENT 2. Structural Components in Place*
0
3. Complete Building*
No. 542
Office of the Building Inspector
Zoning Form No. 002810 Date 6/20/94 Fee $20 Check# 409
Page, 3 Parcel 9 ,Zone RR Section 127 ❑ Yes U No
BUI]LDINGPERMI r-I-I
* Plumbing and Electrical Inspections required
THIS CERTIFIES THAT William Gnatek before Building Inspections
has permission to Repair slate roof Inspection on Site—Foundations
situated on 501 Coels Meadow Road 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 CONSPICU US?L ON THE PREMISES
Certificate of Occupancy --
g Inspector �_