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17A-073 (3) D v T � z � z � i a Zoning Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations NORTHAMPTON, MASS. 19 Additions APPLICATION FOR PERMIT TO ALTER Repair Garage 1. Location rf Lot No. 2. Owner's name ! o Address 3. Builder's name Address Mass.Construction Supervisor's License No. ';2� Ta _ Expiration Date f' 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:- The undersigned certifies that the above statements ge true to the best of his, her knowledge and be��? A r> ✓r t� Signature of rrsp�onsib(e app icani Remarks �J` X 00,-5J T . Date Filed U /��y, ` File No. Z NING PERMIT P I ATION (510. 2) 1 . Name of ApplicaVOAddress : Telephone: 2 . owner of Property: 1 Address : - _ Telephone: 3 . Status of Applicant: owner Contra Pu haser Lessee Other (explain : 4 . Parcel Identification: Zoning Map/ Sheet#_/7 4 Parcel# �3 , Zoning District (s) (include verla s) Street Address Required 5. Existing 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 Proposed Work/Project : (Use additional sheets if necessary) 1z >.� , 1 w c= r 6,L- -e c.1/1� 7 . Attached Plans : Sketch Plan Site Plan 8 . Certification: I hereby certify that the informatio contained herein is true nd accurate to the best of my knowledge Date: Applicant' s Signature: �� -� THIS SECTION FOR OFFICIAL USE ONLY: Approved as presented/based on information presented Denied as presented--Reason: Sp ial' Permit and/or Site Plan Required : Wd ' Requ ' e Variance Required: gnaturL Bu ldi specto a 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. 4io- City of Northampton REQUIRED INSPECTIONS BUILDING DEPARTMENT 2. Structtural and Components in Place* 3. Complete Building* No. 372 Office of the Building Inspector Zoning Form No. 002591 Date 5 f] /g4 Fee $2n Check# Money Order Page, 17A Parcel 73 ,Zone URA Section 127 ❑ Yes No BUI]LDINGPERMIT * Plumbing and Electrical Inspections required THIS CERTIFIES THAT Bob Thibodo before Building Inspections has permission to Replace face layer of shingles Inspection on Site—Foundations situated on 17 Mountain Road Inspection of Plumbing—Rough provided that the person accepting this permit shall in every respect Inspection of Plumbing—Famish 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 perit.Expires six months from date of issuance,ifnot 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 PL THE PREMISES Certificate of Occupancy B spector _ a-