17A-153 (3) pp� a �A88ACI�If4 PIES `� -' �
DEPARTMENT OF BUILDII\'G INSPECTIONS
212 Main Street ' Mun icipal Il�Olding
INSPECTOR NTorthampton, 1Vlass. 01
AS A HOMEOWNER I UNDERSTAND THAT I MAY APPLY FOR AND RECEIVE
A BUILDING PERMIT FOR A HOME OR ADDITION I INTEND TO LIVE IN.
I ALSO UNDERSTAND THAT I AM RESPONSIBLE FOR KNOWING THE STATE
BUILDING CODE AND ZONING ORDINANCE OF THE CITY OF NORTHAMPTON.
BEING A HOMEOWNER AND NOT A PROFESSIONAL CONTRACTOR IN NO WAY
ABSOLVES ME OF ANY RESPONSIBILITY TO INSURE THAT ALL FACETS
OF THE RULES AND REGULATIONS ARE COMPLIED WITH.
ignature Date
41
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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. —'z 56 Alterations
a NORTHAMPTON, MASS. (o -- I 19 Additions
Repair
APPLICATION FOR PERMIT TO ALTER Garage
1. Location (*0 FVX Fgmslta , FFj,.eraeNcP MA Lot No.
2. Owner's name W,� 10,M"t eSTR 1. Address 6® 0JL FAR>AS'RA. .R ? T�,
3. Builders name Sea' Address
Mass.Construction Supervisor's License No. Expiration Date
4. Addition 1Jf�
5. Alteration `z 4""'JTO
e10V-SF
6. New Porch N h
7. Is existing building to be demolished? 1"40
8. Repair after the fire No
9. Garage Nn No.of cars Size
10. Method of heating
11. Distance to lot lines
12. Type of roof
13. Siding house
14. Estimated cost:- �000.
The undersigned certifies that the above statements are true to the best of his, her
knowledge and bel'
Signature of responsible applicant
Remarks
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Date Filed File No. i? A- r-3 Q RA
ZONING PERMIT APPLICATION (510.2)
1. Name of Applicant: • �- d1, 5 ,r A Ate' osrA
Address:,fn %ox �47,zmS A-k1, r�n 4,L; o. 1kJA. Telephone:
2 . Owner of Property:
Address: Telephone:
3 . Status of Applicant: Owner Contract Purchaser
Lessee other (explain: )
4 . Parcel Identification: Zoning Map Sheet#_I'Z4 Parcel# ,
Zoning District(s) (include overlays) �,)f;,4
Street Address (rO Fc,�,r�4,Q K r2A , FI-cRe1t,1,-~ ���
Required
5• Existing Pro Dosed by Zonin
Use of Structure/Property ,,�
(if project is only interior work, skip to #6)
Building height
%B1dg. 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) t �,�,o,e � t,4 p 1) ,� �d rrQSraU— �caie� ��sr,�pwz
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 knowled e.
Date: - i - cj �, Applicant's Signature r °'
- - - - - - - - - - - - - - - - - - - - - - - - - - : '
_ i .a
THIS SECTION FOR OFFICIAL USE ONLY:
v' Approved as presented/based on information presented
Denied as presented -•- --
eas n fob-Venial:
1-47
S gnattir`e of Bui , g Inspector Date
NOTE: Issuance of a zoning permit does not relieve an applicants 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 autltorities.
PERMIT APPLICATION CHECK LIST .
a Fp ctr m 5 `l Yes No Date
1 . Zoning Form Application �.-
2. Permit Application �.
"'7!!�3. Homeowner statement if a licable Lic . # if not
4. 2 sets of i)larys
5. Curb cut
6. Water Department. n
7. Permit fee chec c only QJ� :9 -3 P, 0 °C 4-
�. Special Permit required ALtlLjjeed if applicable
9.
Under section 127 CMR 780
Form A
s'7
4 •
City of Northampton REQUIRED INSPECTIONS
1 . Footings and Walls
z - Structural Components in
BUILDING DEPARTMENT
-� Place
3 . Complete Building
No. 313 Office of the Building Inspector
Date June 5, 19 92
r
BUI DING P RMIT
;J) THIS MAY CERTIFY THAT William & Dianne Dostal Insp. on Site — Foundations
has permission to Remove picture window and install casement windows Insp. of Plumbing — Rough
situated on 60 Fox Farms Road Insp. of Plumbing — Finish
provided that the person accepting this permit shall in every re- Insp. of Wiring — Rough
spect conform to the terms of the application on file in this office,
and to the provisions of the Statutes and the Ordinances relating Insp. of Wiring — Finish
to the Construction, Maintenance and Inspection of Buildings in Insp. of Health (Septic Tanks)
the City of Northampton. Any violation of any of the terms above
noted is an immediate revocation of this permit. Expires six Building Insp. — Rough
months from date. Building Insp. — Finish
Note: A certificate of occupancy will be issued by this office upon Smoke Detectors (Fire Dept.)
return of this card signed by the Plumbing, Wiring and Building
Inspectors. Gas Inspection
THIS CARD MUST BE DISPLAYED IN A CONSP CUOUS PLACE ON THE PREMISES
Certificate of Occupancy
u� ding Inspector
P INOP