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17A-196 (8)
PERMIT APPLICATION CHECK LIST PAGE PLOT ZONE (t-A�6 t ES NO DATE 1 . ZONING FORM APPLICATION v 2 . PERMIT APPLICATIO 3 . OWNER OCCUPANT --STATEMENT LIC. # IF NOT 4 . 3 SETS OF PLANS LOT PLAN 5 . NEW CONSTRUCTION 6 . CURB CU 7 . WATER AVAILABILITY FORMS 8 . REMODELING INTERIOR 9 . ADDITION 10 . ACCESSORY STRUCTURE 1 . SIGN / AWNING 12 . PERMIT FEE - CHECK ONLY - MONEY ORDER 13 . SPECIAL PERMIT REQUIRED WITH DEED IF APPLICABLE 14 . UNDER SECTION 127 - CMR 780 15 . FORM 16 . FILL COMMENTS : C � v b c -e a � � y r E. z N z �. o I A Zoning Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations a NORTHAMPTON, MASS. t ` 19_L� Additions APPLICATION FOR PERMIT TO ALTER Repair �/i Garage 1. Location 151 ��� � 1 " 1 �G- / iC- Lot No. 2. Owner's name Address S 'C, —�-- 3. Builder's name *9f, ddress Mass.Construction Supervisor's License No. t""� Lf Expiration Date �'?�' d 'U 4. Addition 5. Alteration 0L 0Vtc—* -7- Mf tA-t.l ILA 1 TO Ckq/1/l 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 c - J 21 � The undersigned certifies that the above statements are true to the best of his, her knowledge and belief. t ignalure of respo Bible appican! Remarks e , 6 'J Date Filed 3 Q3 � 00100i File No. ZONING PERMIT APPLICATION (§10 . 2 ) 1 . Name of Ap licant ; � Address : .O , G30-c k Tele hone : 2 . Owner of Property: T,Of Z.Y- v Address : /�® , IM �p� ,5� '��t�„z ,�.cfgelephone : 371 � 1 5 3 . Status of Applicant ; Owner Contract Purchaser Lessee Other (explain : kAIL '�,_, ) 4 , Parcel Identification : Zoning Map Sheet# ) 6 Parcel# 1?�' , Zoning District (s) (include ove ays) �lj Street Address Required 5 . Existinq Proposed by Zoning Use of Structure/Property (if project is only interior work, skip to #6) Building height oB1dg . Coverage (Footprint) Setbacks - front - side L: _R:__L: - 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(\V Q,,( 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 : Applicant Is Signa ire : a, - 'e, '/ THIS SECTION FOR OFFICIAL USE ONLY y Approved as presented/based on information presented Denied as presented--Reason : Special' Permit and/or Site Plan Required : in ing R fired : Variance Required ; rr gnat of Buil ' nspector "f3 a NOTE; Issuance of n �gpermit does not relieve an applicant's burden to comply with all zoning roqulromonls and obtain all required porrnits from the [ioard of Health, Conservation Commission, Doparlrnonl of Public.Works and othor appiicablo permit granting authorities, 1071- City of Northampton REQUIRED INSPECTIONS A l. Footings and Walls UILDING DEPARTMENT 2. Structural Components in Place*B 3. Complete Building* Office of the Building Inspector No. 283 001001 Date 5/4/93 Fee 14�o Check# 1812 Zoning Form No. 17A 196 URB Section 127 ❑ Yes © No Page, Parcel ,Zone _ BU1. 1LDING PERWI * Plumbing and Electrical Inspections required THIS CERTIFIES THAT Heartwood Construction/A&C Bertrand before Building Inspections has percussion to Change windows Inspection on Site--Foundations _- situated on 151 North Maple street Inspection of Plumbing—Rough Inspection of Plumbing—Finish provided that the person accepting this permit shall in every respect Gas Inspection conform to the terms of the application on file in this office,and to the provisions of the Statutes and the Ordinances relating to the Construction, I.yspection of Wiring—Rough Maintenance and Inspection of Buildings in the City of Northampton. Inspection of Wiring—Finish Any violation of any of the terms above noted is an immediate revocation 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 US B1E S LAVED IN A CONSPIC U PLA ON THE PREMISES Certificate of Occupancy g nspector r�G"Pf