17A-272 (9) PERMIT APPLICATIOM CHECK LIST
ES NO DATE--
ZONING L,
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2 E
ON
3 , OWNER
3 SETS OF PLANS /PLOT PLAN
NEW S
6 , CURB CUT
7 WATER
8 , REMODELING
9 , ADDITION
0 , ACCESSORY
11 , SIGN / AWNING
2 , PERMIT FEE - MONEY ORD
3 , SPECIAL IF APP IC B
4 . UNDER - CMR 780
5 FORM A
6 . FILL
COMMENTS :
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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations
a NORTHAMPTON, MASS. 19 Additions
APPLICATION FOR PERMIT TO ALTER Repair
r
Garage
1. Location zj" Lot No.
2. Owne.'s name Address •t/ `P
3. Builder's name Address
Mass.Construction Supervisor's License No.,L- /.4a zS� Ex iration Date u�+'
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. Estima [-
`'� ��• The undersigned certifies at the above sta[emcn a true to the best of his, her
knowledge and-belief
Signature of responsible app,ican!
yc L✓ �'
Remarks
� Od
Date Filed File No.
ZONING PERMIT P ICATION (510.2)
I . Name or Applica _
Address: % Telephone:
2 . Owner of El:Address: s Telephone:
3 . Status of Applicant: Owner Contract Purchaser
Lessee Other (explain )
4 . Parcel Identification: Zoning Map Sheet# ig Parcel# r
Zoning District(s) (include_ over ays t--
Street Address t".
Required
5 . ExistincT Proposed bv Zoning
Use of Structure/Property
(if project is only interior woi4, Jgkip t ##6)
Building height
%Bldg. Coverage (Footprint)
Setbacks - front
- side. L: R: L:
- rear
Lot size JJ
Fronta0a_
Floor Area Ratio
.Open Space (Lot area minus Py
building and parking)
Parking Spaces
Loading
Signs
Fill (volume & location)
6 . Narrative Descript' of Propos Wor /Pro ' Use add 'tional shZ_SP/_1 if necessar ) d
ery c
.r
7. Attached Plans: Sketch Plan Site Plan
8 . Certifi ion: I hereby certify that the itlformatio tained he in
is tr nd accurate to the best of my knowledge
f
Date: Applicant's Signature:
r THIS SECTION FOR OFFICIAL USE NLY: -
v i�;P/roved as presented/based on information presented
Denied as presented--Reason:
S cial'' Permit and/or Site Plan Required:
ng Regl red' Variance Required:
gnat e Buy lding In at
NOTE: Issuance of a zoning perTnit does not reliove an applicant's burden to comply Willi all zoning requirements and obtain all required permits
from the Board of Health,Conservation Commission, Dopailmont of Public Works and other applicable permit granting authorities.
City of Northampton REQUIRED INSPECTIONS
1. Footings and Walls
BUILDING DEPARTMENT 2. Structural Components in Place*
3. Complete Building*
No. 443
Office of the Building Inspector
Zoning Form No. 004390 Date 6/8/95 Fee $20 neck# 5289
Page, 17A Parcel 272 ,Zone URB Section 127 ❑ Yes ® No
BUIULDING PERMIT
* Plumbing and Electrical Inspections required
IS CERTIFIES THAT Bob Thibodo before Building Inspections
has permission to strip & reshingle roof Inspection on Site—Foundations
situated on 138 oak Street 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.
Building Inspection—Finish
Smoke Detectors(Fire Department)
Other
THIS CARD MUST BE DISPLAYED IN A CONSPICU U PL THE PREMISES
Certificate of Occupancy
ailding spector -
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