17C-194 (8) PERMIT APPLICATION CHECK LIST
PAGE � - PLOT �14� ZONE � � �- ES NO DATE
1 . ZONING FORM APPLICATION �--�" q Y
2 . PERMIT P I I
3 . OWNER OCCUPANT STATEMENT LICA IF NOT �-'
3 SET S /PLOT PLAN
5 . NEW CONSTRUCTION
6 , CURB CUT
7 WATER
8 . REMODELING
9 , ADDITION
0 . ACCESSORY STRUCTURE
11 . SIGN / AWNING
2 , PERMIT FE - CHECK ONLY - MONEY ORDER
13 . SPECIAL PERMIT REQUIRED WITH DEED IF APPLICABL
4 , UNDER SEC - C R 780
15 . FORM A
16 , FILL
COMMENTS :
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LC
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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations
NORTHAMPTON, MASS. 19 Additions
APPLICATION FOR PERMIT TO ALTER Repair
/ Garage
1. Location (.tom I Lot No.
2. Owners name Address n► e
� 7-
�3. B uilder's name—�4�,m �� r =!to Address 5? V � n-�
Mass.Construction Supervisor's License No. U O / Expiration Date
4. Addition
5. Alteration r
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- 0 C
The undersigned certifies that the above statements are true to the best of his, her
knowledge and belief.
Signature of responsible app,icani
Remarks
003ri29
Date Filed Dec, File No.
ZONI G PERMIT APPLICATION (510.2)
1. Name of Applicant: ,` e
Address: mac= / i Telephone: f-�6
2. 'Owner of Property: / 6
Address: -c— Telephone:
3 . Status of Applicant: owner Contract Purchaser
Lessee Other (explain. )
4 . Parcel Identification: Zoning Map Sheet# 116 Parcel#
Zoning District(s) (include- over a�ys) ,
Street Address X U)J%/t
Required
5. Exis-tincr Proposed by Zoning
Use of Structure/Property
(if project is only- interior wdft, socip to #6)
Building height
%Bldg. Coverage (Footprint)
Setbacks - front
side L: R:
- rear
Lot size
Frontage.
Floor Area Ratio
open Space (Lot area minus
building and parking)
Parking Spaces ,r
Loading
Signs
Fill (volume & location)
6. Narrative Description of Proposed Work/Project: (Use additional sheets
if necessary)
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: y Applicant's Signature:
THIS SECTION FOR OFFICIAL USE ONLY:
✓Approved as presented/based on information presented
Denied as presented--Reason:
gpecial.* Permit and/or Site Plan Required:
in ng Re d: Variance Required.,
gnat Buy ld� specter It, at
NOTE: luumm o(a zoning permit does not re(tove an applicant's burden to comply vhtlt all zoning roqulroments and obtoln all required permits
from tho Board of Health.Conservation Commission, Dopaitmont of Public Works and otltor applicabto permit flranting authoritios.
City of Northampton REQUIRED INSPECTIONS
BUILDING DEPARTMENT 2. Footings and Components in Place*
3. Complete Building*
No.
1251 Office of the Building Inspector
Zoning Form No. 003629 Date 12/9/94 Fee 40 Check#
Page, 17C Parcel 194 ,Zone URB Section 127 ❑ Yes L) No
BUI]LDINGPERMIT
*Plumbing and Electrical Inspections required
THIS CERTIFIES THAT sunrise Contractors before Building Inspections
has permission to Repair garage foundation Inspection on Site—Foundations
situated on 20 Wilder Place 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 CONSPICUOU LA O PREMISES
Certificate of Occupancy
Buil spector