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17C-230 (6)
PERMIT APPLICATION C14ECK LIST PAGE-1176, PLOT 93, 6)zONE -ST � YES NO DATE 1 . ZONING FORM APPLI-CATION 2 . PERMIT APPLICATION �--- 3 . OWNER OCCUPANT STATEMENT LIC . #,�F NOT 4 . 3 SETS OF PLANS OT PLAN 5 . NEW CONSTRUCTION 6 . CURB CUT 7 . WATER AVAILABILITY FORMS 8 . REMODELING INTERIOR 9 . ADDITIO 10 . ACCESSORY STRUCTURE 11 . SIG N / AWNI 12 . PERMI FEE - Y - MONEY ORDER 55 13 . SPECIAL PERMI UIRED WITH DEED IF APPLICABLE 14 . UNDER SECTION 127 - CMR 780 15 . FORM A 16 . FILL COMMENTS : I ,. i i I � . I � � , _ � �� I + ` 1 k I .. � � ; t R i 1 t . L I S' i I v b o• r � � a o z o -� z z d0 d o � y Zoning Miscellaneous Additions,Repairs,Alterations,etc. �+ Tel.No. Alterations a NORTHAMPTON, MASS. t/[, 3 191 Additions Repair APPLICATION FOR PERMIT TO ALTER Garage 1. 30 1J. ov ^110 Ff V t7m L Lot No. 2. Owners name IM•. Address �� a 3. Builder's name h%a1 Vjf— fkit,&% Lek Address C• ✓►� Mass.Construction Supervisor's License No. © 15` ! Z— Expiration Date eJ •' b q 9 . 4. Addition 5. Alteration _ a maw 6. New Porch J 7. Is existing building to be demolished? 0• 8. Repair after the fire Q 9. Garage r a No.of cars '�' Size 10. Method of heating WA A 11. Distance to lot lines &_0''11 12. Type of roof ,J 13. Siding house r,CA 14. Estimated cost:-A-350, l� Q The undersigned certifi that e ve statements are true to the best of his, her knowledge and belief. I� IV- Signalure of esponsible appican[ Remarks 0015 Date Filed r`�` File No. ZONING PO P rLT l� V(l K �s 10 . 2) /11 Name of Applicant: /5- 1NDu5YnrA- Address : Telephone : Owner of Property: ,v . Address : A E Telephones: -3 S 63 . Status of Applicant: Owner Contract Purchaser Lessee Other (explain: ) 4 . Parcel Identification: Zoning Map Sheet# arcel# Zoning District (s) (include ove lays),Zx J Street Address - Required 5 . Existincr 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: L: R: - rear Lot size Frontage Floor Area Ratio : %Open Space (Lot area minus building and parking) Parking Spaces Loading Signs Fill (volume & location) C6) 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 kno ledge— eL j J 1 — — — — _— — — — — — — — — —Date : Applicant' s Signatu / THIS SECTION FOR OFFICIAL USE ONLY: Approved as presented/based on information presented Denied as presented--Reason : ecial' P mit and/or Site Plan Required: ding fired: Variance quired: _ na u e of --- g nspector at 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, Depaitmont of Public Works and other applicable pormit granting authorities. t,T)- City of Northampton REQUIRED INSPECTIONS • 1. Footin s and Walls BUILDING DEPARTMENT 2. Structural Components in Pla * 3. Complete Building* No. 685 Office of the Building Inspector Zoning Form No. 001521 Date 8/3/93 Fee $40 Check#7559 Page, 17c Parcel 230 ,Zone Si Section 127 ❑ Yes No BUI]LDINGPERAM * Plumbing and Electrical Inspections required THIS CERTIFIES THAT Wright Builders/William Arnold before Building Inspections has permission to Sheetrock & insulate 3 ceilings Inspection on Site—Foundations situated on 30 North Maple 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 CONSPICWUS PL THE PREMISES Certificate of Occupancy -:I 7,�:ZX ector (,off 1:?G11 Si1��1