17C-249 (5) PERMIT APPLICATION CHECX LIST
P G _ .... , " ;� YES NO DATE
1 , O U;NG FORM APPLICATION 7 05
2 . -IRQUJI APPLICATION
3 . OWNER OCCUPANT E E IF NO
4 . 3 SETS OF PLANS /PLOT PLAN
NEW CONSTRUCTION
6 , CURB CU
7 , WATER AVAILABILITY S
8 . REMODELING INTERIOR
9 , ADDITION
10 , ACCESSORY STRUCTURE
11 , SIGN / AWNING
12 . PERMIT FEE - O - MONEY 'Q!'`
13 . SPECIAL PERMIT REQUIRED WITH DEED IF APPLICABLE
14 . UNDER SECTION 127 - CMR 780
15 , FORM
16 , FILL
COMMENTS : f
i y
[� ty
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07 c o M
o
Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No.✓4'� G Alterations
ras"""PTa1 NORTHAMPTON, MASS. 19 ✓ Additions
Repair
APPLICATION FOR PERMIT TO ALTER
Garage
1. Location Lot No.
2. Owner's name AfA4dXC ,,j G Address_ 2 :r�1Cf
3. Builder's name S �, �?v.� %4� �--+ Address �� f �L 4 —X41 It
Mass.Construction Supervisor's License No. 4-j �� _Expiration Date
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. Estimated cost:-
The undersigned certifies that the above statements are true to the best of his, her
knowledge and belief.
O
ignatu of responsible app,ican!
Remarks _
Date Filed 001 "6 u ,I File No.
ZONING PERMIT APPLICATION (§10 . 2)
1. Name of Applicant: &
Address : / , , Telephone:
2 . Owner of Property: ,
Address : 7J- S7,-, —Telephone : C_ rJI "
3 . Status of Applicant: Owner Contract Purchaser
Lessee Other (explain ;
4 . Parcel Identification: Zoning Map Sheet# /1 C_ Parcel# 94q
Zoning District (s) (include overlay )
Street Address ,
Required
5 . Existinq Proposed by Zoning
Use of Structure/Property
(if project is only interior work, skip to #6)
Building height
%Bldg. Coverage (Footprint)
Setbacks - front
- side L: R: L: R:
- rear
Lot size
Frontaae
�a minus
ion)
► )f Proposed Work/Project: (Use additional sheets
& _e.-✓ t
Sketch Plan Site Plan
y certify that the information contained herein
_i the best of my knowledge .
Applicant' s Signatu
THIS SECTION SECTION FOR OFFICIAL USE ONL ' ` Y
_y/Approved as resented based on information resented
p / p
Denied as presented--Reason :
cial' Permit and/or Site Plan Required :
indi g Re red* Variance Required ;
S natu in ec
of uildtor D e
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, Department of Public Works and other applicable permit granting authorities.
t.171-
City of Northampton REQUIRED INSPECTIONS
BUILDING DEPARTMENT 1. Footings and Walls
+ � 2. Structural Components in Place*
3. Complete Building*
No.
819 Office of the Building Inspector
Zoning Fonn No. 001704 Date 9/9/93 Fee $20 Check# 001409
Page, 17C parcel 249 ,Zone URB Section 127 ❑ Yes No
BUI]LDINGPERAM
* Plumbing and Electrical Inspections required
THIS CERTIFIES THAT Larry Jubb before Building Inspections
has permission to Install replacement windows Inspection on Site—Foundations
situated on 61 North Main 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 CONSPICUO P AC O THE PREMISES
Certificate of Occupancy
B ector
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