11C-006 (2) PERMIT APPLICATION CHECK I T
PAGE /IC PLOT ZONE (�. ' f ' Ai - YES NO DATE
1 . ZONING FORM APPLICATION N C, Iliq
2 , PERMIT APPLICATION C'
i.J
3 . OWNER OCCUPANT STAUMENT LIC, # IF NOT
4 , 3 SETS OF PLANS /PLOT PLA
5 , NEW . CONSTRUCTION
6 , CURB CUT
7 , WATER AVAILABILITY FORMS
8 , REMODELING INTERIOR
9 , ADDITION
10 . ACCESSORY STRUCTURE
11 , SIGN / AWNING
12 , PERMIT FEE - CUECK ONL - MONEY ORDER � � ti
3 , SPEC 1 _ -_ :u . ; P I; _ D .:--_.,.4_ ' IF APPLIC • 8 _
14 . UNDER SECTION 1,27 - CMR 780
15 , FORM A
16 . FILL
COMMENTS:
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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. ��7-59 3 7 Alterations
NORTHAMPTON, MASS. , t 19_94_ Additions
t Cl
APPLICATION FOR PERMIT TO ALTER Repair
Garage
1. Location 6 t- tgr Lot No.
2. Owner's name i1] 1?th2 tcL Address 72 C 1fe7,3 i a ,/.a-„,...c.•.. t M!t
3. Builder's name JAC:M, £4/7w-n- Address-t%I.Jigt1 ,Na' RtELiki.Q.p..,mik
Mass.Construction Supervisor's License No. (13.2144‘. Expiration Date 1996
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 fy1L4 — pq�p l t ra tn4 ) 4- d iw 0Le-r.
13. Siding house D VV V a
14. Estimated cost:- ,1r$oo,
The undersigned certifies that the above statements are true to the best of his, her
knowledge and belief.
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Signature of responsible applcant
Remarks
I -Aid
Date Filed 00306 '-
)
File No.
ZONING PERMIT APPLICATION (510.2)
1. Name of Applicant: . 1/ ,A;„ ;,
Address: �$4 (iD, • � j•1). . �u pd mj:1_ Telephone: 473e7-5m.57 37 .
2 . Owner of Property: .
Address: rliF �� j- Telephone:
3 . Status of Applicant: ' owner Contract Purchaser
Lessee Other (explain
4 . Parcel Identification: Zoning Map Sheet# Parcel# C7
Zoning District(s) (include v rlays) ft)LC -- `
Street Address
Required
5. Existing Proposed by Zoning
Use of Structure/Property
(if project is only interior work, skip to #6)
Building height
oBldg. Coverage (Footprint)
Setbacks - front
- side L: R: L: R:
- 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 heats
if necessary). --n o,,,QDfi ,aati,c�J6.) /. �i ...
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: a , iR9 Applicant's Signature
THIS SECTION FOR OFFICIAL USE ONLY:
1 Approved as presented/based on information presented
Denied as presented--Reason:
S-ecial• Pe lit and/or Site Plan Required:
ing R` fed: Variance Required:
gna 'u• o Bui.ldi.n I eetor
/5� /. ,y
g..r ate
NOTE: Issuance of a z g permit does not relieve an applicant's burden to comply with all zoning requirements and obtain all required permits
from tho Board of Health,Conservation Commission, Department of Public Works and other applicable permit granting authorities.
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