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11C-009 (4)
PERMIT APPLICATION CHECK LIST PAGE U PLOT q ZONE RA-&- ' - 'STU YES NO DATE 1 . ZONING FORM APPLICATION ei/6 Jl of 2 . PERMIT APPLICATION 3 . OWNER OCCUPANT STATEMENT / LIC .# IF NOT C/ 4 . 3 SETS OF PLANS /PLOT PLAN 5 . NEW CONSTRUCTION 6 . CURB CUT 7 . WATER AVAILABILITY FORMS 8 . REMODELING INTERIOR 9 . ADDITION 10 . ACCESSORY STRUCTURE 11 . SIGN / AWNING 12 . PERMIT FEE - CHECK ONLY - MONEY ORDER © 61)3 �U v 13 . SPECIAL PERMIT REQUIRED WITH DEED IF APPLICABLE 14 . UNDER SECTION 127 — CMR 780 15 . FORM A 16 . FILL COMMENTS : )trou(' 75 T5 T I.v tTI o a Cn f R "C IN o ni � z cn 0 1721 H --3 m .+ . C r> 1 -s Zoning Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations Alterations t74€ NORTHAMPTON, MASS. QU 6 ( I9/ Additions 4.," APPLICATION FOR PERMIT TO ALTER Repair =- Garage 1. Location 9 V A'€ - J _-- 4 e�/ Lot No. . 2. Owner's name Li LI( G J A g+2 Address J ' l. /� .k °� f F try L t;�y� 3. Builder's name f [C-' Fft-P--P 1—f^(t-( Address 4 F 1C cAc l-(t ( (?D it !4(...,..../.0 Mass.Construction Supervisor's License No. 0 _5 0 8' 3 -+- 113 6 xpiradon Date 4. Addition 3�--+'l�96 7/7l�j'` - 5. Alteration n e,„, '1f/ A (..-7— s 64--/.. . 6- L c tic°t 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 U U v..t'U The undersigned certifies that the above s cments are true to the best of his, her knowledge and belief. Signature of responsible app,icant Remarks . ., ., fir ,r... 00301w Date Filed File No. ZONING PERMIT APPLICATION (510. 2) 1 . Name of Applicant: R(C F(t 2 F�At i• ' 1�� Address : 7 f3E-(h }-� E s�_ Ltd elephone: R z 2 . Owner of Property: . /1124 C C 11,i-2t'&. Address: ?. 6Er2 Aik cif-C.— ;) Telephone: 3 . Status of Applicant: Owner Contract Purchaser • Lessee Other (explain: `�� ka C6tCt�Li ) 4 . Parcel Identification: Zoning Map Sheet# lt, Parcel# AVP , 9' Zoning District (s) (include over ..,ys) _ Street Address ` -'=-,,,- �,� 0., °I'!' ,e< Kot'C .5c7.--; L quired • 5 . Ex ' stinq 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 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 sheets • if necessary) 7 . Attached Plans: Sketch Plan Site Plan 8 . Certification: I hereby certify that the information contained herein is true a d a - curate to the best of my knowledge. • Date: (6 2X-'- Applicant's Signature: C ; ../C__— THIS SECTION FOR OFFICIAL USE ONLY: /Approved as presented/based on information presented Denied as presented--Reason: pecial' Permit and/or Site Plan Required: • -F' ding •uired: Variance Required: gnat e o 'f Bu • • Inspector mr 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 Hoaith,Conservation Commission, Department of Public Works and other applicable permit granting authorities. ic''71- A as 6 i, .. 'e► O � 8 e w 1 Ns- : OD � r ~ O A . i 5 ,.: `b'b k o o p,v 0 06 )-i tilig il o a co)--3 co R ° b•t " 'V En ggE ag g � til �. B " �' off: E 11 1.0 d g' c C ° `y00y x O �•gs �' o► v�' c� Cn "-" )7/ E cr (DS' D r 2. ,»• rr tn 'zJ n E p c p-- r....4:, s- = m 0 ' C.4 S s°° °, 5• a)r itif: 0 a = sffrzi- a tlil men.t oaoco .... GM 0 z C4 ci) J km° g b PIZ n mil a c a,. c„ L-A-J try 0 555 -, m ,�d 0 ed ss 111 ro c d II1 O O Q' . w 0 r 5 r crg O O M M ° cra N M aa �. a- v' C 7 W N crQ �c� ° 5 ° 5 av �a o co cp to ►r1 5 M � � 1 e' g O o Rg $. y ti. \ : - 9_ A •1. . c° 1. °c . 1. a t' 5 d 5e, Dr Cil CA log rj * n ls til cr) . 0. i o 0 N 5 °z *