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Zoning—
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. '2 Alterations I
NORTHAMPTON, MASS. 19— Additions
APPLICATION FOR PERMIT TO ALTER Repair
a Garage
1. Location 7 /Lo iJ IZ Lot No.
-? � -T C 1 -7
2. Owner's name S)7 C -1!) Address
3. Builder's name L Q f, Address
Mass.Construction Supervisor's License No. i Expiration Date
4. Addition
5. Alteration �i
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 R J
13. Siding house
ti 3
14. Estimated cost:- �lj i j,"
The undersigned certifie that the above statements are true to the best of his, her
knowledge and*li
Signazure of responsible app,icon
Remarks
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File No. � ���"
ZONING PERMIT APPLICATION (§10 . 2)
PLEASE =,'D OR P=T ALL T_NFORMATION
2
1. Name of Applicant:
1. V
Address: 'L Telephone:'
2. Owner of Property'
P rtY'
: �
Address: C✓ 1 � ' __ tt' Telephone:
3. Status of Applicant: �'" Owner Contract Purchaser Lessee
Other(explain):
4. Job Location:
Parcel Id: Zoning Map# Parcel# District(s): i - -
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
's {
S. Existing Use of Structure/Property
6. Description of Proposed Use/WoNProject/Occupation: (Use additional/sheets if necessary).-
7. Attached Plans: Sketch Plan Site Plan Engineered/Surveyed Plans
Answers to the following 2 questions may be obtained by checking with the Building Dept or Planning Department Files.
8. Has a Special Permit/Vadance/Finding ever been issued for/on the site? LL
NO DON'T KNOW YES IF YES,date issued: n 7? I {
IF YES: Was the permit recorded at the Registry of Deeds?
NO DON'T KNOW YES
IF YES: enter Book Page and/or Document#
9. Does the site contain a brook, body of water or wetlands? NO DON'T KNOW YES
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained Obtained date issued:
(FORM CONTINUES ON OTHER SIDE)
FILE #
4 = 3 _
APPLICANT/CONTACT PERSON: c a
ADDRESS/PHONE: e-7,? Z,
PROPERTY LOCATION:_, 2K &24u= --- c;
MAP � ; P - . _ .__. --2301 ZO
THIS SECTION FOR-OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQ DATE
znNING FORM FRIED OITT
FPP Paid
NewCnnstriirtinn
Addiflon to Existing 0Q4A
AS Setq of Plnnq I Plot Plan
z
V
T OLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION-
A"proved as presentedibased on information presented
Denied as presented:
Special Permit and/or Site Plan Required under: §
PLANNING BOARD ZONING BOARD
Received&Recorded at Registry of Deeds Proof Enclosed
Finding Required under:§ w/ZONING BOARD OF APPEALS
Received& Recorded at Registry of Deeds Proof Enclosed
,4
Variance Required under: § w/ZONING BOARD OF APPEALS
Received&Recorded at Registry of Deeds Proof Enclosed
Other Permits Required:
Curb Cut from DPW Water Availability Sewer Availability
Septic Approval-Bd of Health Well Water Potability-Bd Health
Permit from Conservation mmission
Signature of uil g p e
NOTE: Issuance of at 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.
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