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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. -� �� ?� Alterations
NORTHAMPTON, MASS.
X° f,-?,q�5- 19 Additions
APPLICa ATION FOR PERMIT TO ALTER Repair
Garage
1. Location ��/ L� � �2K-% �� t ^! � ✓-�- -- Lot No.
2. Owner's name !-7{ -- Address ✓ / = ="'-� � !1t,. '
3. Builder's named 1�' � r �-�- � Address ^ '— -��F�'�° �-�✓ �4% i.. ' r'
{ 1
Mass.Construction Supervisor's License No. :1' `"`" Expiration Date
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 ►°3PC� ? -,FZ'"'l (t " T�1- --
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 lief.
)gndYure of responsible appicani
Remarks
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10. Do any signs exist on the property/? YES_U NO -
IF YES, describe size, type and location:
Are there any proposed changes to or additions of signs intended for the property?YES NO
IF YES, describe size, type and location:
11. ALL 1WFORMIATION MUST BE COMPLETED, or PERMIT CAN BE DENIED DUE TO
LACK OF INFORMATION.
This co7� to be filled in
by the Building Depaztment
Required
Existing Proposed By Zoning
Lot size
Frontage
i Setbacks - frnnt
- side L: R: L: R:
- rear
Building height
Bldg Square footage
%Open Space:
(Lot area nflnus .bldg
&paved parking)
# of Parking Spaces
# of Loading Docks
Fill:
(volume & location)
13 . Certification: I hereby certify that the information co tained herein
is true and accurate to the best of my knowl dge.
'1
DATE: APPLICANT's SIGNATURE
N
At -
OTE: luuunniDe, cif a zoning permit does not relieve an applioant's bu n to oosnply with all
zoning requirements and obtain all required permits from the Board of Health,Conn*rvat �
Commission. Department of Public Works and other applicable per granting authoriti
FILE #
OCT 5.1a
File
DEPT Cf BUIL[?!PG iF7SPf.�TlQC�S
���r�€�r��;ara�� eta,��oso
ZONING PERMIT APPLICATION (§10 . .
PT•F,ASE TYPE OR P=T ALL INFORMATION
1. Name of Applicant:
Address: '�� j' elep�ne ' _747> (4C{ q
2. Owner of Property:
Address: ' '
�tc ' �" Telep;�essee >u ��
3. Status of Applicant: Owner Contract Purchaser
Other(explain): k .fir ff
4. Street Address: � { c::>?7
Parcel Id: Zoning Map# 0? Parcel# ,t�� / District(s): V,
(TO B FILLEDD�IN BY THE B LDING DEPARTMENT)
5. Existing Use of Structure/Property
6. Description of Proposed e/Work/Projerct/Occgpabon: (Use additional sheets if necessary):
f/ �
� C o i/-e _�7 / C,i4
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 PermWariance/Finding ever been issued for/on the s' e?
NO DON'T KNOW YES IF YES,date issued:
IF YES: W s the permit recorded at the R istry of Deeds? r
r
NO DON'T KNOW 1 YESy ' '
IF YES: enter Book Page tlVr�rT and/or Document# f'
9. Does the site contain a brook, body of water or wetlands? NO DONT KNOW dfl� YES
IF YES,has a permit been or needito be obtained from the Conse lion Commission? /
Needs to be obtained---� Obtained . ,/ 4 ,date issued:_gam'1
/ (FORM CONTINUES ON OTHER SIDE)_
�, w r
W-4111.
FILE #
7
APPLICANTICONTACT PERS N: _ ��� 13
ADDRESS/PHONE:
PROPERTY OCATION: L� l�
MAP PARCEL: ZO
THIS SECTION FOR-OFFICIAL USE ONLY:
PERNUT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
MNTNC�- FORM M,TFD OUT
Fee Pnid
lied nvit
Jf .
a
� .
THE,FOLLOWING ACTION HAS BEEN TAR HI
N ON TS APPLICATION:
!/Approved as presented/based 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
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 fro Conserve ' o Sion
Signature of Building Inspector Date
NOTE:Issuanoa of at zoning permit does not relieve an applioanYs 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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