32C-140 (23) 4
PERMIT APPLICATrIION CHECK LIST
PAGE 52_(%PLOT /'/D ZONE \�� y 1�-�QGt �r.�� � YES NO DATE
ZONI.NQ FORM L C ATION b l
2 ,
PERMIT APPLICATION
3 , OWNER OCCUPANT E IF NOT --
4 , 3 SETS OF PLANS /PLOT PLAN
5 , NEW CONSTRUCTION
Q . CURB CUT
7 . WA19B AVAILABILITY FOaMS
9 , REMODELING INTERIOR
9 . ADDITI
0 , ACCESSORY STRUCTURE
SIGN AWNING �r
2 , FEE -- C ONLY - O E 0 DER 2-2-x'3 4W
13 . SPECIAL E I E UI D WITH DEED IF APPLICABLE
14 . U QER SECTION 127 - CMR 780
15 . FORM A
16 , FILL
COMMENTS :
0
of 10 o
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Zoning G�
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations
NORTHAMPTON, MASS. 19 Additions
ti
APPLICATION FOR PERMIT TO ALTER Repair
Garage
1. Location : q 0 l- -�i/Z�'c�C Lot No.
2. Owner's name �Br.+� ,— /�,��� ,� T Address
3. Builder's name�Eli< �t ,rl �ZIiiST�',. 1,17<-- - _Address ,q-z
Mass.Construction Supervisor's License No. !'Qr)�q'�lr Expiration Date
4. Addition
5. Alteration
6. New Porch
7. Is existing building to be demolished? _
/7
8. Repair a e,r,1,0-A7—1-60 l6k ee`i-M 64
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.
LA
Signature of responsible aapp,icant 1
Remarks i�--X/5%/`! �r ✓®��' G�//L C_ T ` /,� �/ Ili/ %'- ajL �' //!G 7
AA/A
17, -�
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a� 001 � 5 ��Date Filed File No .
ZONING PERMIT APPLICATION (510 . 2)
1 . Name of Ap l icant: L �� - �1r'»/�CfG i li-J �c .
Address : 1 �'
_ � /%i�'if,�.���i�� ��j Telephone :
2 . Owner of Property:
Address : /0 �c, i �, �'Ti�/� Telephone :
3 . Status of Applicant : Owner Contvact Purchaser
Lessee < Other (explain : jcisZ )
4 , Parcel Identification : Zoning Map Sheet# gal G Parcel# )`W,
Zoning District (s) (include overl )
Street Address ,
Required
5 , Existing Proposed -by Zoning
Use of Structure/Property
(if project is only interior work, skip to #6 )
Building height
%B1dg . 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 Descri tion of Pry°posed Work/Project : (Use additional sheets
if nec ssary) n� -
Z 17 i
7 . Attached Plans : tl Sketch Plan Site Plan
8 . Certification : I hereby certify that the information contained herein
is true and accurate to the best of my knowledge
-� Signature :.
Date : � � � Applicant 's
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
THIS SECTION FOR OFFICIAL USE ONLY:
/Approved as presented/based on information presented
Denied as'presented--Reason :
S pe cial� Per it and/or Site Plan Required :
in �:ng Re i ,Zd: _ Variance Required:
gnatu of Building µI sp�ctor � a 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 Hoalth, Conservation Commission, Dopnrtrnont of Public Works and other npplicnblo pormit grantin41 nuthorilios,
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