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32C-212 (9) T � MI > �. Zoning Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations NORTHAMPTON, MASS. 19_y/ Additions • Repair APPLICATION FOR PERMIT TO ALTER / Garage 1. Location ` t4 e Lot No. 2. Owner's name 'JAR z em h40 Y2s ki, Address �• 3. Builder's name !�� CR/4 —�I,c.��>E�Q 5 Address �• , N Mass.Construction Supervisor's License No. ®G !Yo / f �4*//syiy Expiration Date /q9 7 4. Addition // 5. Alteration L 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:- C,D(�U Ov The undersigned certifies that the above statements are true to the best of his, her knowledge and belief. Signat of responsible app,icanl Remarks 10. Do any signs exist on the property? YES 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 INFORMATION MAST BE COMPLETED, or PERMIT CAN BE DENIED DUE TO LACK OF IWFORMATION. Th±s ool� to be f127 by the 131- diag Dcpa.rtmeat Required Existing Proposed By Zoning Lot size Frontage Setbacks - frnnt - side L: R: L: R: - re ar Building height Bldg Square footage %Open Space: (Lot area minus bldg &paved parking) f 'Parking Spaces of Loading Docks Fill: =(vol-rime--& location) 13 . Certification: I hereby certify that the information contained herein G} is true and accurate to the best of my knowledge. DAVE: 7 APPLICANT's SIGNATURE .d'�t� NOTE: lss ano c0 cn zoning permit does not relieve an ap i oa b den to oompty with all zoning requirements and obtain all required permits fro a oard of Health, Conservation _ iCommisslon, Department of Publio WorKs and other appilaable permit granting eauthorities. FILE if File No.W"Iv,a ZONING PERMIT APPLICATION (§10 . 2) PLEASE =,El OR PRIN'T ALL INFORMATION 1. Name of Applicant: Address: /Y '7 /,i/ q rr,�� c 1 �� M/cyoTelephone: 2. Owner of Property: JD �— , f �(y /}� 7 ,� 6�}jk)s /� r Address: 0 Z n`1J� �` Telephone: 3. Status of Applicant: Owner Contract Purchaser 'Lessee Other(explain): / 4. Job Location: /V r Lyd k16 Parcel ld: Zoning Map# Parcel# District(s): (f0 BE FILLED IN BY THE BUILDING DEPARTMENT) 5. Existing Use of Structure/Property — It 44<G--/ 6. Description of Proposed Use/Work/Project/Occupadon: (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/Variance/Finding ever been issued for/on the site? NO DON'T KNOW V___ YES IF YES,date issued: 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 - i 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) pp FILE # PC 1254 4_ 6 APPLICANT/CONTACT PERSON:. ADDRESS/PHONE: PROPERTY LOCATION: 'T� � ' -� -- t?� yQr p tc✓ a MAP PARCEL: ZONE THIS SECTION FOR-OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE c _lRerrindeling Interior Accessory Strurtivre TH ,VOLLOWING ACTION HAS BEEN TAKEN ON THIS AP ICATION: <' 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 from Conservation miss' n Signature of Building hispgaor Date ` NOTE:Issuanoa of a zoning permit does not relieve an applicants burden to comply with ail zoning requirements and obtain ail required permits from the Board of Health, Conservation Commission, Department of Public Works and other applicable permit granting authorities. z � o �* O x R a FD• cn C° CD x ° N u y IQ o0 a y o � oa � � C o orb CD CA O S I r• CL $. C4 CD � W sr F- Uj � c � �°' S• `� _� c� a rte* 0 �� � =. 5y CD Z CD Now � 0 � C4 �, � o o °.� p o � O 04h CM N N on ITI p CCD 1 s cO n-. b cS n UQ O. o c CD p O Cp CD v; v, O O O p b(Lo• U�On a d C17 ? ? cn Q�y O C➢ CA n CD