32C-218 (6) PERMIT APPLICATIO CHECK LIST
PA YES NO DATE
1 _ --
2 .
3 . OWNER OCCUPANT E NO
4 . 3 SETS OF S PLAN
5 . NEW CONSTRUCTION
6 . CURB CUT
7 . WATER V S
8 .
9 . ADDITIO
10 . ACCESSORY STRUCTURE
11 , SIGN G
1 2 . PERMIT FE - CHECK O P`S �3S�s jw
13 . SPECIAL PERMIT REQUI D I EED IF APPLICABLE
14 . UNDER SECTION 127 - CMR 780
15 . FORM A
16 . FILL
COMMENTS:
>
z > j
Z :n rn
> 3
Z
A
Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations zl�
NORTHAMPTON, MASS. 19 Additions
APPLICATION FOR PERMIT TO ALTER Repair
a
l Garage
1. Location / 110A) Lot fNo.
2. Owner's name 1"' e- Address
3. Builder's name 00-4 Address 7ec
Mass.Construction pe isor's License No. e4/ z-/O / W/l-` , -Y0xpiration Date
4. Addition
5. Alteration � � m
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- 3 Q(Jd,
The undersigned certifies that the above statements are true to the best of his, her
knowledge and belief.
tl,Aal&�
fWSi Lure of responsible app,icant
Remarks
Date Filed File No. _
ZONING PERMIT APPLICATION (§10. 2)
I . Name of Applicant:
Address: IV7 Telephone: �5-
2 . Owner of Property:
Address :_* �?� �ta�� S Telephone: S�
3 . Status of Applicant: Owner Contract Purchaser
Lessee Other (explain: )
4 . Parcel Identification: Zoning Map Sheet# �`3� �.�-,Parcel#
Zoning Districts) (include v 11 ..L-
Street Address (a '
Required
5. Existincr . Proposed by Zoning
Use of Structure/Property
(if project is only, interior work, ip 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 ZZ
Loading
Signs
Fill (volume & location)
6. Narrative Descript'on of Proposed Work/Project: (Use additional sheets
if necessary) 1--.v b �P�,ra2 �,r' �r��� ru m ZZ1411
�A-)rV /AA P L, Z*= cc�.4-
'r
7 . Attached Plans: Sketch Plan Site Plan
8 . Certification: I hereby certify that the information contained herein
is true and accurate to the best of my knowledge.
Date:-44�1) --- Applicant's Signature:
T C FF L
HIS SETION FOR OICIA USE LP
Approved as presented/based on information presented
Denied as presented--Reason:
Spe,q,ial' Permit and/or Site Plan Required:
irg Req Variance Required:
gnat e f gull pector �` � D e
NOTE: tssuwm of a zoning permit does not tellove an applicant's burden to comply with all zoning re uiroments and obtain all required permits
from the Board of Health,Conservation Commission,Departmont of Public Works and othor applicabld portrait granting authorillos.
tell-
.b
co �.
� op
M ° M
CA FV r
cd. o. c
w
moo, 05 CA w N Et
CA
j 'Cy o 0 N 7a
s � ' " � � g
o'q°
1-1 ID
0 ° C 0 x rn (D Q
C17 ' C-) s� C' ° g
d
so
cr, -ft CI
CI 4 ° `� 0
y
�. 0 0 oo
qQ
GQ
1
.d o CI
V)OQ( f" 0
W�� I �• N �Q
o
y O. O. s ti
CIQ (IQ ® IQ
(D
ti'