32C-219 (17) PERMIT APPLICATION CHECK LIST
PAGE C PLOT 2 l ZONE He `y S` YES NO DATE .
ZONING FORM APPLICATION q3
2 . PERMIJ APPLICATION �--°
llo-inc-
3 .
OWNER OCCUPANT IF NOT AP 014 a-9/ 4 -°
4 . 3 SET OF PLANS ZELOT PLAN G--
5 . NEW CO ST UC IO
6 , CURB CU
7 . WATER AVAILABILITY FORMS
8 . REMODELING INTERINTERIOR
9 . ADDITION
10 . ACCESSORY STRUCTURE
11 . SIGN / AWNING
2 . PERMIT FEE - CHEQK ONLY - MONEY -ORDE �-�
13 . SPECIAL PERMIT REQUIRED WITH DEED IF APPLICABLE
14 . U DER SECIION 127 - C R 780
15 . FORM A
16 , FILL
COMMENTS :
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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. a s E G 7 5 Alterations
a NORTHAMPTON, MASS. Nc-t RG K 11 19,)3 Additions
Repair
APPLICATION FOR PERMIT TO ALTER Garage
1. Location 1 PQ Hc�1„) I e-y S I R e e:[ Lot No.
2. Owner's name 14 4q E l,i M BoJ6, A H Eci.tr�Address 10,3 k cx W t c y S%Rcn j
3. Builder's name pl- C�rz p R C,e _ ��t C:n nJ.. Address �i I OMe-RC) y L-Pv n�L. A NI 1-)t<(t'S
Mass.Construction Supervisor's License No. 0 H LC . o/)a9t, Expiration Date 1 `),3
4. Addition
5. Alteration :1�05 T1, I t i to'l Lam,-x i( S
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:-T/-000
000 r'v
The undersigned certifies that the above statements are true to the best of his, her
knowledge and belief.
c
Signature of responsible app,icant
Remarks 1 -- R(1 T to nl WE, G R i I� �I U 7 G� F c 5 (��r 0 A]l�
Date Filed �3 - File No. �3D-G - QJ ?
ZONING PERMIT APPLICATION (510 . 2) c
1. Name of Applicant: A Dec-�_J J— R<
Address: L H 5-F Telephone: ,7,56-6 75:,-_
n
2 . Owner of Property: 0 5 ( A) r,t/
Address: ?� ��(c 5 T" �eZ" Teleph e
3 . Status of Applicant: Owner Contract Purchaser
Lessee Other (explain:
4 . Parcel Identification: Zoning Map Sheet# , C Parcel# Q19 ,
Zoning District (s) (include overlays)
Street Address ,
Required
5 . Existing Proposed by Zoning
Use of Structure/Prope��
(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 Description of Proposed Work/Project: (Use additional sheets
if necessary) l S(RrT7 P
C4
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: �Gj� Applicant's Signature: "
THIS SECTION FOR OFFICIAL USE ONLY:
Approved as presented/based on information presented
Denied as presented--Reason: .�.�
Special Permit and/or Site Plan Required: DEPTt�FSUiIDE _ w5
ding ired• Variance Required• ORTFIA�;� TGei !4i3sl� LEzQ
7
'Paignatial-e of Bui D6to
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 Health, Conservation Commission, Department of Public Works and other applicable permit granting authorities.
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