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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations
a NORTHAMPTON, MASS. 19 Additions
APPLICATION FOR PERMIT TO ALTER Repair
r
Garage
1. Location C- Lot No.
2. Owner's name Address ' /
3. Builder's name 61 Address +�
Mass.Construction Supervisor's License No.&1900 (;l Expiration Date - Z, t
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
11. Distance to lot lines
12. Type of roof
13. Siding house
14. Estimated cosL-
/ The undersigned certifies that e above statements are true to the best of his, her
knowledge and belief
r
Signature of responsible appicant
Remarks^.t%/i' Op/� /1'r/I+�r SidiH� - �v�> / y �r��•�� ��^!JC i�/ f��:v[ ✓S
_ /c✓ C7/GG 13 /`/a �G G
D�i�-CC G✓t�f..-t- ��
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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 MUST BE COMPLETED, or PERMIT CAN BE DENIED DUE TO
LACK OF INFORMATION.
This cola= to be filled in
by the 8ai.lding Lbnattmen t
Required
Existing Proposed By Zoning
Lot size
Frontage
Setbacks
- side L• R: L: R:
- rear
Building height
Bldg Square footage
%Open Space:
(Lot area minus bldg
&paved parking)
#, :of -Parking Spaces
.r
#' of Loading Docks
Fill:
'Avol-ume--& location)
13 . Certification: I hereby certify that the information contained herein
�f is true and accurate to the best of my knowledge.
DATE: /0--/Q - f APPLICANT's SIGNATURE
NOTE: Issuanoe of as zoning permit does not relieve an applloant's burden to oornp'y with all
zoning requirements and obtain all required permits from the Board of Health. Conservation
Commission. Department of Publio Works and other appiioable permit granting authorities.
FILE #
f�
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File No. 9 OCT
ZONING PERMIT APPLICATION (§1 ' � r'cf -
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant:
Address: -7�1 �—_71" >�rA-rrV 4E? Telephone: _--L?y 7
2. Owner of Property: /�i n'�%� /� ✓!Y r ,r�1 /9���.� a
Address: 7,71 z,_-37,,y _5'X Telephone:
3. Status of Applicant: _Owner Contract Purchaser Lessee
Other(explain):
4. Street Address:
Parcel Id: Zoning Map# Parcel# J District(s): Z�� IZ14)10
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
S. Existing Use of Structure/Property X-11—l .
6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary):
_ '�' L'-+COX-��O4:.Jf dO�/'S � �'��/is C-� "�`-.i T'+� .'isi rl` cPt:,C,./'� �'✓r-.S-�'.L :[/=d(/,i
,�c / CG= G:r-�'r-/!!�' G C'/t/,-�,�1-✓�/f"i f' �C�% C`/'�G'r�� � �f �.aC tr �f�/.t r_ %3`
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 PermitNariance/Finding ever been issued for/on the site?
NO DON'T KNOW 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 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)
FILE # 3 2 6
APPLICANT/CONTACT PERSON:
ADDRESS/PHONE:
PROPERTY LOCATION:
MAP PARCEL: IONE S
THIS SECTION FOR-OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
Fee paod
'Myflding Permit Filled wit
Ep�,Paid
x
C Q
THE,F6LLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION:
Approved as presentedfbased 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 o ervation Co sio
Signature of Building kspe6tor Date
NOTE:issuance of a zoning permit does not relieve an applioant'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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