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Al Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel No,� �� �7 7 - //L ' Alterations
z NORTHAMPTON, MASS. Z7° 19 Z'0-2 Additions
APP - CATION F PER IT TO ALTER Repair
Garage
1. Location Lot No.
2. Owner's name Address
3. Builder's name Address
Mass.Construction Supervisor's License No.-,j Expiration Date
4. Addition
S. Alteration K` R
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-
�--19-x✓ '—
The undersigned certifies th t th v fat me are true.to the best of his, her
knowledge and belief.
S191161'.11 of responsible app icane
Remarks
10. Do any signs ebst 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.
Thin cola to be filled is
by the ntaMiay DepastZant
Required
Existing Proposed By Zoning
Lot size
Frontage
Setbacks -frnnt
- side L: R: L: R:
- rear
Building height
Bldg Square footage
%Open Space:
(Lot area minus bldg
&paved parking)
# of Parking Spaces
# of Loading Docks
Fill:
(volume & location)
13 . Cerrtification: I hereby certify that the inform ti co tai d herein
is Fel��157APPLICANT's e to the best of my knowZe
DATE: SIGNATU
NOTE: anoe i a zoning permit does not relieve lioan b n to oomph/ with all
zoning uira ents and obtain all required permits from the Board of Health, Conservation
Comma aion, Department of Publio works and other appiioable permit granting authorities.
FILE #
File No. �Cf�
ZONING PERMIT APPLICATION (§10 . 2)
PLEASE TYPE OR PRINT ALL =ORMATION
1. Name of Applicant: �jl'
Address: T hone: 'Z- /
2. Owner of Pro 0 u
Address: '� elephone:
3. Status of Applicant: Owner Contrail Purchaser Lessee
Other(explain):
4. Street Address:
Parcel Id: Zoning Map# Parcel# c;)16� District(s):
(TO BE FILLED IN BY THE BUILDING DEP TMEN
L 1
5. Ebsting Use of Structure/Property
6. Description of Proposed Use/Work/Project/Occupation: (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 PermiWariance/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 DONT 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)_
E
4
F ` + FILE # "'20000 7 d ZS
� I
APPLICANT/CONTACT PERS N: &-g7,L-9,7 v
ADDRESS/PHONE: ���� _e d 8
PROPERTY LOCATION: � � -�� ee--1,ej
MAP 2 PARCEL: � ZONE a& �
THIS SECTION FOR.�OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
Rnildinar Permit :11-A
Paiti
d /1�
FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION:
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
ermit f Con ervation Commission
ry
Signature B ecto ate
NOTE:lssunnoe of a zoning permit does not relieve an applioant's burden to oomply with all
zoning requirements and obtain all required permits from the Board of Health, Conservation
Commission, Department of Publio Works and other applioable permit granting authorKles. —
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