28-067 (3) > 2
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Zoning ��-
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. � X22 Alterations
NORTHAMPTON, MASS. �( S19
Additions
APPLICATION FOR PERMIT TO ALTER Repair
a
Garage
1. Location 2 2� SyL_J�3 1 LCL CzoPrtt� Lot No.
2. Owner's name��t.1J 4 t SS7'?�" (�E Address 2 Z Ff S leL QCP(-M- 9,0
3. Builder's name QUA �� Address 36 S CAS(4jC— eE�Z
Mass.Construction Supervisor's License No. O y 9 y y lk Expiration Date 6I 96
4. Addition A',U-P Ithb Cam- j —(2 S Z� Z)C i ST—"C K
5. Alteration
6. New Porch
7. Is existing building to be demolished? (1i d
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 c sL-
The undersigned certifies that the above statements are true to the best of his, her
knowledge and belief.
Signature of responsible app icant
Remarks
CONSTRUCT'
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SOLUTIONS
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CONSTRUCT ASSOCIATES, INC. • 36 SERVICE CENTER • NORTHAMPTON, MA. 01060 • 413/584-1224
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CONSTRUCT ASSOCIATES, INC. • 36 SERVICE CENTER • NORTHAMPTON, MA. 01060 • 413/584-1224
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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 Holm to be filled in
by the Building Department
Required
Existing Proposed By Zoning
Lot size l�f'\-C Q �
Frontage
Setbacks - frnnt
- side L:-(O dA-R: (Cut L: R:
- rear p O 4.
Building height
Bldg Square footage
%Open Space:
Lot area minus bldg
&paved parking) '`
# of -Parking spaces
of Loading Docks
N
Fill:
'-{volume--& location) �g _
13 . Certification: I hereby certify that the information contained herein
�f is true and accurate to the best of my knowledge.
DATE: G��� 1 G(� APPLICANT's SIGNATURE_
NOTE: Issunnoe 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 Pubiio Works and other applioabie permit granting authorities.
FILE #
File No. 7 J
ZONING PERMIT APPLICATION (§10 . 2
PLEASE TYPE OR PRINT ALL TNFORMA=ON
1. Name of Applicant: �3 dz Qtr--R
Address: 26 SLe-J(cra Telephone:
2. Owner of Property: �PA4.4a[L 41SS 3 tf-I-�N p, 1°�CZR
Address: -':? Z-0' -&YLQ L Telephone:
3. Status of Applicant: Owner Contract Purchaser Lessee
_jCdther(explain):
4. Street Address: `z2 Sr S`/L-U S' L2q)
Parcel ld: Zoning Map# -` Parcel# District(s): >
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/Property
6. Description of Proposed Use/Work/Project/Occupaticn: (Use additional sheets if necessary):
�o -V-3`A-2-i -Tb pct STAG '��
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/Vadance/Finding ever been issued for/on the site?
NO DON'T KNOW__4 YES IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO DON'T KNOW C,-" 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 4--' 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)
960452
FILE #
APPLICANT/CONTACT PERSON:
ADDRESS/PHONE:
PROPERTY LOCATION: '
MAP PARCEL: ZONE
THIS SECTION FOR-OFFICIAL USE ONLY:
PERK UT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
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THE F LOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION: <'
_IZApproved 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
P mit from C ervat' n Commission
ignature of uil 4 lns Dye
NOTE:lssuanoe of an 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
Commisslon, Department of Public), Works and other applioable permit granting authorities.
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