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35-120 (4) � z w o T r► z a Z > � o x Z ... r 'Ill NO _a 7/ Zoning Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. '� `' 7 C Alterations C C NORTHAMPTON, MASS. f 1 Additions 9 APPLICATION FOR PERMIT TO ALTER Repair Garage 1. Location 3 t,.:t �°�'���`� �G� ��'" Lot No. 2. Owner's name Address P 3. Builder's name Address �1t OS Mass.Construction Supervisor's License No. y t Expiration Date r'�I_ 11,° `1 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 cost- 1-1, 006 The undersigned certifies that the above statements are true to the best of his, her knowle and be f. Signature of responsible appucan! Remarks 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 cols to be filled in by the Building Department (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) .,f -Parking spaces f fof Loading Docks Fill: (vol-ume--& location) 13 . Certification: I hereby certify that the information contained herein is true and accurate to the best of my knowle ge. _1. DATE: APPLICANT's SIGNATU i" NOTE: Issu noe of a zoning permit does not relieve ap IioanYs burden to comply witlr,.all zoning requirements and obtain all required permits from the Board of Health, Conservation Commission, (Department of Publio Works and other applicable permit granting authorities... ;r. FILE # File No. ZONING PERMIT APPLICATION (.§10 . 2) PLEASE TYPE OR PRINT ALL INFORMATION 1. Name of Applicant: r / Address: I t)_ �4—� =i ! /9 `; Telephone: 2. Owner of Property: La-0 Y-5� r-e v— Address: _ �,Ir C'��.� (�v� )^ ��- Telephone: 3. Status of Applicant: Owner Contract Purchaser Lessee OxnOLAre- Parcel 4. Job Location: s Id: Zoning Map# -S Parcel# e" District(s): - 7 (TO BE FILLED IN BY THE BUILDING DEPARTMENT) S. Existing Use of Structure/Property z 2 t �-�1 6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary): 4 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/Variance/Finding ever been issued for/on the site? NO DON'T KNO:^:___,y.' . 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 # � zo (i U L AWLI6ANT/CONTACT PERSON: E Y( ��� 41�� ADDRESS/PHONE: C "' PROPERTY LOCATION: y' �t / Y MAP 35r PARCEL: / c ZONE THIS SECTION FOR-OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE 70NING FORM FULED OUT Fet- Paid Riiilding Permit Filled njit Fee Plid Type of Construction- 1 THE JOLLOW]NG ACTION HAS BEEN TAKEN ON THIS AP ICATION: 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 Permit from Conservation mission Signature of Buil g Date NOTE:Issuanoe of a zoning permit does not relieve an applioant's burden to comply with all zoning requirements and obtain ail required permits from the Board of Health, Conservation Commission, Department of Publio Works and other applioable permit granting authorities. z �rD � o as * z O' `U O fD � O O � ° ��• cn .T. w � c.n (7 CD a ?; rn w In In CD C CD C. Es z ' N cb a d CD (D PEI o- a c) �3' o o• � � g �:l rD x O Q o n � � Coll C� ~ ~ c CD rn • C, N O Q C7 w N IO orq r) o CD un A� n CD i(-