35-161 PERMIT APPLICATION CHECK LIST
PAGE ��`� PLOT 161 ZONE -� �� -2 � YES NO DATEr
ZONING FORM APPLICATION
2 , PERMIT APPLICATION c�
3 . OWNER OCCUPANT C-fC , A, IF NOT c
4 . 3 SETS OF PLANS ZELOT PLAN--
5 . NEW CONSTRUCTION
6 , CURB CUT
7 . WATER
8 . REMODELING
9 . ADDITIO
10 , ACCESSORY STRUCTURE
11 . SIGN AWNING
r
1 2 . PERMI EE — C — D .� -�
13 . SPECIAL PERMIT REQUIRED WITH DEED IF APPLICABLE
14 . UNDER SECTION 127 — CMR 780
15 . FORM
16 , FILL
COMMENTS :
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p Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. `�l" ��a Alterations
NORTHAMPTON, MASS. `- f _19 Additions
APPLICATION FOR PERMIT TO ALTER Repair
f7 Garage
1. Location t�5 t —��• /{s w_ Lot No.
2. Owner's name & �-� s! �d kL Address �7 (u
3. Builder's name -5a&h t Address z
Mass.Construction Supervisor's License No. Cl) ,Expiration Date
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:%,/
(('' The undersigned certifies that the above statements are true to the best of his, her
knowledge and belief.
\W�
Signature of responsible app,icant
Remarks
s 4s�yti �
�„ 93 'I 0 0 0156 31 Date Filed File No,
ZONING PERMIT APPLICATION (910 . 2)
1. Name of Applicant:
Address : °7
_ ��� /.� 9J= Telephone: r-
2 . Owner of Property:
Address: Telephone : — � �-s- F
3 . Status of Applicant: L,40`wner Contract Purchaser
Lessee Other (explain: )
4 . Parcel Identification: Zoning Map Sheet# Parcel# ,
Zoning District(s) (include,-gverlays)-
Street Address
5. Required
Existing,, ProDosed by Zoning
Use of Structure/Property
(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 & locations
6 . Narrative Description of Proposed Work/Project: (Use additional sheets
if necessary)
7 . Attached Plans : Sketch Plan Site Plan
8 . Certification: I hereby certify that the information contained herein
is true a d accurate to the best of my knowledge. _
Date: ��/h Applicant' s Signature:Y�!G �Gs����� �
THIS SECTION FOR OFFICIAL USE ONLY:
Approved as presented/based on information p resented
Denied as presented--Reason:
al' Permit and/or Site Plan Required :
ng Re r Variance Requir d:
gf g Ins pector at
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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