35-193 (2) PERMIT APPLICATION CHECK LIST
1S NO DATE
2 =, IL TOATION
2 PERMIT
3 . OWNER OCCUPANT NO
3 SET OF -PLANS PLAN
5 . NEW CONSTRUCTION
6 . CU RB CUT
7 . WATEB AVAILABILITY FORMS
8 . REMODELING
9 . ADDITION
0 . ACCESSORY
11 . SIGN / AWNING
13 . SPECIAL PERMIT REQUIRED WITH DEED IF APPLICABLE
14 . UNDER SECTION 27 - C R 780
15 . FORM A
16 . FILL
COMMENTS : L�
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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations
NORTHAMPTON, MASS. 19 Additions A.2ati 19(Pc.<
APPLICa ATION FOR PERMIT TO ALTER Repair
_ �J,� Garage
1. Location �f 9 �'�!//, >0, Floi^ewc--e— Lot No.
2. Owners name fiG fj4 Q��X.✓ Address /'/JF Qa"J'
3. Builder's name it !�/�r.�-Jim-C it:;e,, :1 a Address
Mass.Construction Supervisor's License No. / R G 33 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 cosL- o
The undersigned certifies that the above statements are true to the best of his, her
knowledge and beli
Signature of responsible app,icant
Remarks
41\
f
Date Filed f. File No.
ZONING PERMIT APPLICATION (§10.2)
1. Name of Applicant: ��-Pl?
Address: r Telephone:
Gl�
as fe 41/w �-
2 . Owner of Property: 4 o
Address: � r Telephone: FIX
4V/40 v
3 . Status of Applicant: Owner contract Purchaser
Lessee Other (explain: )
4 . Parcel Identification: Zoning Map Sheet#_3� Parcel# )q%3 ,
Zoning District(s) (include overlays)
Street Address
Required
5 . Existing Proposed by Zoning
Use of Structure/Property
(if project is only interior work, skip to #6)
( Building height
%Bldg. Coverage (Footprint)
Setbacks - front
- side L: R: L: %R: L
- rear i p►
Lot size
Frontage.
Floor Area Ratio
. %Open Space (Lot area minus
building and parking)
Parking Spaces
Loading
Signs
Fill (volume & location)
6 . Narrative Description of roposed Work/Pro 'ect: (Use additional sheets
if necessary) /s/
1
7 . Attached Plans: Sketch Plan Site Plan
8 . Certification: I hereby certify that the information contained herCfin
is true and accurate to the best of my knowledge.
Date: _ Applicant's Signature:
Y/ THIS SECTION FOR OFFICIAL USE ONLY:
Approved as presented/based on information presented
Denied as presented--Reason:
cial' Perm' and/or Site Plan Required:
'ndiefiq Re ed• Variance Required,
gnatu)e*' of ~Buildi.ng spector '�-� to ;-
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 Hoollh,Consorvation commission, Department of Public Works and other applicable permit granting authorities.
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