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Zoning
Miscellaneous Additions,Repairs,Alterations, Tel.No. Alterations
ti NORTHAMPTON, MA 1� Additions
Repair
' APPLICATION�01 M7-e ALTER
,r D Garage
1. Location of No.
2. Owner's name I a c� Address / G
3. Builder's name c�C` Address
Mass.Construction Supervisor's License No, = 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 cosC-
-
The undersigned ce the above s n are true to the best of his, her
knowledge an lief. 1
Sig t re of responsible app icant
Remarks �G C
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 columa 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)
:of. "Parking Spaces
# of Loading Docks
Fill:
'4vol-;ime--& location)
13 . Certification: I hereby certify that the info 'on cont ed herein
G, is true and accurate to the best of my kno ed
APPLICANT'S SIGNATU ,
NOTE: Iss oa of a oning permit does not relieve an plioant's rden to comply_with all
zoning i,amants and obtain all required permits from the Board of Health, Conservation _
Commissi n, Department of Publio Works and other applloable permit granting authorities.
FILE #
psi File No. [��3
ZONING PERMIT APPLICATION (§10 . 2)
PLEASE TYPE O T ALL INFORMATION
1. Name of Applicant:
Address: 'L - e one:
2. Owner of Property: G v .QiLc
Address: ,
�c — Telephone: c�
3. Status of Applicant: Owner '" Contract Purchaser Lessee
Other(explain): -
4. Job Location:
ee-
Parcel Id: Zoning Map# &44 Parcel# District(s): -Ze
(TO BE FILLED IN BY THE BUILDING D PARTMENT�
5. Existing Use of Structure/Property �
6. Description of Pro Us ork/Project/Occupation: yse additional sheets'f 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 PermitA/adance/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 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
APPLICANT/CONTACT PERSON:
ADDRESS/PHONE:
PROPERTY LOCATION:
MAP J6 PARCEL: f ZONE
THIS SECTION FOR-OFFICIAL USE ONLY:
PERNUT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
7,ON-INC-FORM FILLED OUT
Fep Paid
Addition to Existing
ellided-
Q
THE,F'OLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION:
V 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
X15—1-911,�
Signature of Building lmpr Da e
NOTE:lssuanOe of a zoning permit does not relieve an appiioant'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 appiioable permit granting authorities. —
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