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36-180 (2) PERMIT APPLICATION CHECK LIST PAGE ' PLOT �9,n ZONE ��� YES NO DATE 1 . ZONING FORM APPLICATION � �•� j�(� �� � f, y �� � ���� ���� 2 . PERMIT I T 0 c ) c;,te Ian 3 . OWNER OCCUPANT STATEMENT LIC IF NOT 4 . 3 SETS OF S /PLOT PL C' j 4F,7 '7 Q- 5-, � NEW CONSTRUCTION 6 . CURB CU WATER V B I 0 S 8 . REMODELING 9 . ADDITION 0 . ACCESSORY STRUCTURE 11 . SIGN AWNING r -i: OW-9 2 , PERMIT FEE - CHECK ONLY - MONEY ORDER -131Q-•0C) 13 . SPECIAL PERMIT REQUIRED WITH DEED IF APPLICABLE 4 . UNDER SECTION 127 - CMR 780 5 , FORM A 16 . FILL _ COMMENTS : `i4 X Y-r) e C .4- 1 �,t F !c nr- A (I U n, b b o r a 0 z � O Z `+ O JU z- - 1 u � ti Cj Zoning s Miscellaneous Additions,Repairs,Alterations,etc. Tel.No.�y7- P ZC 9' Alterations ti NORTHAMPTON, MASS. Additions_ " APPLICATION FOR PERMIT TO ALTER Repair X 1. Location G y Lot No. -36 / S' 0 2. Owner's name bete—!A # -U Address /0 3 P y rV lP t f K 3. Builder's name W M. Q. G lV i (-0 S Address 7 �FGV'I -S7- Act-() Mass.Construction Supervisor's License No. /O -/ Y 5 �7 � Expiration Date 9 3 4. Addition Y X 6 oT`2 13•�5M&--I C-A✓h- +.- ,-oQ- oc,r e-d- ,C(a-, 5. Alteration D t K-96 k e-PQ,a o 4C L w G 40,e- PGa c e one mod` 4' �oW . Dad-e, 6. New Porch ICU 7. Is existing building to be demolished? y 8. Repair after the fire /V O 9. Garage y e s No.of cars Size y x C e 10. Method of heating / c--� (- L-_ 11. Distance to lot lines o20 +►'t ems--` s )3G.-c�c G D r r — ���Jt� 6`{ t o-� fsrtG�f�rt 12. Type of roof �4 S 1 0 Q d o C S ti;,," 2 le-L 13. Siding house V �-- 14. Estimated cost 0 C The undersigned certifies that the above statements are true to the best of his, her knowledge and belief. t -- .�1 ature of responsible appicant Remarks I '� :\ i a w .rhYti •y 000'713 Date Filed ? j File No. 190 ZONING PERMIT APPLICATION (510. 2 ) 1. Name of Applicant: C'"IL0 S Address : /3-2, E-L_ri i aT` Telephone: q ZC Y 2 . Owner of Property: j- /J,�a /,_ Address:. /0 3 you ry ,o b,,.., p 2 —Telephone: �, ,9 »ot 5'71-03,v" 3 . Status of Applicant: Owner Contract Purchaser Lessee Other (explain: ) 4 . Parcel Identification: Zoning Map Sheet# Parcel// I � r Zoning District(s) (include overlays) Street Address Required 5 . Existing Proposed by Zoning Use of Structure/Property Llvrw ac,e 4401w S e '04 e (if project is only interior work, skip to #6 Building height oZa ` f %Bldg. Coverage (Footprint) p °, rioR-- -raL_ Setbacks - front G o oc ly-G 7-e-►- - side L: ,rr.-R: 17 oR: /7 '`"" - rear C.04" - o >>s • «- - Lot size Frontage o0 Floor Area Ratio %Open Space (Lot area minus building and parking) Parking Spaces Loading Signs Fill (volume & location) 6 . Narrative Description of Proposed Work/Project: (Use additional sheets if�necessar 7 . Attached Plans : �6(9;:�,Sketch Plan Site Plan 8 . Certification: I hereby certify that the information contained herein is true and accurate to the best of my knowledge. Date: /!F L91 `3, Applicant's Signature: THIS SECTION FOR OFFICIAL USE ONLY: t A Qk ZApproved as presented/based on information presented ' FFQ 1 6 Denied as presented--Reason: i"• pecia Pe mit and/or Site Plan Required: di quired: Variance Required: 2 % 7 �� ig r of B ing Inspector Date NOTE: Issuance f 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. ie,71 CIO ' H 0 O s M Uobi) bD ho C\i Edo Ca O O O or- 0 bA C\j O =0 ° o O o o ? In a a ►� :3 z _ 0 a N O r\ � p L v� O L1, «t N .r.r O � o2s 3� � � CO � w O � ti F•-i c� x° o 0 r••i a� •2 44-0 0 .�•n A �I••rr -0� N O, G 00 -y 1 a vOi bi) rou N 3 G, bbcd � bb M uo c cu CY) w O O O H y c '- ° •�+ '++ +! ed U C) q �. ctY w Q a W y c o 0, Z bo M04L.,M60 O M a� Z a