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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations
a NORTHAMPTON, MASS. �C� `� 192 Additions
APPLICATION FOR PERMIT TO ALTER Repair
r
Garage
1. Location 90 ludo. 6iV�a,,p Mfl- Lot No.
2. Owner's name Address
U
3. Builder's name Address, [�� N��D� 14-
Mass.Construction Supervisor's License No. 6319%2(' 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 ,,, (-(�kO A -".,)
13. Siding house
14. Estimated cost:- 3000 ce
The undersigned certifies that the above statements are true to the best of his, her
knowledge and belief.
Signature of responsible app,icant
Remarks
10. Do any signs exist on the property? YES NO C.
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 colm= to be filled in
by the Banding Department
Required
Existing Proposed By Zoning
Lot size
1
Frontage
Setbacks
- side L: R: L: R•
- rear
Building height
Bldg Square footage
%Open Space:
(Lot area minus bldg
' &paved parking)
pf. _Parking Spaces
fof Loading Docks
Fill:
':{vol-ume--& location)
13 . Certification: I hereby certify that the information contained herein
Gj is true and accurate to the best of my knowledge.
DME: Igq�o APPLICANT's SIGNATURE.Aj�jA. �m�(s�.F•1B)
ri.. NOTE: Isauan a of a zoning permit does not relieve an mpplio n�b�dan of oomply witfX 44l
zoning requirements and obtain all required permits from the Board of Health, ConServation..s
Commisalon, Department of Publio Worke and other applloabla permit granting authorlties,:,::
�aii, FILE #
File No. 49�ky
ZONING PERMIT APPLICATION (§10 . 2)
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant: , ,
Address:,T, IAIAJ,- &. M�k Telephone: ,E3-,jiL7- 92V r7
2. Owner of Property:
Address: ,��Q „f � t—Telephone:
3. Status of Applicant: ;a�� Owner Contract Purchaser Lessee
Other(explain):
4. Job Location: 1 1 IM 11
Parcel Id: Zoning Map# Parcel# 6/-, District(s): Gtr
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/Property
6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if 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 Permit/Variance/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 L- 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: 3 �
PROPERTY LOCATION: - Ye)
MAP --9 PARCEL: 45 ZONE ,
THIS SECTION FOR-OFFICIAL USE ONLY:
PERK HT APPLICATION CHECKLIST
ENCLOSED REQUIRED DA
Fet-
13nilding Permit Filled nitt
lRe ._
ct-14
e 3f
OLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION:
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-Rd Health
!Permit from Conservation mmission a
Signature of Building Ins for Date
NOTE: Issuance of as zoning permit does not relieve an applicant'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 applioeble permit granting authorities.
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