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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations
NORTHAMPTON, MASS. oZT I q Additions
' APPLICATION OR PERMIT TO ALTER Repair
,/ Garage
1. Location / y' P� i , / �1� � jq.,4' Lot No.
2. Owner's name �7014) ff la TO Address 77 /W,0
3. Builder'sname �.t' �a� �'��'c� Address 116YC/fl,4
Mass.Construction Supervisor's License Expiration Date t,
4. Addition
S. 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 P I a�
14. Estimated cost 6--<b0l \
The undersigned certifies that the above statements are true to the best of his, her
knowledge and belief.
zs�
Slgnarur oJresponsible app,icanl
Remarks
Ft
f
Date Filed 003396 File No.
ZONING PERMIT APPLICATION (510.2)
1. Name of Applicant: -J'0VrL_' 5>"WA6 -vii
Address: p5l , 9�, iKJITelephone: Sqe.
2 . Owner of Property: '-v ,J N
Address: Z ,R, ,J A_ Telephone:
3 . Status of Applicant: Owner Contract Purchaser
Lessee Other (explain: )
4 . Parcel Identification: Zoning Map Sheet# G Parcel#�,
Zoning District(s) (include overl-.a�Ly�)
Street Address /l�,� 0�Z-�1 _
Required
5. Existina Proposed by Zoning
Use of Structure/Property
(if project is only interior work, skip to #6)
Building height
%B1dg.Coverage (Footprint)
Setbacks - front
- side
- rear
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 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 and accurate to the best of my knowledge.
Date: , /i Applicant's Signature: __17 -
- - - - - - - - - - - -
THIS SECTION FOR OFFICIAL Ti-SE ONLY:
Approved as presented/based on information presented
D led as presented
e fo 1:
ignataYre of B 4-inspector V 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 Healtfi,Conservation commission,Departrnent of Public Works and other applicable permit granting auttwritie&
PERMIT APPLICATION CHECK LIST
PA YES NO DATE
lw
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.1
2
3 . OWNER OCCUPANT STATEMENT lF NO
3 SETS OF S PLAN
5 . NEW CONSTRUCTION
6 . CURB CUT
7 WATER S
8 . REMODELTNG
9 . ADDITION
10 , ACCESSORY STRUCTURE
11 , SIGN
12 , PERMIT FE ONLY - MONEY ORDER�---
13 , SPECIAL PERMTT REQUIRED WITH DEED IF APPLICABLE
14 . UNDER SECTION 127 - C R 780
15 , FORM
16 , FILL
COMMENTS:
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