29-327 (4) Massachusetts Electric Company
548 Haydenville Road
Massachusetts Electric P.O. Box 305 Florence
Northampton, Massachusetts 01060-0305
A New England Electric System company
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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. .���� -�� Alterations
a NORTHAMPTON, MASS. 19` d Additions
APPLICATION FOR PERMIT TO ALTER Repair
r
I Garage
1. Location , �,P�!�t;T�� !i'< i ��� Lott No.
2. Owner's name y' �� : Address
3. Builder's name (1/1 ! Address ✓ c�: 'u�'� "P�'� S �%- ^: ' 3
Mass.Construction Supervisor's License No, 1jL7 Expiration Date r
4. Addition �' 4kW
5. Alteration
6. New Porch
7. Is existing building to be demolished?
8. Repair after the fire
9. Garage No.of cars Size
0. Method of heating
1. Distance to lot lines
2. Type of roof
3. Siding house
4. Estimated cost-
The undersigned certifies that the above statements are true to the best of his, her
knowle/d°g`ee and belief.
Signature of responsible app icant
temarks
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 cola,= to be Pilled in
by the Building Department
Required
Existing Proposed By Zoning
Lot size
Frontage
Setbacks
- side L: R:
- rear � �
Building height
Bldg Square footage
%Open Space:
(Lot area minus bldg �)
&paved parking) ( C,
# of -Parking spaces
f 46f Loading Docks
Fill:
4vol-ume-& location)
13 . Certification: I hereby certify that the information contained herein
is true and accurate to the best of my know,/'(]].edge.
1 / r
DA'Z'E: /4:;'� `j APPLICANT's SIGNATURE
NOTE: 1 uanoe of a zoning rmit does not relieve an
g p piioan �4.1 rden to oompiy with all
zoning requirements and obtain all required permits from the o Health. Conservation
Commission. Department of Publio Works and other applioabl eit granting authorities.
FILE ,>
4
2 719% •
File No.
ZONING PERMIT APPLICATION (§10 . 2)
•• PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant:
Address:
�� � r� ��� ✓�� Telephone:
2. Owner of Property:
r/
7' Jf�6i'�t"f J `t" ffo✓
Address: ��J � ��,�'�� � ®6�° Telephone:
3. Status of Applicant: Owner Contract Purchaser Lessee
Other (explain):
4. Job Location: 1/9
Parcel Id: Zoning Map# c2�9 Parcel# ,:;' / District(s):
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/P rope rty d? _ h
Y
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/Vahance/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 #
9611'73 l
' l
APPLICANT/CONTACT PERSON: C'
ADDRESS/PHONE:
PFIOPERTY LOCATION:
MAP PARCEL: , _-il 2 zon ZC 19
THIS SECTION FOR OFFICIAL USE ONLY:
PERK UT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
Fee PAid
]Ruilffin2 Permit Filled nill
.Remndeling Tnterinr 4; X_ /r
AdffitinutnExisting
(1)k Sets of Plans /I&PInn
THE LLOWING ACTION HAS BEEN TAKEN ON THIS APfUCATIOM 1.4
Approved as presented/based on information presented
Denied as presented:
Special Permit and/or Site Plan Required under: §
PLANNING BOARD ZONING BOAR
Received &Recorded at Registry of Deeds Proof I
Finding Required under:§ w/ZONING BOAR
Received &Recorded at Registry of Deeds Proof l
Variance Required under: § w/ZONING BOA
Received&Recorded at Registry of Deeds Proof Ei /
Other Permits Required:
Curb Cut from DPW Water Availability
Septic Approval-Bd of Health Well Water Potability-_
!Permit from Conservation Co ission
Signature of Building ecto DIN
NOTE: lssuanoe of as zoning permit does not relieve an appiioanYs 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 applioable permit granting authorities.
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