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PERMIT APPLICATION CHECK LIST
'AGE ac? PLOT 9G3 ZONE [( RAI w5 p YES NO DATE
I . ZONING FORM APPLICATION
PERMIT APPLICATION
3 . OWNER OCCUPANT STATEMENT LIC J IF NOT
G . 3 SETS OF ANS OT PL ��` 1' eLCK
i . NEW CONSTRUCTION
3 . CURB CU
WATER AVAILABILITY FORMS
3. REMODELING INTERIOR
3 , ADDITIO
10 . ACCESSORY STRUCTURE
11 . SIGN AWNING
1 2 . PERMIT FEE - CHECK ONLY - MONEY ORDER C-I� 3 x`75- yC, e,
13 . SPECIAL PERMIT REQUIRED WITH DEED IF APPLICABLE
4 . UNDER SECTION 127 - CMR 780
5 . FORM A
6 . FILL
;OMMENTS : AkinyH_ Gr au Y,c4 Pno I (�u 1 j n c k
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LAS91C ROUND ° r _
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"The Signature of Quality" and Larger S iffl ill'CV'
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Everyone loves a pool . .
AVAILABLE WALL COLORS:
Your kids will always have
"something to do"on those long BLUE
hot summer days. They'll be WOODGRAIN
having a splashing good time in
their very own swimming pool.
You'll make memories all
summer long as you and your SILVER
family relax and enjoy classic WOODGRAIN
good times in your new Esther
"We're having more fun Williams pool. And, our 50"
han we ever expected. wall height and larger pool BROWN
sizes add up to more swimming WOODGRAIN
area...for more fun and
comfort.
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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations
go NORTHAMPTON, MASS. 19 Additions
APPLICATION FOR PERMIT TO ALTER Repair
Garage
1. Location a).j/A'C>rf 1,1 rn G0 )t Imo Lot No.
2. Owner's name r f r;rf. H d- k y^F ice + , /� � Address /! ('C.!° hQ ,,f< nr. El a a n zz—
3. Builder's name �; v o��l�r jp�, 2� Address s 'Ti
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 cost:-
1 J �U The undersigned certifies that the above statements are true to the best of his, her
knowledge and belief.
Signature o re onsible applicant
Remarks
PRIN._�S�P
Date Filed_r/l-<00, File No. :29-5?G3
ZONING PERMIT APPLICATION (§10 . 2 )
1 . Name of Applicant: J; ',q��,�
Address : 1—��r,�A ,L� �� Telephone:�s'kl-,� 75"�
2 . Owner of Property: XA,.-f- Zcf' ,5- &11,),,e &�-, A . 4EA Ff g
Address : ��� �'C,, E. d ,, , Telephone: &-,?l n 7S/
3 . Status of Applicant : L-""O wner Contract Purchaser
Lessee Other (explain: C Q -f,r A ) rd t= Ir- )
4 . Parcel Identification: Zoning Map Sheet#6Cr Parcel#-6 3 ,
Zoning District (s) (include overlays) U �S P
Street Address
Required
5 . Existing Pro Dosed by Zoning
Use of Structure/Property
(if project is only interior work, skip to 76)
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) Z"n� S �m ( (n 4, a :&lipI,C g t-r.c.,.rd+ Taal--,
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 : ��! s1 z Applicant Is Signature:
- - - - - -- - - - - -
THIS SECTION FOR OFFICIAL USE ONLY: .-
5
(Approved as presented/based on information presented
Denied as presented
eason fo enial :
ignat e of Bui Inspector bate,
NOTE: Issuanoe of a zoning pormit dons not relieve an applicarWa burden to comply with all zoning requirements and obtain all requlrod permits
from tho Board of Health, Consorvation Commission, Dopart mont of Publio Works and othor applicable pormh granting authorities.
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