29-371 (3) PERMIT APPLICATION CHECK LIST
P '. YES NO DATE
of
1 . F604 APPLIPAIJp
2 '
3 . OWNER OCCUPANT NOT
4 . 3 SETS OF PLANS PLAN
5 , NEW CONSTRUCTION
Q . CURB CU
7 , WATER AVAILABILITY 0 S
8 , REMODELING INTERIOR
9 , ADDITIO
10 , ACCESSORY - STRUCTURE
11 . SIGN / AWNI
12 , PERMIT FE TO - MONEY ORD5*
13 . SPECIAL PERMIT REQUIRED WITH DEED IF APPLICABLE
14 . UNDER SEC ION 127 - CMR 780
15 . FORM
16 . FILL
COMMENTS :
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/ Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. }�1�� Alterations
a NORTHAMPTON, MASS. Jtit; r 19 � Additions
4 4
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APPLICa ATION FOR PERMIT TO ALTER Repair
Garage
1. Location c1 Lot No.
2. Owner's /name t�r� ilk' r, Address ���' T_C E
3. Buildei s name :S(- f e Address
Mass.Construction Supervisor's License No. //��, > Expiration Date
4. Addition
5. Alteration (lj a I ci r r -
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: -�(c"2
The undersigned certifies that the above statements are true to the best of his, her
knowledge and belief. /
V Si ature o responsible appicant
Remarks
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FM�N �1
J ' 001 ?
Date Filed File No.
Z NING PERMIT APPLICATION (§10 . 2 )
I . Name of Applicant: �;7
Address : <; (_ _ 7 -(� K , c✓� Telephone: _
Lit
2 . Owner of Property:'/ {�,� �n
Address :-_ �� � C I ( Telephone :
3 . Status of Applicant: Owner Contract Purchaser
Lessee Other (explain : )
4 . Parcel Identification: Zoning Map Sheet// =Xl Parcel# ,
Zoning District(s) (include overlays) u
Street Address (S
Required
5. Existinq Pro nosed —.bv Zonin
Use of Structure/Property
(if project is only interior work, ski ' to # )
Building height
%B1dg. Coverage (Footprin
Setbacks - front
- side L:
- 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) i,C ez rcl 6e LAP i r /toe
L
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 . r,
Date : JCii o _� Applicant' s Signature : /f,-/%
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
ZApproved THIS SECTION FOR OFFICIAL USE ONLY:
as resented based on informat ' o p / information presented
Denied as presented--Reason :
Special' Permit and/or Site Plan Required :
in ing q ' red: Variance Required :
igghat e- of Bui nspector ' 1 D6.te
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 Hoalth, Conservation Commission, Department of Public Works and other applicable permit granting authorities.
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