29-435 /�, PERMIT APPL UATIUfV CHECK L18
PAGE ; PLOT �' D' ZONE4,-L/)/"/ �—v? e `�~ G ig %� YES _ O DATE
ZONING —FORM APPLICATION
`
2 , PERMIT APPLICATION
3 OWNER OCCUPANT E { I 0
3 SETS OF S PLAN
5 , NEW CONSTRUCTION
6 CURB CU
7 WATER V I I IT O S
8, REMODELING INTERIOR
9 , ADDITIO
C) ACCESSORY STRUCTURE
11 , SIGN AWNING
2 , PERMIT EEE - C O D 7,o' ' � T
13 , SPECIAL PERMIT REQUIRED WITH DEED IF APPLICABLE
14 , U DER SECTION 127 CMR 78-0
15 , FORM
16 , FILL
COMLMENTS ;
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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations
so NORTHAMPTON, MASS. 19 Additions
APPLICATI N FOR PERMIT TO ALTER Repair
�-- - Garage
1. Location ' ! c t No.
2. Owner's name Address
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3. Builder's name eA Address
Mass.Cons'Vuction 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:-
...
/ The undersigned certifies that the above statements are a to the best of his, her
knowledge and belief. �,,.--''"'_ /
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nature of responsible app,icani
Remarks
Date Filed 00114 1 "" File No.
ZONING APPLI9ATX/QN (§10 . 2 )
1 . Name of Applicant :
Address :
phon e:
2 . Owner of Property:
Address . Telephone :
3 . Status of Applicant: owner Contraqt Purchaser
Lessee other (explain : ZIC
4 . Parcel Identification: Zoning Map Sheet# Parcel#
Zoning District (s) (include overlays)
Street Address—
Required
5 . Existinq Proposed —by Zoning
Use of Structure/Property
(if project is only inter. or work, skip to #6)
Building height
%Bldg. Coverage (Footprint)
Setbacks - front
- side L: R: L: R:
- 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 erein
is true air d accurate to the best of my knowledge . _72
Date : �-Applicantls Signature:,
�- - - - - - - - - - - - - - - - - - - - - - - - -
J
THIS SECTION FOR OFFICIAL USE ONLY:
proved as presented/based on information presented
Denied as presented--Reason:
S ecial' Permit and/or Site Plan Required :
j - ing q ' red: Variance Required.:
U
itignati(re of Build c or
, permit NOTE: issuance of-of
permit does not relieve an applicant's burden to comply with all zoning requirements and obtain all required permits
from the Board of Health, Conservation Commission, Department of Public Works and other applicable permit granting authorities.
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