32A-255 (99) a
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l C� Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel No. J Alterations
NORTHAMPTON, MASS. /? �X 19 Additions
a .APPLICATION FOR PERMIT TO ALTER Repair
Garage
1. Location MI-- "'DRT*�""t--'7v J �z'r � Lot No.
2. Owner's name_ 740 Tr-t-- r1°'c r) Address ,' 4- G 13-
3. Builder's name Ob✓clf_ Cfje t,, J Address .16 "1e-✓tc-E- "-JT e.
Mass.Construction Supervisor's License No. 0-71 7- Expiration Date 9�"
4. Addition
5. Alteration .1N17*4A- TW 1 I /�►�?7T`�al�•� ! /� ,��itr�rs� 44o 4J6
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:-X O�
ZC7V°
The undersigned certifies that the above statements are true to the best of his, her
knowledge li
Signature of responsible applicant
Remarks
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 columm to be filled in
by the Building Department
Required
Existing Proposed By Zoning
Lot size
Frontage
Setbacks - front
- side L: R: L: R:
- rear
Building height
Bldg Square footage
%Open Space:
(Lot area minus bldg
&paved parking)
pf -Parking spaces
of Loading Docks
Fill:
4vol-time--& location)
13 . Certification: I hereby certify that the information contained herein
rf is true and accurate to the best of my know
DATE: APPLI CANT's SIGNATURE
NOTE: lssuanoe of a zoning permit does not relieve an applionnt's burden to comply with all
zoning requirements and obtain all required permits from the Board of Health, conservation
commission, Department of Publio Works and other applionble permit granting authorities.
FILE #
File No.
ZONING PERMIT APPLICATION 010 . 2
PLEAS/E� TYPE OR PRI�jN�-T ALL INFORMATION
1. Name of Applicant: �/G� �� �` �1�'•tG�^�
Address: ?6 f���L C �EiC Telephone: ey
2. Owner of Property:
Address: 3 L Telephone: f1 y '-1 lo—o
3. Status of Applicant: Owner Contract Purchaser Lessee
Other(explain):
4. Street Address:
Parcel Id: Zoning Map# Parcel# District(s): l:
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
S. Existing Use of Structure/Property A M t —
6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary):
zro t'ro 777110 /'INS
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/Vadance/Finding ever been issued for/on the site?
gyp,..•5 /�..a.�
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 _V_ 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)
i�
FILE # 96053
APPLICANT/CONTACT PERSON: C '�� '
ADDRESS/PHONE: 3-
PROPERTY LOCATION:
MAP }- PARCEL: ZONE
THIS SECTION FOR-OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATF
7,ONTNr.FORM FILLED OUT
Fee pfk*fi
13nildin2 Permit Filled out
L�
/
-7 ✓
Sb'
a -y
AddifinntnExisting
3 X617-3
-3
er
TIDE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION:
/ Approved as presented based on information presented
Denied as presented:
Special Permit and/or Site Plan Required under: §
PLANNING BOARD ZONING BOARD
Received&Recorded at Registry of Deeds Proof Enclosed
Finding Required under:§ w/ZONING BOARD OF APPEALS
Received&Recorded at Registry of Deeds Proof Enclosed
Variance Required under: § w/ZONING BOARD OF APPEALS
Received&Recorded at Registry of Deeds Proof Enclosed
Other Permits Required:
Curb Cut from DPW Water Availability Sewer Availability
Septic Approval-Bd of Health Well Water Potability-Bd Health
Permit m o ervation Commission
ignature g Inspector Date
NOTE:issuance of a oning permit does not relieve an applicant's burden to comply with ail
zoning retquirements and obtain all required permits from the Board of Health, Conservation
Commission, Department of Public Works and other appiioabie permit granting authorities. —
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