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A- �. PERMIT APPLICATION CHECK LIS"f
PAGE �Z A- PLOT ��� ZONE � (- YES NO DATE
s
ZONING FOR
APPLICATION
2 PERMIT APPLICATION
3 . OWNER OCCUPAN T E # I • NO
3 SETS OF S } /PLOT PLAN
5 . NEW CONST U ION
6 CURB CUT
7 , WATER AVAILABIOTY FOPMS
s REMODELING INTERIOR
9 ADDITION
10 ACCESSORY STRUCTURE
11 , SIGN / AWNING
12 PERMIT FEE - CHECK ONLY - MONEY ORDER
13 SPECIAL PERMIT REQUIRED WITH DEED IF APPLICABLE
141 UNDER SECTION 127 - CMR 780
15 FORM A
16 FILL
COMMENTS :
j•� (7 l
Date Filed �r File No.
ZONING PERMIT APPLICATION (510. 2)
1. Name of Applicant: 0/1✓cr 15e /.
Address: ?(, 5',0aflca ce jTex Telephone: sey - �2%y
2 . Owner of Property: 40 7-0 1 i`'v,Cn4,, —010-J
Address: ?b F7- Telephone: �b'y
3 . Status of Applicant: Owner Contract Purchaser
Lessee Other (explain: If`2 7'o2 )
4 . Parcel Identification: Zoning Map Sheet# 3: A Parcel# a!5,5-
Zoning District (s) (include overlays) C- 0
Street Address
Required
5 . Existincr Proposed by Zoning
Use of Structure/Property "" 641 orb,,e ZgAs,
(if project is only interior work, skip to 6)
Building height
%B1dg. Coverage (Footprint)
Setbacks - front -
- side L: R: L: R:
- rear
Lot size r-
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) C.oY✓Ay ,rx ,fr.,r+G g0Tq-44 ,+-"o OkTr, 1'ro,"c.-" 7'd
OFAC-IF 79 L- PAV47-1r IVAr1110e^JCX - Jh'CW.a o..9 /}7r✓1c14
P
7 . Attached Plans: ✓ Sketch Plan
S . Certification: I hereby certify that the
is true and accurate to the best of my kn � j
Date: Applicant's Signatur v
;Approved- - - - - - - - - - - - - - - - - - - -
THIS SECTION FOR OFFICIAL
as presented/based on information
Denied as presented--Reason:
Special Permit and/or Site Plan Required :_
Fin Re ired Varianc
Signature of Building I or
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 Health, Conservation Commission, Department of Public Works and other applicable permit granting authorities.
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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. `sue L/ Z Z y Alterations
NORTHAMPTON, MASS. 19_12 Additions
: Repair
APPLICATION FOR PERMIT TO ALTER
Garage
1. Location 3 5T. N Lot No.
2. Owner's name N v 21+fh—r,"T'v'r4 Address J 6
3. Builder's name O L 1 y E)2- ,£s6 L, r•1 Address 0 SCr '�"` Ca&If
Mass.Construction Supervisor's License No. Expiration Date 9.3
4. Addition
5. Alteration
&r.✓,per- e ,x ilT,a G fro�c K 7b O r A c�= �Kli br N c-0 At-a ✓1 AF .
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 ^/�J✓l�` �I' �"" t. Cc
13. Siding house
14. Estimated cost:-
The undersigned certifies that the above statements are true to the best of his,
knowledge 'ef.\ -
Signature of responsible appsican!
Remarks
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