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PERMIT APPLICATION CHECK LIST
UP,A
PAGE 9 PLOT ZONE W-9P 3 �� C,-m0 Cocart YES NO DATE
1 . ZONING .FORM APPLICATION
2 . PERMIT IC IO
3 . OWNER OCCUPANT STATEMENT LICA IF NOT
3 SETS S 0 S 0 P L A Fc,u y) c{ Q--C ► o n p cc-n 1—
4 . NEW CONSTRUCTION
6 . CURB OUT
7 . WATER I 0 S
8 . REMODELING INTERIOR
9 . ADDITION--
0 . ACCESSORY STRUCTURE
11 , SIGN AWNING
2 . PERMIT
3 . SPECI L PE MI7 REQUIRED WITH DEED IF APPLICABLE
4 .
UNDER SECTION 7 - C -780
5 . FORM A
16 FILL -
COMMENTS :
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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. ;�5�\ ' �3�1� Alterations
NORTHAMPTON, MASS. 1�'Z5 19,13— Additions
APPLICso ATION FOR PERMIT TO ALTER Repair
Garage
1. Location r..\__z, C_1_- V Lot No.
2. Owner's name.'"'S�,v�L -y Lrz o Cs(z-,tee. k.F Address \t
3. Buildersname Address
Mass.Construction Supervisor's License No. Expiration Date
4. Addition
5. Alteration
6. New Porch S c� [v' iu
7. Is existing building to be demolished? Vv 0
8. Repair after the fire W)
9. Garage -_....__....,__ No.of cars ii4+` Size
10. Method of heating N a -e
11. Distance to lot lines
12. Type of roof ec,e,&c, vv p,19,\3r ,.....Gi
13. Siding house
14. Estimated cost:-
The undersigned certifies that th7ave statements are true to the best of his, her
knowledge and b ief.
Signature of res onsible appicanl
Remarks
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Date Filed q /Q_-3 / 93 0 0 0 91 u
File No. a4- l Z`'
ZONING PERMIT APPLICATION (§10. 2) R A LAJS P
1. Name of Applicant: 1Mw ')
Address :- << 2c�ti- l\.,.�\.� & 5` Telephone: SZ.-1
2 . Owner of Property: -"Sw„\G •� ��; �.p
Address:- t ,,Telephone: ,4sy _ti3`�
3 . Status of Applicant: Owner Contract Purchaser
Lessee Other (explain: ,\�� r )
4 . Parcel Identification: Zoning Map Sheet# Dcl Parcel#
Zoning District (s) (include overlays) D R A J �
Street Address
Required
5. Existing Proposed by Zoning
Use of Structure/Property ,�
(if project is only interior work skip t0 #6) �t
Building height
%B1dg. 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) ,,� to V
7 . Attached Plans : A Sketch Plan Site Plan
8 . Certification: I hereby certify that the information cont ai ed herein
is true and accurate to the best of my knowledge. ?
Date: Applicant's Signature: I/ G
- - - - -
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
/Approved THIS SECTION FOR OFFICIAL USE ONLY:
as resented based on information resented
p / P
Denied as presented--Reason:
Special Permit and/or Site Plan Required:
F ' d g Required: Variance Required:
y ZG
fsigXazure of Bu tor 6ate
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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