29-188 (3) PERMIT APPLICATrION CHECK L ST
PAGE PLOT / ZONE l-Ch A� YES NO DATE
1 . ZONING FORM APPLICATION
2 . PERMIT APPLICATION
3 . OWNER OCCUPANT # F NO
4 . 3 SETS OF S P L 0 T PLA
5 . NEW CONSTRUCTION
6 . CURB CU
7 . WATER V MS
8 . REMODELING T I
9 . ADDITION
10 , ACCESSORY STRUCTURE
11 . SIGN AWNING
12 . PERMIT FEE - L - MONEY ORDER �{�6
13 , SPECIAL PERMIT REQUIRED WITH DEED IF APPLICABLE
14 . UNDER SECTION 127 - CMR 780
15 , FORM A
16 , FILL
COMMENTS :
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Zoning L)
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations
NORTHAMPTON, MASS.. 1993 Additions
y APPLICATION FOR PERMIT TO ALTER Repair
Garage
A
1. Location 0 C) 0 Lot No.
2. Owners name ll� r Ylr� � ( 'l. Address_ �L—
3. Builder's name CLC Address
Mass.Construction Supervisor's License VY382P _Expiration Date lq�5 1
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 gcya r iii A ��J t /6� Ie f 70 �r - ry b n¢- 20 � t—
12. Type of roof ?cr6)I[°
13. Siding house I--— I f 1
14. Estimated cost:- ��,Dw
The undersigned certifies that the above statements are true to the best of his, her
i d knowledge, d b lief.
Signatur responsible appirani
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Date Filed % File No,
ZONING PERMIT AP`P'LICATION (§10 . 2)
1 . Name of Applicant: 7i �t ( � C'
Address : elephone:
2 . Owner of Property: (�
Address :-- elephone : Sg y- �y/
3 . Status of Applicant: Owner Contract Purchaser
Lessee Other (explain : )
4 . Parcel Identification: Zoning Map Sheet# ,2 Parcel# JopC?
Zoning District (s) (include o erla sa
Street Address - c j 1
Required
5 , Existinq Pro Dosed - by Zonin
Use of Structure/Property S liek
(if project is only interior work, skip to #6)
Building height Ip '
%Bldg. Coverage (Footprint) 96 F3-
Setbacks - front d , -t- 0
- side L: R: L: (" fi-R: J 15
- rear t � 30
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) i0 ' °l,,.' he _ n, tc 0214C,C-
Y
7 . Attached Plans : X Sketch Plan Site Plan
8 . Certification : I hereby certify that the information contained herein
is true and accurate to the best of my knowle ge.
Date: (�� � � , lqq,,_) Applicant's Signature: ,-�L
- - - - - - - - - - - - - - - - I - - - - - - - - - - - - - - - - - - -
THIS SECTION FOR OFFICIAL USE ONLY:
Approved as presented/based on information presented
Denied as presented--Reason:
ecial' Permit and/or Site Plan Required :
in ed: Variance Required '
gnat of g Inspector ®� a
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, Departmont of Public Works and other applicable permit granting authorities.
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