29-182 (4) PERMIT APPLICATION CHECK LIST
PAGE `� PLOT g O ZONE ar-ie-r-LoOC r1 D r. YES NO DATE
1 . ZONING FORM APPLICATION F 4 - aG- 93
2 . PERMIT APPLICATION
3 . OWNER OCCUPANT STATEMENT L I C . # IF NOT � a/ z4 C; l -D-
4 . 3 SETS OF PLANS PLOT PLAN
5 . NEW CONSTRUCTION
6 . CURB CU
7 . WATER VAIL BI ITY FORMS
8 . REMODELING INTERIOR
9 . ADDITION
10 . ACCESSORY STRUCTURE
11 . SIGN / AWNING
QIc. # lSgO
12 . PERMIT FEE- - CHECK ONLY - MONEY ORDER 'o
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
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations
NORTHAMPTON, MASS. Additions
i
APPLICATION FOR PERMIT TO ALTER Repair
Garage
1. Location f Lot No.
2. Owner's name r Address
3. Builder's name rzl..J%r e-c Address
Mass.Construction Supervisor's License No. Z�' f 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 true to the best of his, her
knowledge and belief.
Signature of responsible appicant
Remarks
• `. 000060
Date Filed /-{/ a-(� / (73 File No. a9- /9'.)-
ZONING PERMIT APPLICATION (510 . 2) u ��/ w Sf
1. Name of Applicant: , /; �f,/�, � ✓ro
Address: �J � Q Telephone:
2 . Owner of Property:
Address : Q- ,� _ Telephone: G6 ;� Z-
3 . Status of Applicant: Owner Contract Purchaser
Lessee Other (explain: )
4 . Parcel Identification: Zoning Map Sheet# a9 Parcel# / 91 ZL-,
Zoning District (s) (include overlays)
Street Address c3a a-rielct"006 Dr. ,
Required
5 . Existing Proposed by Zoning
Use of Structure/Property
(if project is only interior work, skip to #6)
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)_ X 4e
7 . Attached Plans : Sketch Plan Site Plan
8 . Certification: I hereby certify that the information contained herein
is true and accurate to the best of my knowledge.
Date: /9'��?Applicant r s Signature: 46,7 4�7
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
THIS SECTION FOR OFFICIAL USE ONLY:
Zoved as presented/based on information presented
Denied as presented--Reason:
S ecial Permit and/or Site Plan Required:
i ing fired: Variance Required,
y f
gnat e-of Bu ' nspector Oate
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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