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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No.57 Y✓S-71J.y Alterations
NORTHAMPTON, MASS. / � 19 / Additions
APPLICATION FOR PERMIT TO ALTER Repair
Garage
1. Location c,2 7 11644,12/-f_ L���r tt�- � Lot No.
2. Owner's name G/t -e. �/ f Address
3. Builder's name :j,-Dk l Address
Mass.Construction Supervisor's License No. US3'J�� Expiration Date
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.
f Signature of responsible app icani
Remarks �� �r/iw 111 A/ 4 L2 116-,'nAd�� ^� YC-
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
- side L: R: L: R:
- rear
Building height
Bldg Square footage
%Open Space:
(Lot area minas bldg
&paved parking)
Vof Parking Spaces
f %f Loading Docks
Fill:
volume -& location)
13 . Certification: 1-hereby certify that the information contained herein
G� is true and accurate to the best of my knowledge.
_ ja
DATE: 1 !/ L
APPLICANT's SIGNATURE
NOTE: Issuance of a zoning permit does not relieve an pii s "rden to oomply with all
zoning requirements and obtain all required permits t m Me Board of Health. Conservation _
Commisslon. Department of Publio Works and other applloable permit granting authorities.
;!,„ FILE if
File No.� �
ZONING PERMIT APPLICATION (§I0 . 2)
PLEASE =10 OR PRINT ALL INFORMATION
1. Name of Applicant: u �
Address:_IcP A4 - Telephone: S29y'%2
2. Owner of Property: ,L�t�-I �- 5�;✓�-� 2
Address: -2-7 16,A-7-Vc— j l2 Telephone: S9`1
3. Status of Applicant: Owner Contract Purchaser Lessee
Other(explain): ""'V�/L.
4. Job Location: c217 ay—t'-a—
Parcel Id: Zoning Map# Parcel# 1l"'41 District(s):
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/Property_ Sh-yl� A„2,
6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary):
7. Attached Plans: Sketc 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/Variance/Finding ever been issued for/on the site?
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 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)
FILE # [) f o (1
APPLICANT/CONTACT PERSON: %'%l
ADDRESS/PHONE: r
t �-
PROPERTY LOCATION:
P_ 9Z PARCEL: ZONE P �L
THIS SECTION FOR-OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM M T.RT) OUT
Fee PAid
Fee pniff
Adfiitinn to Existing -JItellIc!ZC."� I-,
ense
ment
�r
THE . LLOWING 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 from Conservation miss�iori
Signature of Building Date
NOTE:Issuance of a zoning permit does not relieve an applloanrs burden to oompty with ail
zoning requirements and obtain all required permits from the Board of Health. Conservation
Commission. Department of Pubiio Works and other applioable permit granting authorities. —
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