29-223 PERMIT APPLICATION CHECK LIS
€S NO DATE
L
3 , OW
3 SETS OF PLANS /PLOT PLAW
5 . NEWCONSTRUCTION
6 CURB CUT
7 WATER
8 , REMODELI
9 . ADDITION
0 , ACCESSORY
11 . SI N / AWNING
2 E - MONEY -0 DER
3 . SPECIAL I IF -APPLICABLE
4 . UNDER S - CMR 780
5 FORM A
6 . FILL
COMMENTS ;
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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. C-) Alterations
NORTHAMPTON, MASS. I 19 267 Additions
a �CBQ"�
APPLICATION FOR PERMIT TO ALTER Repair ✓
� Garage
1. Location 19,6 c rp_<- �a k D,(,� Lot No.
2. Owner's name �e� C �e� (��!1� Address 1 :28 C&N� Sc-cC` k C-:n'.
3. Builder's name h�{ lilC� 'fie �� Address (aq-_:!>
Mass.Construction Supervisor's License No. �'4 P 7 Expiration Date
4. Addition VNO
5. Alteration A C'
6. New Porch n1D
7. Is existing building to be demolished? Yl 1D
8. Repair after the fired Y!:>
9. Garage 10-� No.of cars Size I q X,4
10. Method of heating m _- -- -
11. Distance to lot lines
12. Type of roof ca
13. Siding house
14. Estimated cost. ,3��"9
The undersigned certifies that the above statements are true to the best of his, her
knowledge an belief.
Signature of responsible app,icant
Remarks
+ i t
Date Filed �p~ "� File No.
ZONING PERMIT APPLICATION
I . Name of Applicant: Wc'
Address: Telephone: - - (Jz
2 . Owner of Property: .
Address: Telephone:
3 . Status of Applicant: Owner Contract Purchaser
Lessee Other (explain )
4 . Parcel Identification: Zoning Map Sheet#_ Parcels `'_ i ,
Zoi'ting District(s) (include over,61
Street Address
Required
5. Exis-ting Proposed b Y ZonLncr
Use of Structure/Property
(if project is only interior work, skip to #6)
Building height
°sB1dg. Coverage (Footprint)
Setbacks - front
- side L: R: L:
- rear
Lot size
Frontagb.
Floor Area Ratio
. %Open Space (Lot area minus
building and parking)
Parking Spaces
Loading IL
signs
Fill (volume & Zocatio
6. Narrative .Desc 'ption of Proposed Work Project: (Use additional sheets
if necessary) C)� t'� 6e.,P --
fi' Irh
' i n
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 know;4e dge.
3 .
Date: 6--?- g5 Applicant's Signature: UGC
THIS SECTION FOR OFFICIAL USE ONLY:
ZAPproved r
as presented/based on information presented
Denied as presented--Reason:
Special* Permit and/or Site Plan Required:
inding ire Variance Required:
gnat of .Bui1d1ng I forl
NOTE: issuance of a ion 9 permit does not mn vo an applicant's burden to comply with all zoning requirements and obtain all required permits
from the Board of Hoalth.Conservation Commission, Department of Public Works and other applicable permit granting authoritlos.
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