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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations
aNORTHAMPTON, MASS. 19 Additions
APPLICATION FOR PERMIT TO ALTER Repair
- r
Garage
1. Location - TI c Lot No
.
2. Owner's name ��1 L 911 ro o Address
3. Builder's name) ��— � " tEZ / &ddress
Mass.Construction Supervisor's License No. l�51 �i`l' Expiration Date $ -q 9�
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 cosL:64V,,
a under ned certifies t the above statements are true to e st of his, her
knowledge d beli
Signature of repo ible ap
Remarks
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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:
I1. ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE DENIED DUE TO
LACK OF INFORMATION.
This CO1== to be filled in
by the Building Department
Required
Existing Proposed By Zoning
Lot size
Frontage
Setbacks - frnnt
- side L: R: L: R:
- rear
Building height
Bldg Square footage
%Open Space:
(Lot area minus bldg
' &paved parking)
# .of -Parking Spaces
fr8f Loading Docks
Fill:
(vol-ume--& location)
13 . Certification: I hereby certify that the orma on contained herein
4 is t e a d accurate to the best of m nowl dg
.1
DATE: � 113M7 APPLICANT's SIGNATU
NOTE: leau noe of a zoning permit does not reliev an plio nYs bur a ply,with„"tl-
zoning requirements and obtain all required per is f the Board o Conservation
Commission, Department of Publio Works and of er pi a permit grants g authorities:;..
= ' '; FILE #
MAR i 3 Env �7i
File No �
ZONING PERMIT APPLICATION (§10 . 2)
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant: ��T� /� /��1�f �/["1 L—[ (�jf���y<
Address: (/(l� G�/L—Sa/� C_l/ Gt�i/�/�elephone:_ �� ( ��
2. Owner of Property:
/Z.19/( /
Address: —Dk Telephoner 7 a' o S
3. Status of Applicant: Owner Contract Purchaser Lessee
Other(explain):
4. Job Location:
Parcel Id: Zoning Map#_'4� Parcel#_ District(s): ,►
(TO BE FILLED IN BY THE BUILDING DEPARTMEN
5. Existing Use of Structure/Property
6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary):
7. Attached Plans: Sketch 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 K NCI'A 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)
2� 1
FILE #
0 1 APPLICANT/CONTACT PERSON
ADDRESS/PHONE:
PROPERTY LOCATION: 'l
-
MAP 1�29 PARCEL: ZONE,,,,Gc"- 4"-q.,0
THIS SECTION FOR..OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FH,T,FD MIT
Rnilfjin2 Permit Filled ailt
Rt-rrindelin2 Interior
z_
`7
Sets of Plan.- / Plat Plan
TIDE �LLOWIING ACTION HAS BEEN TAKEN ON THIS AP ICATION:
(/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:
urb Cut from DPW Water Availability Sewer Availability
Septic Approval-Bd of Health Well Water Potability-Bd Health
it oe*Ka " C
Signature of Building Inspector IMe
NOTE: Issuance of is zoning permit does not relieve an applloant'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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