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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. 'n Tel.No.,Oy Y ����C Alterations
a Garage----
NORTHAMPTON, MASS. �// V C— 7 19l� Additions
APPLICATION FOR PERMIT TO ALTER Repair
//
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1. Location L,���C Lot No.
LA
2. Owner's name���4ay� �Z �14—�- Address �` LA`- - r-
3. Builder's name j lu L��� Address J P 1'ti[rCJ L
Mass.Construction Supervisor's License No. �/J L le i'000 Expiration Date
4. Addition
5. Alteration"t j~ S i A-L(-,r Aci r1tC- /� L/iti�L D r'/��4C_�_�-� �1ti✓
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 statemcnts are true to the best of his, her
knowledge and lief.
Signature of responsible app scant
Remarks
10. Do any signs exist on the property? YES NO /x
iy#Y'ES,Abe 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 MAST BE COMPLETED, or PERMIT CAN BE DENIED DUE TO
LACK OF INFORMATION.
This corn to be filled in
by the Building Department
Required
Existing Proposed By Zoning
Lot size
Frontage
Setbacks frnot
- side L: R: L: R:
rear
Building height
Bldg Square footage
%Open Space:
(Lot area minus bldg
&paved parking)
# pf -Parking spaces
of Loading Docks
Fill:
(volume -& location)
13 . Certification: I hereby certify that the .information contained herein
'f
is
rue and accurate to the best of my kn edge,.
DATE: APPLICANT'S SIGNATURE ,�
NOTE: Iss ano of a zoning permit does not relieve, applioa burden to oomply with all
zoning requirements and obtain all required per is from the Board of Health, Conservation
Commission, Department of Publio Works and other applioable permit granting authorities.
FILE
—.a r
�..M2 y
I as
File No.
u -
ZONING PERMIT APPLI CATION (§16 . 2')
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant: G t�-
Address:- 6 01 w1 cc CC r; ( Telephone: ,.Sy `f �� 7
2. Owner of Property/: ��-N�f ttit,� �.�� �/�L-LrA-c�,.� r7
Address: �f at_rAC-lL .y c f-r LA Telephone:
3. Status of Applicant: Owner Contract Purchaser Lessee
Other(explain):
r -
4. Street Address:
Parcel Id: Zoning Map#l 'p - District(s):
L" �� Parcel# � �(TO-BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/Property r, i.s r //1Ca L fS
6. Description of Proposed Use/Work/Project/Occupabon: (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/Vadance/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)
960519
FILE
APPLICANT/CONTACT PERSON: � / ?
ADDRESS/PHONE: : i< Je , '
PROPERTY LOCATION: AX _ � �z - 2 r f�dc6l LK 1�'2
MAP PARCEL: ZO
THIS SECTION FOR-OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
70NIFNC�FORM OITT 7,77=77
Fee Pnid
lRivilding Permit Filled nvit
Fee Pn*d
":�'C ✓
T,/B/FOLLOWING 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:
Curb Cut from DPW Water Availability Sewer Availability
Septic Approval-Bd of Health Well Water Potability-Bd Health
rmit fr onse ation Commission / ____
ignature o ilding Inspector -___. ----- ate
NOTE:Issuano a zoning permit does not relieve an applioant's burden to oomply with all
zoning requirements and obtain all required permits from the Board of Health, Conservation
Commission, Department of public- Works and other applioabie permit granting authorities. —
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