35-031 (6) PERMIT APPLICATION CHECK LIST
PAGE PLOT / ZONE__ � �� � '� YES NO DATE
1_, iONING FORM APPLICATION
2 . PERMIT APPLICATI ON �-
3 . OWNER OCCUPANT IF NO
4 . 3 SETS OF PLANS PLAN
5 . NEW CONSTRUCTION
6 . CURB CUT
7 WATER S
8 . REMODELING
9 . ADDITION
10 , ACCESSORY C U
11 . SIGN / AWNING
2 , PERMIT FEE L - MONEY ORDER
13 . SPECIAL PERMtT REQUIRED WITH DEED IF APPLICABLE
14 , UNDER SECTION 7 - C R 780
15 , FORM
16 , FILL
COMMENTS :
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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. � Yom" t Alterations
NORTHAMPTON, MASS. 19 Additions
APPLICATION FOR PERMIT TO ALTER Repair
a
p Garage
1. Location �o �� //,�__ �1 �-J Lot No.
2. Owner's name P61 y-Ct/ t�fiH2l9 C f Jc Address '7 I` '/1°9'✓ Rd
3. Builder's name Address
Mass.Construction Supervisor's License No. 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 ojresportsible oppkonl
Remarks
w 00346
Date Filed , File No.
ZONING PERMIT APPLICATION (510.2)
1. Name of Applicant: Pu l-er
Address: f2 Telephone:
2 . Owner of Property: I'Cale*- 'y
Address: S7 Telephone: Yai•<
3 . Status of Applicant: Owner Contract Purchaser
Lessee Other (explain: )
4. Parcel Identification: Zoning Map Sheet# .3`5- Parcel#
Zoning District(s) (include gverlays)
Street Address �.
Required
5. Existin Pro osed b Zoning
Use of Structure/Property
(if project is only interior work, skip to #6)
Building height
%B1dg. Coverage (Footprint)
Setbacks - front
- side
- 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 f Proposed Work/Project: (Use additional sheets
if necessary) •ts_� tr ,ati rr/� tt'04-t( s70v-f
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: �D� r- Applicant's Signatur:-�
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
THIS SECTION FOR OFFICIAL O
Zpproved as presented/based on information presented
Denied as presented
P,easQn f ial:
Z-
tignatAre o y Bui nspector te
NOTE: Issuance of a zoning permit does not relieve an applicanes 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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