35-043 (6) PERMIT APPLICATION CHECK LIST
PAGE '�3 5- PLOT 1-43 ZONE YES NO DATE
1
ZONING F PPLI ION � _l 1 i�ycL � � L� - tl9-Ci
2 . PERMIT APPLICATION
3 . OWNER CCU NT S TATEMENT - LIC. # I NOT ` t--
4 3 SETS OF PLANS /PLOT PLAN
5 . NEW CONSTRUCTION
6 . CURB CU
7 . IYATER AVAILABILITY FORMS
8 REMODELING INTERIOR
9 . ADDITION
10 ACCESSORY STRUCTURE
SIGN AWNING
1 :, G
12 . E I E — CHECK ONLY — MONEY ORDER �7 4f O. c% C>
13 . SPECIAL PERMIT REQUIRED WITH DEED IF APPLICABLE
4 UNDER SECTION 127
15 . FORM A
16 . FILL
COMMENTS :
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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. 64 `� �y Alterations
NORTHAMPTON, MASS. 17 19 '(Z Additions
APPLICATION FOR PERMIT TO ALTER Repair
Garage
1. Location i 'g'e) � �0rr r, 'C" �<il ����__ Lot No.
t_O lrwr
2. Owner's name �� L� (q < �?j4(! Address �:�,.' �
3. Builder's name 1) .fi t! o e r4�_tN•r' Address (x-,dt t+)VA,f/ RL 62 Al Jl
Mass.Construction Supervisor's License No. 6209 31 Expiration Date 6 c
4. Addition
5. Alteration t +!* f " ,�
NJ
6. New Porch '
7. Is existing building to be demolished? NO"
P ,
4
8. Repair after the fire £�`r-'�t � � iZ f�.v,e`'� � �� `�'�-'� 't7\J-
9. Garage No.of cars Size
10. Method of heating
11. Distance to lot lines
12. Type of roof RS-ey,Al
13. Siding house w eU D `
14. Estimated cost:- I0,c,
The undersigned certifies that the above statements are true to the best of his, her
knowledge 4nd be ' f.
1 "
Signature of responsible applicant
Remarks 1N b,R+ ner H UU LC 0 FT e{1. V:a fke-- lye f h tit Vy0,C3,. It-`
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Date Filed__'g-/.1(71 Z File
ZONING PERMIT APPLICATION (510 . 2) Jc
1 . Name of Applicant: y),61AA DC'"e
Address : 4; Co�utLA41 t W6 Telephone:
2 . Owner of Property:r//&'1
Address : 1 vv Telephone: I-,C2 -=4;k4 J
3 . Status of Applicant: Owner Contract Purchaser
Lessee Other (explain: C„r,r-;Z,��- 1 _)
4 . Parcel Identification: Zoning Map Sheet# !� Parcel# ,
Zoning District(s) (include over s) �
Street Address �I �G( .
Required
5 . Existina Proposed by 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 of Proposed Work/Project: (Use additional sheets
if necessary) 8f-wtcue 'S iwtR> r`Ze
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: b�!'7��12 - Applicant ' s Signature: i� E
- - - - - - - - - -
� - - - - - -
THIS SECTION FOR OFFICIAL USE ONLY: AUG f 8 '. .'
/�Approved as presented/based on information presented LD De ed as presente
fa 1:gnat o nspector ✓ to
NOTE: issuance of a zoning permit does not relieve an applicant's burden to comply with all zoning requirements and obtain all required permits
from Ow Board of HeaM, Conservation Commission, Department of Public Works and other applicable permit granting authorities.
-3
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