35-052 (2) PERMIT APPLICA IST
PAGE PLOTS ZONE ES NO DATE
r ,
2
3 OWNER O
SETS OF PLANS /PLOT PLAN
5 , NEW CONSTRUCTION
6 CURB CUT
7 . WATER AVAILABILITY FORMS
8 , REMODELING INTERIOR
9 ADDITION
10 , ACCESSORY STRUCTURE
11 , 81GN / AWNING
2 PERMITp
3 , SPECIAL UI D WITH DEED IF APPLICABLE
4 . UNDER - CMR 780
5 FORM A
16 FILL
COMMENTS :
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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations
NORTHAMPTON, MASS. 19 Additions
APPLICa ATION FOR PERMIT TO ALTER Repair
Garage
1. Location Oohea ✓•�>%,r� ��y � Lot No.
2. Owner's name /�� y�' ��� w l�Z Address
3. Builder's name L6fi/ .���/�P� /' Address /,0>f
Mass.Construction Supervisor's License No. � U '� Expiration Date JUZ �I RV
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. sdmated cost- 41cla y X!
The undersigned certifies that the above statements are true to the best of his, her
> knowledge and belief.
V 111k,
Signature of responsible app,icanl
Remarks
�- 00255
Date Filed File No.
ZONING PERMIT APPLICATION (910 . 2)
1 . Name of Applicant:
Address : fp�y l�j/y�iT. ,�f'j>yG il/v ,a��°�,• Telephone: S �'9Y✓_
2 . Owner of Property: U�6/C1Fw/c�-
Address : 9,61 41 Telephone:
3 . Status of Applicant: Owner --Contract Purchaser
Lessee Other (explain:
4 . Parcel Identification: Zoning Map Sheet#_ Parcel#
Zoning District(s) (include ver s)
Street Address —
Required
5 Existin Proposed
-by Zoning
Use of Structure/Property
(it project is only interior work, sk p to )
Building height
%B1dg. Coverage (Footprint)
Setbacks - front
- side L: f2: L: R:
- rear
Lot size
Frontage
Floor Area Ratio
%open Space (Lot area minus
building and parking)
Parking Spaces
Loading
Signs
Fill (volume & location)
16;/ Narrative Descriptio-p of Proposed Work/Project: (Use additional sheets
if necessary)
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: Rv Applicant' s Signature: LIA110 6 //r�ur✓
THIS SECTION FOR OFFICIAL USE ONLY:
Approved as presented/based on information presented
Denied as presented--Reason :
pecial' Pe mit and/or Site Plan Required:
,Fin g R tir tl: Variance Re uired:
S gnature of Buil nspector �� at
NOTE: Issuance of a zoning n ng permit does not relieve an applicant'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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