29-053 (2) a
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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel. o. Alterations
NORTHAMPTON, MASS. j�. 19 uL Additions
APPLICa ATION FOR PERMIT TO ALTER Repair
Garage
1. Location i i=. Cr-r Lot No.
2. Owner's name r�1� ��'� Address lx-
.4 � y
t�a
3. Builder's name Address ✓v 3'
Mass.Construction Supervisor's Lic se No. 7� 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.All
i nature of responsible appicanl
Remarks t'i��£' t ^l :�"/ ru° t� K` �7 �l�`� �G' � c>. G��t.
a- �
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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:
11 . ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE DENIED DUE TO
LACK OF INFORMATION.
This —I— to be filled is
by the Building Department
Required
Existing Proposed By Zoning
Lot size
Frontage
Setbacks
- side L: R: L: R:
- rear
Building height
Bldg Square footage
%Open Space:
(Lot area minas bldg
&paved parking)
# of Parking Spaces
of Loading Docks
Fill:
-(Vol-time--&' location)
13 . Certification: I hereby certify that the information contained herein
is true and accurate to the best of my kno edge.
D71-'1'E: i APPLICANT's SIGNATURE /'d
NOTE: Issuance of a zoning permit does not relieve an`a lioant' urden to comply with all
zoning requiremenss and obtain all required permits tro the 133itgOd of Health, Conservation
Commission, Department of Publio Works and other applioable permit granting authorities.
.,;, FILE
l5 L J
MAR 1 419%
ZONSNGAF PERMIT APPLICATION (§10 . 2)
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant:
Address: ,' � ./ -� z''��� Telephone:
2. Owner of Property:
Address: Telephone:
3. Status of Applicant: Owner %Contract Purchaser Lessee
Other (explain):
4. Job Location: —r-
i
Parcel Id: Zoning Map# Parcel#v'� � r
� '� District(s): i� ,f-
(TO BE FILLED IN BY THE BUILDING DEPARTMENT) �—
5. Existing Use of Structure/Property
6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary):
L �
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 Specialermit/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)
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143 FILE
-960722
LPLICQ M
A T PlF.RqnN- '54
A 19,
PROPERTY LOCATION:
-,
MAP 6 PARCEL:
ZONE_,L
THIS SECTION FOR-OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONTNG FORM MILD OUT
Fei- PAid
1Ryiijdin2 Permit MUM mit
EP -Paid
TXjit- nf Cnnqtny&inn-
New Cnnstrurtinn �1e
-Remndelin:4 Interinr
Atid;flnn to Existing
Arreqqnry Stmirtitrt,
0 ant
3SPtq of Plans I Pint Plan
THF�OLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION-
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
—Permit from Consery n Co fission
Signature of Building �tor Date
"*
NOTE:losuanoe of a zoning permit does not relieve an appiloant's burden to oompty with all
zoning requirements and obtain all required permits from the Board of Health, Conservation
Commission, Department of Publio Works and other applioable permit granting authorities.
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