29-044 (3) . PERMIT APPLICATION CHECK LIST
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PAGE 7 PLOT ZONE l.,%5"`� l+'S%'` '•-� � � .. � a YES NO DATE
1 . ZONING FORM APPLICATION 27�
2 . PERMIT APPLICATION
3 . OWNER OCCUPANT STATEMENT LIC . # IF NOT
4 . 3 SETS OF PLANS /PLOT PLAN
5 . NEW CONSTRUCTION
6 . CURB CUT
7 . WATER AVAILABILITY FORMS
8 . REMODELING INTERIOR
9 . ADDITION
10 . ACCESSORY STRUCTURE
11 . SIGN / AWNING
12 , PERMIT FEE C L - MONEY ORD R2 --;2i�- .
13 . SPECIAL PERMIT REQUIRED WITH DEED IF APPLICABLE
14 , UNDER SECTION 127 - CMR 780
15 . FORM A
16 , FILL
COMMENTS :
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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No.51 C. 5 3 2- Alterations
a NORTHAMPTON, MASS. ZU 191.- Additions
APPLICATION FOR PERMIT TO ALTER Repair
Garage
1. Location 33 1.U 4 e c G" �jz let Lot No.
2. Owner's name u �c 1,+ FY-e ? Q c (c.C- �e,) gkddress__ )c Cs
3. Builder's name -E A 11 �y t. (( vu s Address
Mass.Construction Supervisor's License No. —Expiration Date
4. Addition �� U
5. Alteration -
6. New Porch ci
7. Is existing building to be demolished? -
8. Repair after the fire Na _
9. Garage ��� V No.of cars�� (/ � Size (
10. Method of heating_
11. Distance to lot lines (1�
12. Type of roof i�C ( A-
13. Siding house N
14. Estimated cost:- S j ���Jv
The undersigned certifies that the above statements are true to the best of his, her
knowledge and belief.
Signature of resp le appicanl
1�
Remarks ��( f w Z ( J� V�/ a d �/ c�` c o z �"i A-e r
_ C C S S "i •1 f. 1 w`1 U L� ri �.�� ..,. D ,�J`4`c•v
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001 ';x ,;
Date Filed File No.
ZONING PERMIT APPLICATION (SiO . 2 )
1 . Name of Applicant:
Address : 3 ; VI ,� t�,Lv C_s Telephone: �, 3 2_6
2 . Owner of Property: Sa c,t
Address : ! j ,,,,Z c Telephone : S A lu, e
3 . Status of Applicant: t�wner Contract Purchaser
Lessee Other (explain: )
4 . Parcel Identification: Zoning Map Sheet#_�_ Parcel#
Zoning District (s) (include overt s)
Street Address « Q�
Required
5 . Existinq Pro nosed -by Zoning
Use of Structure/Property ,A
(if project is only interior work, skip to #6)
Building height
%B1dg. Coverage (Footprint)
Setbacks - front
- side L: R: L: R:
- 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 ot���l aOosed Work/Project : (Use additional sheets
if necessary) h , ( a l( !� j (c (c, (, t C �, ( e,- ,-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: � ��� j Applicant's Signature :_ � fG
/ THIS SECTION FOR OFFICIAL, USE ONLY:
Approved as presented/based on information presented
Denied as presented--Reason:
Special' Permit and/or Site Plan Required:
Finding Required: Variance Required:
S gnature of,/Builcling Inspector �(AA Date
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 the Board of Health, Conservation Commission, Departmont of Public Works and other applicable permit granting authorities.
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