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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. �� Alterations
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a NORTHAMPTON, MASS.. ?e c - 19 Additions
APPLICATION FO ERMIT TO ALTER Repair
Garage
U
1. Location fZ Lot No.
2. Owner's name ddress
3. Builder's name �1
Q/3a/
Mass.Construction Supervisor's License No. 111 Qik rL Expiration Date �o
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���yy,,��
12. Type of roof 4-f'�/'"'
13. Siding house
14. Estimated cost- �°
The undersigned certifi at the abov statements are true to the best of his, her
knowledge and tef.
Signature of responsible app,icant
Remark �� 10 > FG
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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 MAST BE COMPLETED, or PERMIT CAN BE DENIED DUE TO
LACK OF INFORMATION.
Thia col— to be filled in
by the Building Department
Required
Existing Proposed By Zoning
Lot size
Frontage
Setbacks - frnnt
- side L: R: L: R:
- rear
Building height
Bldg Square footage
%Open Space:
(Lot area minus bldg
&paved parking)
# of Parking spaces
# of Loading Docks
Fill:
(volume & location)
13 . Certification: I hereby certify that the informa,tio contai d herein
i4true nd accurate to the best of my know ge.
CLA
DATE: APPLICANT'S SIGNATURE
NOTE: oe of c o ing permit does not relieve an ap oanta bu den to oomply with all
zoninements and obtain all required permits front the Board of Health, Conservation
Commission, Department of Publio Works and other applioable permit granting authorities.
FILE #
w
s �
MAY 51997
File No. �/
ZONING PERMIT APPLICATION (§10 . 2)
PLEASE. E O, "INT ALL INFORMATION
1. Name of Applicant.
Address,�� � ,, , � G eleph e:��T�,,��'
2. Owner of Property:
Address: ) Telephoner
3. Status of Applicant: Owner Contract Purchasep:�Z —Lessee
Other(explain):_----- � dU -
4. Street Address:
Parcel Id: Zoning Map#� Parcel# i District(s): _Z6-�Ql
(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):
7. ache 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 Special Permit/Variance/Finding ever been issued for/on the site?
I
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)
FILE ; .L J
A�&RANT/CONTACT PERSON:
t=A4
ADDRESS/PHONE:��g1J .?_/ Je D t36 d
PROPERTY LOCATION: �� 2J1 z�
MAP PARCEL:_ ZO !lt. a
THIS SECTION FOR-OFFICIAL VSE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FTTJET) OI T
Fee Paid
Building Permit Filled pt
,�r ,ate ✓
FPP Pa id °�-
Type of Construction-
New Cnnqtmi&inr,
�. —
Additinn to Fyktin2
ArrPtcnry Strrtrtnre
nildi a Plan-,Tnrinde-d- _
(lwnPr/C)rrtTant StatPmPnt nr V�—� �tc, �
3 SPt-, of Plan-, /Plot Plan
THE OWING ACTION HAS BEEN TAKEN ON THIS AP ICATION: .
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 Conservation Commission
Signature of B ding or Date
NOTE:Issuanoe of a zoning permit does not relieve nn applloanYs bur-don to oompty with all
zoning requirements and obtain all required permits from the Board of Health, Conservation
Commisslon, Department of Publio Works and other applioable permit granting etuthortties.
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