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Date Filed ( File No',
7j ON-12IG PERMIT APPLICATION
7oni.ng O.rdinai)ce sabtion 10 , 2
1 . Name of Applicant :
' A d d r. c a s ; .-5" 5�-�-,{�
2 , Owner. of Pro er. t
Address ; I l'elephone ; '�.:=lc�
3 . Status of Applicant : Owner Contract Purchaser
Iaessee otFEr (e-Xr)1ain ; G .,f,4/
4 . Parcel Identi.f.icati^on ; Zoning Map Sheet,` ;- 1
Zoning Districts)
Street Address '
5 , ' Compliance' with Zoni.nu ; t , g Proposed
Use of Structure/Property
Size of Structure (s cr , f t , )
Building height sR' "_
% Bui.lding Coverage /yi ,., ,1e --
o ,
Setbacks - front . ,f1
- ,.side �.E;° L�< mss= ,F? ' s
{�. - rear e
Lot: Size �
Frontage f
Floor Area Ratio
Open Space
Parking spaces
Loading Spaces
Signs '
Fill (volume & location)
6., Nar.ratite Description of Pr. onosad Work•/Pro- ect ; (Use
addit ' dnaa. shee -s if necessary)
7 . Attached-Plans : Sket:ch Plan Site Plan
S . Certification ; z hereby certify that the •ih�prmation, contained
herein is true and accurate to the best o my .knowledge ,
Date ; Applicant ' s signature ;
THIS - SECTION FOR OFFICIAL USE ONLY:
V` Approved as presented
Denied as presented
Reason for Denial ; ,
Signature of Building Inspector. • /� Dat , {' 3/
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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations
so NORTHAMPTON, MASS. � 1;� 19�Y Additions
APPLICATION FOR PERMIT TO ALTER Repair
Garage
1. Location o. ra'. Lot No.
2. Owner's name Address % fi
3. Builder's name Address
Mass.Construction Supervisor's License No. Expiration Date
4. Addition X-10
5. Alteration c;,-4/,J/1705
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
Le � /
11. Distance to lot lines I'—�'f//'- Go � � ��
12. Type of roof / S,Oh.R.../�
13. Siding house C,•� /
14. Estimated cost
The undersigned certifies that the above statements are true to the best of his, her
knowledge and belief.
17 i
Signature of responsible applicant
Remarks
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