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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. l Alterations
NORTHAMPTON, MASS. �d �:� �� 19�( � Additions
APPLICATION FOR PERMIT TO ALTER Repair
{ J Garage
1. Location %� C. ( / } ��/Z__ Lot No.
9 y�
2. Owner's name /�C 1 t Address c�J e-i- J":�o/Z
3. Builder's name )a 7" 1))v ` it,- Address kbL--e z Sir( A'
Mass.Construction Supervisor's icense No. o Expiration Date 7 arc V
4. Addition I JJ
5. Alteration G1 'r
6. New Porch
7. Is existing building to be demolished?
8. Repair after the fire
9. Garage J No.of cars Size
10. Method of heating
11. Distance to lot lines
12. Type of roof
13. Siding house
14. Estimated cost:- F✓ �}
The undersigned certifies that the above statements are true to the best of his, her
knowledge and belief.
ffSignature of responsible appicant
Remarks
10. Do any signs exist on the property? YES NO_1 Z
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 col— to be filled in
by the Rul ding Department
Required
Existing Proposed By Zoning
Lot size F
Frontage 2 fa
Setbacks
- side L: R: L: R:
- rear
Building height
Bldg Square footage
%Open Space:
(Lot area minus bldg
' &paved parking)
-Parking Spaces
#`8f Loading Docks
Fill:
'4vol-ume--& location)
"13 . Certification: I hereby certify that the information contained herein
_ 4 is true a d accurate to the best of my knowledge.
a
DATE: �.� �� ! APPLICANT's SIGNATURE M
NOTE: issunnoe of a zoning permit does not relieve an pica s burden to oom I '
P? M±�tr ,.mil.
zoning requirements and obtain all required permits from the card of Health, Con$ervation
Commission. Department of Publio Works and other applicable permit greinting authorities:--
FILE #
,
/ APR K ^� ����
' , ~~~` File No' - ^�~
/
IF PT= qm ���� �� �� �
RING PE=T ����������� « ��� . ��
PLEASE =E OR PRINT ALL ZYEORMAZI[N
1. Name of Applicant: _
-
Address: Telephone:
� .
_' Owner of Property:
3. Status ofApplicant: Owner Contract Purchaser Lessee
Other(explain):
4. Job Location:
Parcel Id: Zoning Map# c2 Parcel# District(s):
(TO BE �ILLED IN BY THE BUILDING DEPARTMENTj
5. Existing Use of0muture/Pmperty
~
'
6. Description of Proposed Use8Work/pnojacVDonuoaUon: (Use additional sheets if necessary):
.' Attached_ Plans: -- Plan ____---_-Site Plan Engineered/Surveyed
`
Answers»u the following o questions may ue obtained uy checking with the Building Dept m Planning Department Files.
8. Has a Special Ponnit/Vahanoe/Fndingeverboonkanaedhmhnthesde?
NO DON'T KNOW NF YES,date issued:
IF YES: Was the permit recorded at the Registry ofDeeds?
NO KNOW YES
IF YES: enter Book Page� and/or Document
8, Does the site contain e brook, body of water orwetlands? NO DON7 KNOW YES
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs tobe obtained Obtained date issued: _
(FORM CONTINUES ON OTHER SIDE)
'
- '
i # t FILE #
962132
APR 117 M7
L A.PPLICAINT/CONTACT RSON:
iFI7 OF ADUR /PHONE: J
.,,
_ PROPERTY OCATION: 2A 4
MAP PARCEL: CCU ZO l6
THIS SECTION FOR.�OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FO-RM VR.Y.F.T) OUT
Fee Pnid
Building Permit Filled nilt
Type of Constmiction-
Ne
>/
1/
cri>
f�
XOLLOWING ACTION HAS BEEN TAKEN ON THIS AP ICATION: `
Approved as presentedfbased 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 Conservatio ommi i
Signature of Building Inr f®r ate
NOTE:Issuanoe of at zoning permit does not relieve an appiioants burden to oompfy with afi
_ zoning requirements and obtain ail required permits from the Board of Health, Conservation
Commission, Department of Public), Works and other applioable permit granting authortties.
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