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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No.,M-e 9767 Alterations X
NORTHAMPTON, MASS. 191-„C' Additions
APPLICATION FOR PERMIT TO ALTER Repair
Garage
1. Location 2 ..�f /= Lot No.
2. Owner's name 8 cj6=/ 04 177- Address 7L-) rn,Q,,w 5,, /y A;j bW 72,8,1 Alr-y,
3. Builder's name a PJ ✓ Dr- G/ ,9,4,7J/ rh A
Mass.Construction Supervisor's License No. O d T-"7 Expiration Date
4. Addition
5. Alteration CA14N4.4 1-clg4g4v A4,&m /—ia of%-iee
6. New Porch
7. Is existing building to be demolished? ^-- Cl
8. Repair after the fire
9. Garage No.of cars Size
10. Method of heating /' >�/ 5 Z/ 6
11. Distance to lot lines
12. Type of roof
13. Siding house
of-
14. Estimated cost 315-00
The undersigned certifies that t above statements are true to the best of his, her
knowledge and belief.
Signature of responsible app icant
Remarks L 16A- v e �-
6 9'c/f Spa T-S ?-i--J- ] i--,,C tz IZA-or /J
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:
II. ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE DENIED DUE TO
LACK OF INFORMATION.
This cols to be f111ed in
by the 8nildiug Department
Required
Existing Proposed By Zoning
Lot size
Frontage
Setbacks
- side L• R: L: R:
- rear
Building height
Bldg Square footage
%Open Space: AA
'(Lot area minus bldg
&paved parking)
# of Parking Spaces
# of Loading Docks
Fill:
(volume & location)
13 . Certification: I hereby certify that the information contained herein
is true and accurate to the best of my knowledge.
DATE: p 7-/7-qj — APPLICANT's SIGNATURE IIJ2 /-. .
NOTE: laauanoe of a zoning permit does not relieve an 9(ppi-j6a nYs urden to oomply with all
zoning requirements and obtain all required permits from 10he Bo rd of Health, Conservation
Commission, Department of Publio Works and other appiioable ermit granting authorities.
FILE #
G^f�1 —�J
File No. ���
ZONING PERMIT APPLICATION (§10 . 2)
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant: f O'E}d/v19"
Address: ZU/ 4/ Sfi eL—L S CtZ g vAl m 4 Telephone:�y/3,1 ' 6 7-370 7
2. Owner of Property: /1'°°"'`� ��"°' �'"��'°' Ae"07—
Address: 2-17 T7- C,7-4 Telephone: tQEZ-G f 70
3. Status of Applicant: Owner Contract Purchaser Lessee
_Other(explain): Dg a o r �'. �✓/L
4. Street Address: fLY.9 ✓ i'Z
Parcel Id: Zoning Map# Parcel# District(s):
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/Property sc l�ra,� / Lo�hh'/ladn
6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary):
LOLh6/COdM 77) DI`i=/G� /wi //F /�fl/1-T�I-G✓ L✓/lGLS
_ 40"TD aE
u/ o d/L-f %O Z,- , 7-7 46Z2"'
4idJ�d^/f '0"V •S a.✓Glf 4„/€I26 /f2`/1OGti S`7- G L /�✓J�GitG�G fi�9Gl .o1?a/° CAX/L/•I
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 Special Permit/Variance/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-_`C 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 # -
APPLICANT/CONTACT PERSON:
ADDRESS/PHONE: ,,,��r
=PROPERTY OCATION:C PARCEL: C�' " ZONE c
THIS SECTION FOR-OFFICIAL USE ONLY:
PERAUT APPLICATION CHECKLIST
.ENCLOUD REQUIRED DATE
MNINC-FORM FIT.I.ED OUT
Fee Pfi*d
EP - Paid
Add*t*nn to Existing
TH�FOLLOWING 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
ermit o onse tion Commission
,signature 4<111ding Fwpector
NOTE:Issuance of a zoning permit does not relieve an applicants burden to comply with all
zoning requirements and obtain all required permits from the Board of Health. Conservation
Commission, Department of Publio Works and other appiioable permit granting authorities.
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