35-127 (2) PERMIT APPLICATION CHECK LIST
NO -DAT
. PAOtx
1 . ZONING FORM APPLICATLON
2 . PER U. ,
3 . OWNER OCCUPANT STATEMENT IF NOT
4 . 3 SET S T PLAN
5 . NEW CONSTRUCTION
6 . CURB CU
7 . WATER MAILABILITY FORMS
8 . REMODELING INTERIOR
9 . ADDITION
10 . ACCESSORY STRUCTURE
11 . SIGN AWNING
12 . PERMIT E O LY - MONEY 0 R
13 . SPECIA PERMIT REQUIRED WITH DEED IF APPLICABLE
14 . UNDER SECTION 127 - CMR 780
15 . FORM
16 . FILL
COMMENTS :
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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations
NORTHAMPTON, MASS. S b / 19_1�y Additions
' APPLICATION FOR PERMIT TO ALTER Repair
y f Garage
1. Location F C', '- r/'r" Lot No.
2. Owner's name D►^It C4 G e r ti eA s c' Address Ca k c(tQ. .e_ f c,,-
3. Builder's name v, Roe Address &3 earl`ST &7�.rny roi, J/(o,
Mass.Construction Supervisor's License No. O 3 G�o Y Expiration Date
4. Addition
5. Alteration
6. New Porch
7. Is existing building to be demolished?
S. Repair after the fire
9. Garage No.of cars Size
10. Method of heating
11. Distance to lot lines
12. Type of roof s111'!22 1t c
13. Siding house
14. Estimated cost- 2 0 0
The undersigned certifies that the abov s ments are true to the best of his, her
know dg belief.
Sig awre of responsible app,icanl
Remarks
Date iled- 002694
3/ y File No.
ZONING PERMIT APPLICATION (§i0 2)
1. Name of Applicant: e,n.,,S L A 01-7-
Address: G 3s7-_ 5 �s h Telephone: L -S'Zy7
2 . Owner of Property: �, ��•_s ,'
Address: d-7 �aLi.�f uve r:�r` =fo,R Telephone: 5'� - 6-266
3 . Status of Applicant: Owner Contract Purchaser
Lessee Other (explain )
4 . Parcel Identification: Zoning Map Sheet` �n Parcel# 12-7 ,
Zoning District(s) (include ov rlays) A �j
Street Address i ,�Le�,� <�, e- 't",
Required
5. Existina Proposed - by Zonin
Use of Structure/Property
(if project is only interior work, skip to #0
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 of Proposed Work/Project: (Use additional sheets
if necessary) ooF - Orr
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: V(f 52f Applicants Signature: �2(�L
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
THIS SECTION FOR OFFICIAL USE ONLY:
r- Approved as presented/based on information presented
Denied as presented--Reason:
Sp cial.' Perm ;,and/or Site Plan Required:
Re iced: variance Required:-
gnatu uildin ector `� Delte
NOTE: Issuance of a zoning permit does not rellove an applicant's burden to comply Willi all zoning roquirements and obtain all roquired permits
from tho Board of Health,Conservation commission,Doparlmont of Public Works and other applicablo pormit granting aulhoritios.
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