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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations
NORTHAMPTON, MASS. 19 1 Additions
APPLICa ATION FOR PERMIT TO ALTER Repair
Garage
/ s
1. Location �� ���i���9 / 2, f-/ate `� Lot No.
2. Owner's name GAS D� Address o
t�.9�//,9►� %c�i�>�, Flo A
Cr Address r u T
3. Builder's name �D�+J l✓��✓ — ///1; 0'2 ii/�J,ti.
Mass.Construction Supervisor's License W.. O ez ?
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
12. Type of roof
13. Siding house
14. Estimated cost-
The undersigned certifies that the above statements are true to the best of his, her
knowledge and belief.
Signature of res/o sible app scant
Remarks
Date Filed 000339"'1 File No.
ZONING PERMIT APPLICATION (§10.2)
1. Name of Applicant: :2C W, N 4, /51g lli
Address: 21�:/ ,mot /✓6/,-74 : ,) /q-4-Telephone:
2 . Owner of Pro erty:
Address 14 I � ��,��, ,�/���,�c:� A77-9 Telephone: S$6-- R
3 . Status of Applicant: Owner Contract Purchaser
Lessee Other (explain: )
4 . Parcel Identification: Zoning Map Sheet# Parcel#
Zoning District(s) (include ov r a S
Street Address
Required
5. Existina Proposed by Zoning
Use of Structure/Property
(if project is only interior work, skip to #6)
Building height
%Bldg.Coverage (Footprint)
Setbacks - front
- side
- 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)
— 3/v/
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: A " 2y Applicant's Signature:
- - - - - - - - - - -
THIS SECTION FOR OFFICIAL USE ONLY:
�'Approved as presented/based on information presented
Denied as presented
s for n'
- 'gnat a of Build' spector �� ate
NOTE: Issuance of a zoning permit does not relieve an applicant's burden to comply with all zoning requirements and obtain all required permits
from the Board of Health.Conservation commission,Department of Public Works and other applicable permit granting audwrities.
PERMIT APPLICATION CHECK LIS
PAGE PAGEI NO DATE
3 . OWNER OCCUPANT STATEME 0
4 . 3 SET PLAN
5 . NEW CONSTRUCTION
6 CURB CUT
7 , WATER FORMS
-
8 . REMODELING
9 . ADDITION
0 . ACCESSORY STRUCTURE
11 . SIGN / AWNING
2 , PER IT FEE - C - MONEY ORDER
13 , SPECIAL PERMIT REQUIRED WITH DEED IF APPLICABLE
4 . UNDER SECTION 7 - C R 780
15 . FORM A
16 , FILL
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