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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. �° 946a Alterations
NORTHAMPTON, MASS.
a l9� Additions
Repair
APPLICATION FOR PERMIT TO ALTER Garage
1. Location r Lot No.
2. Owner's name Address � �,l �C�aar p rr.
3. Builder's name 040 1, 8" Address L Omni &i"
Mass.Construction Supervisor's License No. V e Irl� R/ `7 Expiration Date
4. Addition
5. Alteration 'Y` —'rocs �► t� C A C a� 1cy1 SQ i
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:- 4-a to e) .06)
The undersigned certifies that the above statements are true to the best of his, her
knowledge and belief.
Signat responsible appicant
Remarks
00101(Ir%'Uate Filed • File No.
ZO ING PERMIT APPLICATION (910 . 2 )
I . Name of Applicant; C s ;
Address ; c Telephone ;
2 . Owner of Property:
Address : ")0C - Telephone :
3 . Status of Applicant : Owner 'ontract Purchaser
Lessee Other (explain ; )
4 . Parcel Identification : Zoning Map Sheet# Parcel#
Zoning District (s) ( include ov rlays)
Street Address �z ,
Required
5 . Existing Pro nosed - by Zoning
Use of Structure/Property
(if project is only interior work, skip to #G)
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 Propose Work/Pro ' ect : se additional sheets
if nece �arY) ; _ o r
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 : l,� - q� Applicant Is Signature :_
^THIS SECTION FOR OFFICIAL USE ONLY:
v
Approved as presented/based on information presented
Denied as presented--Reason :
&naecial' Permit and/or Site Plan Required :
�n ng quired : Variance Required :
tu Bu , __
g � 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 Hoard of Hoallh, conservation commission, Dopartrnont of Public Works and other applicablo permit granting authorities.
ic'T)_ 1) 1'
PERMIT APPLICATION CHECK LIST
PAGE PLOT /!J-;- ZONE � `C� -. ` ` • YES NO DATE
1 . ZONING FORM APPLICATION
2 . PERMIT P LIC TIO �-
3 . OWNER OCCUPANT E E LIC # IF NO
4 . 3 SETS OF S /PLOT PLAN-
5 .
NEW CO ST UC ION
6 , CURB CU
7 . WATER V I I S
8 . RE ODE I G INTERIOR
9 , ADDITION
0 . ACCESSORY STRUCTURE
11 . SIGN AWNING
2 , PERMIT FEE-- CHECK ONLY - MONEY0 DE Rl �
13 . SPECIAL PERMIT--REQUIRED WITH DEED IF APPLICABLE
14 . UNDER SECTION 127-- - CMR 780
5 , FORM A
16 FILL
COMMENTS :
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