35-157 (3) PERMIT APPLICATION CHECK LIST
PAGE j� .BLOT f ZONE D YES NO DATE
Z0-N- I-NG FORM APPLICATION F 4-
2 . PERMIT P LIC TIO i-
3 , OWNER OCCUPANT E E L IC # IF NO
4 . 3 SETS OF NS ZPLOT PLA N V-
5 , NEW CO ST UC ION
6 . CURB CUT
7 , WATER AVAILABILITY FORMS
8 , RERODELING
9 , ADDITION
10 . ACCESSORY STRUCTURE
11 . SIG AWNING
2 . PERMIT FEE - CHECK ONLY - MONEY ORDER
13 , SPECIAL PER IT REQUIBED WITH DEED IF APPLICABLE
14 . UND ER SECTION 127 - CMR 780
15 . FORM
16 . FILL
COMMENTS :
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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. a Tel.No. 1te s
NORTHAMPTON, MASS. / � Y i` '� 1953 Additions
Repair
APPLICATION FOR PERMIT TO ALTER
1 R
Garage
1. Location Lot No.
�
2. Owner's name iL. .Z.,q- R"t 6 ,e Address .0k2L=F�l�
3. Builder's namer�f? S a trU t" Address c20 Y U i- ci►-c
Mass.Construction Supervisor s License No. n/2 Expiration Date
4. Addition
5. Alteration da X
6.
7. Is existing building to be demolished?_ STS
8. Repair after the fire
9. Garage No.of cars Size
10. Method of heating 0A c-
11. Distance to lot lines
12. Type of roof
13. Siding house
14. Estimated cost:- r f d 6 d
The undersigned certifies that the above statements are true to the best of his, her
knowledge and befie/f.
69.44( � Signature of responsible app,icant
Remarks
�e'iyra y
Date Filed L//-;? V ?_3 File No.
— I ZONING PERMIT APPLICATION (§10 . 2)
1. Name of Applicant: 76",_e_5 'Q('C� `
Address : 9 CA Telephone: fTC
2 . Owner of Property:
Address : Fit Telephone:
3 . Status of Applicant: _2�_Owner Contract Purchaser
Lessee Other (explain: )
4 , Parcel Identification: Zoning Map Sheet# '� Parcel# 6�> ,
Zoning District(s) (include overlays) $
Street Address ,
Required
5 . Existinq Pro Dosed bv Zoning
Use of Structure/Property DW of 'i.h
(if project is only interior work, kip to #6) �
Building height o? -dry ry
%B1dg. Coverage (Footprint)
Setbacks - front D
- side L: R: L: R:
- rear o c yd
Lot size
Frontage
Floor Area Ratio
%Open Space (Lot area minus
building and parking)
Parking Spaces
Loading
Signs
Fill (volume & location)
6 . Narrative Descr`p ion of Proposed Work/Project: (Use additional sheets
if necessary) e ow, e G c Q �E "' 13 --o
J3,6112 eW 7`d 12—"
/y e' /3reC•_t, 1�4ay L3el-q.,ee-A nw5 o! a a L2Ne__
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 knowled e. 4
Date: IZ 1' Applicant's Signature
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - --- - - - -
THIS SECTION FOR OFFICIAL USE ONLY:
_AZApproved as presented/based on information presented
Denied as presented--Reason:
Special Permit and/or Site Plan Required:
finding R u 'red: Variance Required: q _
S~ /
igna r Bui g Inspector D to
NOTE: issuance of a zoning permit does not rolieve 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 authorities.
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