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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. j Tel.No.( �` Alterations
NORTHAMPTON, MASS. �I `� 19 � Additions,/25 .-,LsS
a #--APPLICATION FOR PERMIT TO ALTER Repair
�. Garage
I. Locations L� `�`�G'1�'' Lot No.
2. Owners name � ;i';? Address / "� ��'�`✓''r j
3. Builder's name Address
Mass.Construction Supervisor's License No.6-11 Expiration Date "Z �i
4• Addition
5. Alteration ,A;-1 A—
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 s tements are true to the best of his, her
knowledg d belief.
Signaiure aJ esponsible app icon!
Remarks
fop
APR I 1 199
3E INS..
• map
,tea
6'0 4
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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:
11. ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE DENIED DUE TO
LACK OF INFORMATION.
This column to be filled in
by the Building Department
Required
Existing Proposed By Zoning
Lot size
Frontage
Setbacks - frnnt
- side L: R: L: R:
- rear
Building height
Bldg Square footage
%Open Space:
(LOtarea minus bldg
' &paved parking)
# of Parking Spaces
f of Loading Docks
Fill:
Avol-ume--& location)
13 . Certification: I hereby certify that the information containe herein
is true and accurate to the best of my k;the dge.
DATE: APPLICANT'S SIGNATU
NOTE: ss a e of zoning permit does not relieve n oant's burden m wit
PtY If,..all.
zpning requirements and obtain all required permits Board of H th, Conservation
Commission, Department of Publio Works and other plioabla permit 9tafiting authorities:..
.,.;:, FILE #
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,
APR i 1 1997
DEPT Of St 1W, File No.
NON'
ZONING PERMIT APPLICATION (§10 . 2)
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of A licant:
Address: f Telephone:
2. Owner of Prope �.
Address: Telephone:
3. Status of Applicant: L� Owner Contract Purchaser Lessee
Other(explain):"�
4. Job Location: //C�40,v�f-�' '6�-
Parcel Id: Zoning Map# 357 Parcel# 62 7 3 District(s): 5 fQ�
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/Property �lG
6. Description of Proposed Use/Work/Project/Occupabon: (Use additional sheets if necessary):
�Az
7. Attached Plans: Sketch Plan .4 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 9�:-- 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 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)
�t2 II t�l FILE #_
a�
PICT PERSON:
E: ",
DEPT f�F St1il0ltaG INSPF%T10taS
NORTHAMPTON k1d,`1�6___� ,..
LOCATION: (_57 d1✓L
MAPS' 3 r PARCEL: ZONE_&&
THIS SECTION FOR-OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FrI.T.F.T) OITT
Fee PAid
Addition to Eyisting
3 Sets nf Plans I Pint Plan
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THE LOWING ACTION HAS BEEN TAKEN ON THIS AP ICATIW
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
Permit from Conservatio ommissio
Signature of Building for ate
NOTE: l"uanoe of a zoning permit does not relieve an applioant's burden to oompty with all
zoning requirements and obtain ail required permits from the Board of Health, Conservation
Commission, Department of Publio Works and other applioabie permit granting authorHles.