25-015 (51) •v
T r.►
a
0 3 m
L
J
�_ rrli�,j11 �y
Z ^� rr
X � C17
r
rs
I
I
Zoning
Miscellaneous Additions,Repairs,Alterations,etc. /Tel.No. Alterations
NORTHAMPTON, MASS. ��' 19 Additions
APPLICATION FOR PERMIT TO ALTER Repair
7 r Garage
A. ation , &j i Lot No.
� � �s 1 dress ' A/ r�14 ,ya
V� e m C j
3. Builder's name Address
Mass.Construction Supervisor's License No. Expiration Date
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 we to the best of his, her
knowled and beli
Signal" of sponsible appicani —
Remarks
20f
31 F.
1 .
yb
� t
o y
1
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.
Thim colamm to be f1120d in
by the Building Aeparbwnb
Required
Existing Proposed By Zoning
Lot size
Frontage
Setbacks
- side L: R: L: R•
- rear
Building height
Bldg Square footage
%Open Space:
'(Lot area minus bldg
&paved parking)
# ,pff 'Parking Spaces
# rof Loading Docks
Fill:
:(vol-lime--& location)
,r
'13 . Certification: I hereby' certify that the information contained herein
is true and accurate to the best of my knowledge
DATE: APPLICANT's SIGNATU
=`r NOTE: Issuanoa of a zoning l
g permit does not relieve an pplioan s burl o comply with all
zoning requirements and obtain all required permits rom the Board eslth. Conservation
Commission. Department of Pubiio Works and other appiioabla perm t granting authorities.
FILE #
e
File No.Lclolla
01996
ZQING PERMIT APPLICATION (§10 . 2�
F x°fir .,_PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant
Address: �/ , /D��Telephone:
2. Owner of Property: -
Address: ` �� Telephone:
3. Status of Applicant: Owner Contract Purchaser_�Lessee
Other(explain):
4. Job Location-:. t� 2
Parcel Id: Zoning Map# Parcel# / `�,r District(s): 5
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/Property
6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary):
7. Attached Plans: Sketch Plan 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 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)
Y
FILE # 961128
2 01996
APPLICANT/CONTACT P RSON• Z"-
ADDRESSIPHONE:
PROPERTY LOCATION: C
MAP , - � PARCEL: /�S ' '7/ ZONE
THIS SECTION FOR-OFFICIAL USE ONLY:
PERWr APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FRIED 0111
11nilding Permit Filled nnt
Accessory Structure
3 .Q,ets of Plans,/Pint- Man
r
f tY
G�
T .OLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION-
k"
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 Conservation Co mission
Signature of Budui z ate
NOTE:lssuanoe of a zoning permit does not relieve an applioant's burden to comply with all
zoning requirements and obtain all required permits from the Board of Health. Conservation
Commission. Department of Publio Works and other applioable permit granting authorities.
4.
d
o
=• cp � R
o z m CHI
ebb
tz g '�
� aa a
C�� � rt O
M�--1 R y ° f D 'U fart � 0
s' fD � 0
s- o vn' co rt
bd c C J �3, Q
w c
CD °�94 �
lQ In to O
CY) In cm
CD
En
OQ
� o p
O O
CT.n ° ° Eli
ON ~
c a
cro '� '° s i s i o. g. N v' c
o
b .^. o
• °V oao M o cn M
❑ o o b g
W
� d
p
11J O
0 tD