31B-244 (2) PERMIT APPLICATION CHE LIST
PAGE 3 �� PLOT ! ZONE �'''� �� Z�v""�� N DATIZ
1. ZONING FORM APPLICATION 1'
2. PERMIT APPLICATION
3. OWNER OCCUPANT STATEMENT LIC.# IF NOT
4. 3 SETS OF PLANS ZELOT P LAN
5. NEW CONSTRUCTIO
6. CURB CU
7. WATER VAI I T 0 S
8. REMODELING INTERIOR
9. ADDITIO
10, ACCESSORY STRUC
11. SIGN / AWNING
12, PERMIT FEE - CHECK ONLY - MONEY ORDER- 11 go b-
13. SPECIAL PERMIT REQUIRED WITH DEED IF APPLICABLE
14. UNDER SECTION 127 — CMR 780
15. FORM
16. FILL
COMMENTS:
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Zoning
Miscellaneous Additions, Repairs, Alterations, etc. Tel. No. �7 -� 0 Alterations
NORTHAMPTON, MASS. Additions
APPLIC ATION FOR PERMIT TO ALTER Repair
Garage
1. Location IA^ / j'V G d 4& LA_V G P &Ot AC ICJ //J' O Lot No.
2. Owner's name 1A-i 17 G - 4-4-/S G Address / 3 V oA AA
3. Builder's name R*�AI/ eN,0 1 �1'G }f�Gr' Address d e4-4 C1Q�? 0
Mass. Construction Supervisor's License No. C� ��1 Expiration Date " y
4. Addition
5. Alteration /5i Z,,40 GF (!) P L-
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 c'j
The undersigned certifies that the above statcments are we to the best of his, her
knowledge and belief.
v �
Signature of responsi le appicant
Remarks
` u 00231
Date Filed � A /.� /j 'f -,{ tle No.
ZONING PERMIT APPLICATION ( 510.2)
I. Name of Applicant: 2ai405 jc
Address: �L��� C/K Telephone: r S^�
v 4- Xd it
2. Owner of Property: XA4L r-r4 CU e-1_G'!�'
Address: /_7 r c-A I — Telephone: s''J- a
3. Status of Applicant: Owner Contract Purchaser
Lessee Other (explain: 6//_1
4. Parcel Identification: Zoning Map Sheet # Parcel# 117
Zoning District(s) (include ove, s)
Street Address F54 w (IT
Required
5. Existinq Proposed —by—Zoning
Use of Structure /Property 0R-A P 0,QX4
(if project is only interior work, skip to #6)
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 Proposed Work /Project: (Use additional sheets
if necessary) e/ If 7'1'
9 02 /e 6�'
-► th s -r c � D o m ,�
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: tit ,{ / Applicant's Signature: e, r �f �
THIS SECTION FOR OFFICIAL USE ONLY:
LZ Approved as presented /based on information presented
Denied as presented -- Reason:
Special' Permit nd /or Site Plan Required:
Z nadd'ng Req Variance Required:
igna u f uilding ector ✓ ate J
NOTE Issuance of a zon rTnh 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 authorities.
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