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FILE # n 3 4 <i 1/40g 3
APPLICANT/CONTACT PE• ON: '0" 273'3
ADDRESS/PHONE: / _ = e
- �_
PROPERTY LOCATION: / /,��_,� 2�� •, vit,�'�e 7 AO-2,J
MAP 23D PARCEL: (D • ZONE /4P
THIS SECTION FOR-OFJiICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED (fliT .�
Fee Paid
Building Permit Filled nut (°/; e�
Fee Paid 96 &4'6
Type of C'nnctruetinn•
New C'nnctrnetinn
Remodeling Interior / �4,
Additinn to Evicting
A reeccnry Strnrture
Building Planc Tnrinded• j
Owner/flrrnpant Statement L cence# O///�` [/
3 Setc of Planc /Pint Plan
TH ..?'OLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION:
V 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
p •u.it fro SO ervation CI 11 V ssion
Signature of Building or ate
NOTE:issuanoe of a zoning permit does not relieve an applicant's burden to comply with all
_ zoning requirements and obtain all required permits from the Board of Health, Conservation
pomrnisslon, Department of Public Works and other applioable permit granting authorities. -
File No.
ZONING PERMIT APPLICATION P OF SUILDIL]G�NSPEiThONS
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant: cc->o
1 3
Address: �' 12`a4)t,,v,%: Telephone: rl
2. Owner of Property:
Address: _ ;. 4,/ f C . �: lira, relephone:
3. Status of Applicant: Owner Contract Purchaser Lessee
Other(explain): J c!®- {
4. Street Address: �,9�y C c J / QJJ 71-29K/-4�'�>vr
Parcel Id: Zoning Map# � `� Parcel# 06 44 District(s): Zl /R3
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/Property J
6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary): •
�L�� �1 1 is ,✓� r.l ,' c1:6
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 PermitNariance/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 DONT KNOW YES
IF YES: enter Book _ Page and/or Document#
9. Does the site contain a brook,body of water or wetlands? NO DONT 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)
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
gas
Building height
Bldg Square footage S foota .��
q 9 .0)\b)'
\,)
%Open Space: ,i
(Lot area minus bldg �
&paved parking) • '
b
# of -Parking Spaces
# of Loading Docks
Fill:
':(vol-ume -& location)
13 . Certification: I hereby certify that the information contained herein
(e is true and accurate to the best of my knowledge.
DATE: - APPLICANT'S SIGNATURE
NOTE: lssuanoe of a zoning permit does not relieve an applioant's burden to oomply 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.
' ., FILE #
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Zoning
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Miscellaneous Additions,Repairs,Alterations,etc. Tel.No i 2 Alterations
�,te,�r� NORTHAMPTON, MASS. 19 Additions
` ``-744:-��!!!! APPLICATION FOR PERMIT TO ALTER Repair
``�'� L Garage/. A „�< ' 1 1. Location C col u,., �lsFj, ' l 4z., --e S`t , ;/,
Lot No. p
�/�
2. Owner's name �. a�� �/l�'�r �i�">�./1 Address 'CF�as4i•�J�w:..-��- `���a� �-k,,,-a,�r ,,� ,,,,,�.`',,
3. Builder's name cc-_-_,-' r7 .,.,, 0 Address ' e - i ///�//�'
Mass.Construction Supervisor's License No. 0 11 J 3J Expiration late -' / '7'7
4. Addition
,� J
5. Alteration '� ‘9,i4 lf,t/L `o 7s(0 lac-, 1 - rJ L 1 - ���
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 I/—
14. Estimated cost:-
p,, //, , The undersigned certifies that the above statements are true to the best of his, her
knowledge and belief.
(TC-----c-,61 '1..1v-6-c 97- (:4;--C•ke.'74 /
Signature of responsible appicant
Remarks
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