23D-012 (6) No-roruck _ t", flo . PERMIT APPLICATION CHECK LIST
PAGE D PLOT ci Q- ZONE CL B YES NO DATE
1 . ZONING FORM APPLICATION L G_.l e "92
2 . PERMIT APPLICATION
3 . OWNER OCCUPANT STATEMENT / LIC . # IF NOT O / v
4 . 3 SETS OF PLANS /PLOT PLAN
5 . NEW CONSTRUCTION
6 . CURB CUT
7 . WATER AVAILABILITY FORMS
8. REMODELING INTERIOR
9 . ADDITION
10. ACCESSORY STRUCTURE
11 . SIGN / AWNING
12 . PERMIT FEE - CHECK ONLY - MONEY ORDER -TS M
13 . SPECIAL PERMIT REQUIRED WITH DEED IF APPLICABLE
14 . UNDER SECTION 127 - CMR 780
15 . FORM A
16 . FILL
COMMENTS :
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Filed - .:-i''' File No. �� D - 0 1 L
Date
ZONING PERMIT ION (510. 2) < t F\-' Q
1 . Name of Appin11111V4L,464_,,,Aill _ `__
Address : fir' ; t4 i ,�% i Telephone: _ ; �3r�T
I
2 . Owner of Pro• -rty: _,,1,!2/ � r ,; tit.._
Address : / 0. ,, /0i—_', Telephone:
3 . Status o Applicant: Owner )<Co act Purchaser
Lessee Other (explain: Pu
.._ .-c. )
4 . Parcel Identification: Zoning Map Sheet# a3 D Parcel# oil, ,
Zoning District (s) (include overlays) OR B
Street Address
Required
5 . Existing Proposed by Zoning
Use of Structure/Property
(if project is only interior work, skip to #6)
Building height
%Bldg. Coverage (Footprint)
Setbacks - front
- side �.�Wi lam► / ,iRK;.,
- rear Or �__
Lot size
Aiwa � �
Frontage
Floor Area Ratio
%Open Space (Lot area mini,
4111111111111111111 ,
building and parking)
Parking Spaces
Loading wasimammingsmo
Signs .i`'7 �Nil/RrtIIIIIIIIIIIIII
Fill (volume & location) it /
6 . Narrative Description of Proposed Work/Project: (Use additional sheets
if necessary) .
• .
7 . Attached Plans : S etch Plan Site Plan
8 . Certification: i hereby certify that the information contained herein
is true and accurate to the best of my knowledg- .
,Date: `' / 0 ,C' Z _ ,Alicant t ,_
0•J:
THIS SECTION FOR OFFICIAL USE ONLY: _ r
/Approved as presented/based on information presented ' I 0
Denied as presented
/Pe on •r Denial :
-ign. .re of Bui •±n g Inspector Date
NOTE: Issuance 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 Commission, Department of Public Works and other applicable permit granting authorities.
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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations
=1r,,,".,, NORTHAMPTON, MASS. 19 Additions
9 Al y',•9
`L e APPLICATION FOR PERMIT TO ALTER Repair
-,ze..- , Garage
C"'
1. Location 0 Si A., f.R ' I Lot No.
f�'
2. Owner's nam:/ , , /—.A...- Address C)_ �1„/ '
3. Builder's na '/.� .L. �, Address z / - _//,L.�
Mass.Cons iir tion Supervisor's Lic•nse No. , 1 *--^- _ Expiration Date E v C
4. Addition 40'2' se >�-Q r t e7' '_- -t--1t.,.. t -- " i#_ ...,
G i5. Alteration I `o ,r' g," fir r.„1",‘,q
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 Gt) ��77-L-
V20 7 6 ce The undersigned certifies Yhat th• above statements are true to the best of his, her
knowledge and belief
- I 1 R . 0
Signature of responsible applicant
Remarks
P
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