32C-030 (3) PERMIT APPLICATION CHECK LIST
PAGE * „c A
2
3 . OWNER OCCUPANT STATEMENT / LIC , # IF NOT
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
1 2 , PERMIT FEE — CHECK ONLY — MONEY ORDER Z' � �
13 . SPECIAL PERMIT REQUIRED WITH DEED IF APPLICABLE
14 . UNDER SECTION 127 — CMR 780
15 , FORM A
16 , FILL
COMMENTS :
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001350
Date Filed File No.
ZONING PERMIT APPLICATION (§1O . 2 )
1 . Name of Applicant: /4 (C Stta7(rcu
Address : t__f hS1.=;/ ,,., _ 1 /--, �4.:,, _ A-A. c i„;Telephone: 2- I -
2 . 53 Owner of Property: `-`y..2, ,v f -4-0v F
Address : ( (3(9,,;;far e T PO J 7,t5.' ' 4'c lic Telephone : f-g;2 -3g y"%
3 . Status of Applicant,' Owner /Contract Purchaser
Lessee Other (explain : C,..4 - )
4 . Parcel Identification: Zoning Map Sheet# 326 Parcel#_5 ) ,
Zoning District (s) (include overlays) Cam--)
Street Address 16 Uktiu m , tt • ,
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 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 n e c e s soar Y) N�.�,..r�vr+t r (� !° �u f t
/19 1.6 f c is_,:� 1`-'r S ..�. ., -r i��("' _ ifs r7.,.�y ` � .cc:--
5 - J
7 . Attached Plans : Sketch Plan Site Plan
8 . Certification : I hereby certify that the information contained herein
is true nd accurate to the best of my knowledge .
Date : l c6 Applicant' s Signature,/ A -40;
/� THIS SECTION FOR OFFICIAL USE ONLY:
Approved as presented/based on information presented
Denied as presented--Reason :
Special Permit and/or Site Plan Required :
- n• ing Rop ired: Variance Required :
�/ 7 ':t-1ignat .'=� o Buildin_.-± - - •ector
ate
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. c% -35 "/7 Alterations
t NORTHAMPTON, MASS. - l0 19 L Additions
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'T4" '� Repair
i
APPLICATION FOR PERMIT TO ALTER
/ Garage
(1. Location -17 ( " 1 r� C Lot No.
2. Owners name T-14._ I%a,j t -f L--ro✓e Zi c. Address F' ∎=7-7 4/0 r, 9/9 ,/
3. Builder's name if-i'r- f" e�e Pftro0 --t, i/,.. P:.. atc'/ Address --1=1,,C'f"r' (.: i, 4�(4-f7 .?_ l„,,� I,;o.:�
Mass.Construction Supervisor's License No. r U 'Li' i 0 Expiration Date 0`;'1i
4. Addition 1
5. Alteration (?_Q,/ ,.Jo I 0_F P /i -o, ,z., d j. .-i',.� / . (Al '' ': 47. f�-c�:-i ✓t:i c)/-
6. New Porch t / \ �i/°/t /11 S I i,�l 5 d,.�
7. Is existing building to be demolished? MI ,7,
8. Repair after the fire /V A
9. Garage /1f ' No.of cars Size_
10. Method of heating
11. Distance to lot lines
12. Type of roof
11. Siding house F.i,-;.4-1 / F 5 A ,`r//c.
h4 Estimated cost:-
ll�J /'i/ ii(1)()'`0 The undersigned certifies that the above statements are true to the best of his, her
,r, knowledge and belief.
ci -
Signature of responsible applicant
Remarks wood (/ . h1-r-Ct 5 U +'1 0,, ft-A. I 1 /} 1;.%/-1 JCS 7 -�
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