32C-109 (8) 4' -
PERMIT APPLICATION CHECK LIST
PAGE ZG 9 > M _„ 70,0X' 7g ) NO
YES DAT.
1 . . ICATION ..
2 . PE” ;j 4PPl,;CATION
3 . OWNER OCCUPANT STATEMENT / 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
12 , PERMIT FEE — p c} - ;.ONLY — MONEY ORDER u
13 . SPECIAL PERMIT REQUIRED WITH DEED IF APPLICABLE
14 . UNDER SECTION 127 — CMR 780
15 . FORM A !1!
16 . FILL
COMMENTS :
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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations
%r NORTHAMPTON, MASS. 19 Additions
tA' APPLICATION FOR PERMIT TO ALTER Repair
Garage
1. Location ., 2 C6 x' Z V1-- / E it ►t. Lot No.
2. Owner's name Address
3. Builder's name CA./4457-r-, A. L- 14-in 11' I( U r( Address 'R )(' /f 0 Gns Ai)h,
Mass.Construction Supervisor's License No. 00L/ 161 Expiration Date C/L'i/c 6-'
4. Addition
5. Alteration (3/1 1/J iN 0 O 7' X el Ii C)e' '17
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
�c
14. Estimated cost- /5--t9 0
The undersigned certifies that the above statements are true to the best of his, her
. ((' '6 "-
knowledge and be ef.
'01
Signature of
ble app,icant
Remarks
i . ,l
Date Filed i7 O File No.
ZONING PERMIT APPLICATION (§10. 2)
1 . Name of Applicant: 4v/04-1-2/` /2_ z- nza-)J/C,
Address : 'j:GK //o G.osisr'yu M4')7)3 Telephone: -6e "00i
2 . Owner of Property: s 1,h b/2 k FON TO j/AJ c
Address : '78 Co ,1, 2 - S Telephone:
3 . Status of Applicant: Owner Contract Purchaser
Lessee Other (explain )
4 . Parcel Identification: Zoning Map Sheet# 's C) Parcel# /Uel ,
Zoriin District s S
t ( ) idle o rlays)
Street Address �.
JJ Required
5 . Existing Proposed by Zoning
Use of Structure/Property cui6 rri tousr7. SA yr►✓J g
(if project is only interior work, skip to #6)
Building height
%Bldg. Coverage (Footprint)
Setbacks - front
- side L: R: L: R:
- rear
. Lot size 3/3 m : /6)/ ri?vl Sp FT-
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). �rw g 77- 11„0c341 GLcsF �- lx6r?S
7/ ( 9-" i
1-(450 19 /wSJ 0I: CA)oA < C1 Pt,L..f
y
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.
e
Date: x//3/99 Applicant' s Signature: L,�/- ��`�,.
THIS SECTION FOR OFFICIAL USE ONLY:
Approved as presented/based on information presented
Denied as presented--Reason:
S• -cial• Permit and/or Site Plan Required:
• , g Req -d' V` i�nce Required:
I13
L r f. 6 A ze q y
.t gnat e 4,f Tuilding Inspector
NOTE: Issuance of a zoning permit does not relieve an applicant's burden to comply with all zoning requirements and obtain all required permits
froth the Board of Health, Conservation Commission, Department of Public Works and other applicable permit granting authorities.
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