32C-123 (4) ,I�,PE MIT APPLICATION�� f�� C�ECK LIST
PAGE :32-G"PLOT 10 ZONE �"� �9 - ES N DATE
1 . ZONING FORM APPLI C I 0
2 . PERMIT V"
3 , OW IF NOT v
4 . 3 SET PLAN
5 . NEW CONSTRUCTTON
6 , CURB CUT
7 WATER
8 . REMODELING INTERIOR
9 . ADDITION
0 . ACCESSORY
11 . SIGN / AWNING
2 . PERMIT FEE - CHECK ONLY _ I T3 L"
13 . SPECIAL UI D WITH DEED IF APPLICABL
14 . UNDER E - C R 780
15 . FORM A
6 , FILL
COMMENTS :
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lot
Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations
NORTHAMPTON, MASS. 5 19 Additions
APPLICATION FOR PERMIT TO ALTER Repair
Garage
1. Location " il T, a ri 4,7 ? 4 k Lot No.
2. Owner's name 1�'�' Address r` ��,T 5' ,
1 � r Vin-2n4 -1 1-r oR/&,:r
3. Builder'sname =Address 43s 5'
Mass.Construction Supervisor's License No. C? ? q Expiration Date
4. Addition
5. Alteration
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 t r
14. Estimated cost- Y
, cc
The undersigned certifies that the above statements are true to the best of his, her
n knowledge and lief.
\V V Signature of responsible app scant
Remarks
Date Filed File No.
ZONING PERMIT APPLICATION (510. 2)
�1
1. Name of Applicant: ��r �s-- c o ^ • '
Address: 3 ephone: ,
T`c ? Z
2 . Owner of Property:
Address :-. �- .� Telephone:
3 . Status-`of Applicant: L----owner Contract Purchaser
Lessee Other (explain �
4 . Parcel Identification: Zoning Map S eet# Parcel# 1 ,
Zoning District(s) (include overlay )
Street Address 9,0
Required
5. Exis-tincr Proposed by Zonin
Use of Structure/Property
(if project is only, interior wo , skip to #6)
Building height
%Bldg. Coverage (Footprint)
Setbacks - front '
- side L• R
- rear
Lot size 10000
Frontage
Floor Area Ratio
oOpen 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) F,
7. Attached Plans: Sketch Plan Site Plan
8 . Certification: I hereby certify that the information contained herein
is true/an a curate to the best of my knowled e.
Date: _ Applicant' s s Signature.
THIS SECTION FOR OFFICIAL USE ONLY:
t/Approved as presented/based on information presented
Denied as presented--Reason:
Special' Permit and/or Site Plan Required:
Finding Required: variance Required:
S. gnature of uildi.ng Inspector (� t
NOTE: Issuance of a zoning permit does not reilove an applicant's burden to comply whit all zoning roquiroments and obtain ail required pormlts
from tho Board of Health,conservation Commission, Dopartmont of Pubtic Works and ollwr applicabio pormit Vranting authorttlos.
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