32C-123 (5) a
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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No.L-2 1(7`r 45' 7 Alterations
a NORTHAMPTON, MASS. 1'�' 1916 Additions
APPLICATION FOR PERMIT TO ALTER Repair
- Garage
1. Location t O w' Lot No.
2. Owner's name Tk Address f, `:f x,21 6N"�,' 57—
7— elD
3. Builder's name r vv Address i•��
Mass.Construction Supervisor's License No. Expiration Date
4. Addition
S. 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 Ile - c-X X4 V arc 5
12. Type of roof t f (w
13. Siding house
14. Estimated cost
The undersigned certifies that the above statements are a to the hiLher
knowledge and belief.
Sign re ojr onsible app icanz
Remarks
�{T
Y
10. Do any signs exist on the property'? YES NO �' *`4.,
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 MAST BE COMPLETED, or PERMIT CAN BE DENIED DUE TO
LACK OF INFORMATION.
This colffi to be Pilled in
by the Bu:Uding Department
Required
Existing Proposed By Zoning
Lot size
Frontage
Setbacks
- side L: R: L: R:
- rear
Building height
Bldg Square footage
%Open Space:
Lot area minus bldg
' &paved parking)
of -Parking spaces
of Loading Docks
Fill:
{volume -& location)
13 . Certification: I hereby certify that the information contained herein
is true and accurate to the best of my knowledge.
""�S ���
DATE: APPLICANT'5 SIGNATURE ,
NOTE: Instlanae of as zoning permit does not relieve an appiioants burden to comply with all
zoning requirements and obtain nil required permits from the Board of Health, Conservation
Commission, Department of Public Works and other applionble permit granting authorities.
FILE if
.�; File No. �
t
ON 6G PERMIT APPLICATION (§10 . 2)
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant: P w' ,
Address: kf eS % elephone: 2Y 7 <1 3 :Z
2. Owner of Property: �T2i c8 C.a i�p�
Address: '1 riC6- S Telephone:
3. Status of Applicant: Owner Contract Purchaser Lessee
Other (explain):
4. Job Location: 70A_)
Parcelld: Zoning Map# Parcel# District(s): ,�/� i
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/P rope rty €' — �% �
6. Description of Proposed UseANork/Project/Occupation: (Use additional sheets if necessary):
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 PermitNadance/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 DON'T KNOW YES
IF YES: enter Book Page and/or Document#
9. Does the site contain a brook, body of water or wetlands? NO "� DON'T 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)
FILE # —.3 `l
R
f AM I X96
PLICANT/CONTACT PERSON: �L� / / �i�lQ/
lV0; f i r
PROPERTY LOCATION: k l �
MAP 'S%�, PARCEL: tom, _ ZONE
THIS SECTION FOR-OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
Ryiildin2 Permit Filled niit
2-
ii
THE FLOWING ACTION HAS BEEN TAKEN ON THIS AP ICATION:
!/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
Permit from Conservation Commi
3"/,/
Signature OITTUildin9 impec r D to
NOTE:issuance of at zoning permit does not relieve an applicant's burden to oompty with all
zoning requirements and obtain all required permits from the Board of Health. Conservation
Commission. Department of Publio Works and other applioable permit granting authorities.
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