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12C-080 (3) T � a o in 1 Q L Z m tTf O I � I Zoning Miscellaneous Additions,Repairs,Alterations,etc. Tel.No.- Alterations NORTHAMPTON, MASS. 19 Additions APPLICATION FOR PERMIT TO ALTER Repair Garage 1. Location r c r/1 Lot No. 2. Owner's name f 1 O t�z1 c� �' Address 3. Builder's name Q �+ r� -j( Address .S i rk40catc s/ Mass.Construction Supervisor's License No. /e1 S>tJ© /fit C Expiration Date 2719 :7 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 14. Estimated cost:- C) F tI 4 The undersigned certifies that the above statements are true to the best of his, her knowledge d bel . ? gnature of responsible appicant Remarks 10. Do any signs exist on the property? YES NO IF YES,describe size,type and location: g a, •1 - Are there any proposed changes to or addition�of signs intended for the property?YES Ito IF YES, describe size,type and location: 11. ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE DENIED DUE TO LACK OF INFORMATION. Tbis co2tu= to ba =i11.ed in by the Building Dcpnrt -nt 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) # pf -Parking spaces of Loading Docks Fill: 4vol-ume--& location) 13 . Certification: I hereby certify that the information contained herein is true and accurate to the best of my knowledge. 1 DATE: -/ APPLICANT's SIGNATURE NOTE: iss anon of a zoning permit does not relieve applioanrs rden to oom ty with ail zoning requirements and obtain all required permits from the Board of Health, Conservation Commission, Department of Publio Worica and other applicable permit granting authorities. FILE ,i v Fi 1 e No t; ZONING PERMIT APPLICATION (§10 . 2) PLEASE TYPO OR PRINT ALL =FORMATION 1. Name of Applicant: _j c7 l t Address: �+ �/�'�d��- f _Telephone: SSG` d 7r 2. Owner of Property: Address: � Telephone: y Q 2,0/ 3. Status of Applicant: Owner Contract Purchaser Lessee Other(explain): 4. Job Location: Parcel Id: Zonin g Ma P# � Parcel# District(s),4m (f0 BE FILLED IN BY THE BUILDING DEPARTMENT) 5. Existing Use of Structure/Property 6. Description of Proposed Use/Work/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 Permit/Variance/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---,::k,— 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) C � +` FILE APPICNTACT PERSON: ADDRESS/PHONE: f Adt �-- PROPERTY LOCATION: MAP /�� PARCEL: ZONE , THIS SECTION FOR�OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE Fee Pn*fi Mfflding Permit Filled apt izf Fee P2id Type of Construction- New Congtructinn 'I Sets of Plans I Pint Plan Q TI FMS LLOWING ACTION HAS BEEN TAKEN ON THIS AP ICATION: t 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 C ission Signature of Building Inspeo 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. Jr w a z CA, � y N o CC) - n CD CD Oil 00 ko Un CD � CD a. o �� L/1 � afD � n y o b �, D y o V`c CD 11:3. m o tTf aR " c o a ti o' CD o 5• p� qq CD p- o� � r� CD CD r n � Fr n r o a� 9 C, La 5CD rt Woo ° d O O C CD N 0 z CD y � �p C �. �' `L7 C7 � �•. G � d c .r .- O n '» CD � � ° CAD � O• CD ffl C'D W N - ^ '.3 •dam �� UQ UQ QQ CIQ r.h (D III CD CD ' � N � 0 " CD O)q CD a. 4 Z rn CD CD o cn * O CD