32C-137 (4) PERMIT APPLICATION CHECK LIST
PAGE -3.)� C PLOT )3 ;7 ZONE YES NO DATE
1 . r/ /o
ZONING FORM L IO
2 . PERMIT APPLI
3 . OWNER OCCUPANT STATEMENT LICA IF NOT
3 SETS
5 . NEW S
6 CURB CUT
7 WATER
8 . REMODELING
9 . ADDITION
0 . ACCESSORY
11 SIGN / AWNING
PERMIT E — QHEZONLY — -MONEY 0 / as ✓�.�
13 . SPECIAL UI D MITH DEED IF APPLICABL
4 . UNDER SEQTIOU 127 — CMR 780
5 FORM A
6 , FILL
COMMENTS:
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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. 527-1360 Alterations
NORTHAMPTON, MASS. October 31, 19 94 Additions
ti
APPLICATa ION FOR PERMIT TO ALTER Repair x
Garage
1. Location 395 Pleasant Street/JPS Elastomerics Lot No.
2. Owner's name Jack Fortier, Jr. Address P.O. Box 376. Florence. MA 01060-0376
3. Builder's name The O'Leary Co. , Inc. Address P.O. Box 377, Southampton, MA 01073-0377
Mass.Construction Supervisor's License No. 055791 Expiration Date 8/1/96
4. Addition N/A
5. Alteration Install slope build—up d—up Components and new roof panels
6. New Porch N/A
7. Is existing building to be demolished? no
8. Repair after the fire N/A
9. Garage N/A No.of cars N/A Size
10. Method of heating
11. Distance to lot lines N/A Repair of existing building roof
12. Type of roof metal
13. Siding house N/A
14. Estimated cost:- $19,187.00
The undersigned certifies that the above statements are true to the best of his, her
knowledge and belief.
signal e of responsible app,ican[
Remarks In general, this work will involve reworking two areas of rnnf 141 wide v gg' long
at the west and east end of the building to alter the slope of the rnnfparels to
permit positive roof drainage. Currently, ponding is occurring and creating ononing-
roof leaks.
Date Filed l0 00354Q 3 / `7 File No.
ZONING PERMIT APPLICATION (§ib. 2)
1. Name of Applicant:
Address :_ 0.&X 3-77 w11+ Telephone: x5;7-7 - /3ln d.
2. Owner of Property: .j�j< �f�,�►� S►2.
Address : $ �1,o, 1 ,oK 3z-►& Florchcr MA- Telephone:
3 . Status of Applicant: Owner Contract Purchaser
Lessee Other (explain C�r�c►� C�-, �r�-t )
4 . Parcel Identification: Zoning Map Sheet1_3_�,Q., Parcel#,
Zoning Districts) (include o lays)
Street Address
Required
5. uxistincl Proposed by Zoning
Use of Structure/Property DC
(if project is only interior work, skip to #6)
Building height
oBldg. Coverage (Footprint)
Setbacks - front
- side L: R: L: R:
- rear
Lot size
Fronta91e.
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) 74, ' ..�.
o✓iq�/rr �4-T��
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.
Date: /G/3/ / � y Applicant's Signature:
ZApproved T CT FF E HIS SEION FOR OICIAL US ONLY as presented/based on information presented
Denied as presented--Reason:
ecial" permit and/or Site Plan Required:
ing a iced: Variance Required'
rte-
gna e f Bu �. Inspector bat
NOTE: lssunnoo of a zoning permit does not relieve an applicant's burden to comply will,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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