29-305 (2) PERMIT APPLICATION CHECK LIST
PAGE y PLOT `9Cj-t5- ZONE URA YES NO DATE
ZONING FO APPLICATION `7 ��-
2 . PERMIT APPLICATION
3 . OWNER COUP E C # IF NOT
3 SETS 0 PLANS /PLOT L AN e-Cc
NEW CO ST UC IO
6 . CURB CUT
WATER V I I FORMS
8 . REMODELING INTERIOR
Y
9 . ADDITION
0 . ACCESSORY STRUCTURE
11 . SIGN AWNING
2 , PERMIT FEE - CHECK ONLY - MONEY ORDER 4o. oc
13 . SPECIAL PE I E U ED WITH DEED IF APPLICABLE
,14 UNDER SECTION 127 - CMR 780
15 , FORM A
16 . FILL
COMMENTS :
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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. "� L! � Alterations
soNORTHAMPTON, MASS. 19 Additions
APPLICATION FOR PERMIT TO ALTER Repair
I' Py, Garage
1. Location � � '� f-tG�E?J?ql Lot No.
2. Owner's name Address S
3. Builder's name Address
Mass.Construction Supervisor's License No. 1 Expiration Date _
4. Addition
5. Alteration G )3q
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 v . `> C4 _
12. Type of roof A S L,l 4 sl-\A
vto-
13. Siding house V C- C(A ' A0 CAA
14. Estimated cost- ,G(3 n vti , i I(c.s Dom`
O / The undersigned certifies that the above statements are true to the best of his, her
knowledge and belief.
Signature of responsible app,icant
Remarks
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Date Filed �- ,� _ r� " File No. '.)_9 - 30
ZONING PERMIT APPLICATION (§10. 2)
1. Name of Applicant: D R C(wL
Address : Telepfhon(e1�:
2 . Owner of Property: �l } 1�•ea� l-"-t-I
Address : �� Telephone: ig � L 2
3 . Status of Applicant: Owner Contra t Purch ser n )
Lessee Other (explain: nni/iF�_r,1
4 . Parcel Identification: Zoning Map Sheet#act Parcel# o ��,
Zoning District (s) (include overlays) (BRA
Street Address
Required
5. Existirta Pro nosed —by Zoning
Use of Structure/Property r
(if project is only interior i4brk, `k p to #6)o t
Building height
%B1dg. Coverage (Footprint) L
Setbacks - front
- side L: •3 R: ) L: - ' R: Z
- rear 1
Lot size
Frontage
Floor Area Ratio
%Open Space (Lot area minus
building and parking) 121" 7L
Parking Spaces 7
Loading
Signs
Fill (volume & location)
6 . Narrative Description of Propose Work/ ro 'ect: (Us additiona sets
if ne essary) o
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: —�2— `� Applicant's Signature:- - - THIS SECTION FOR OFFICIAL USE ONLY: `
✓ Approved as presented/based on information presented JAN 7 '
Denied as presented--Reason:
ecial P mit and/or Site Plan Required: DEPT OF8UlI�?!'JG w5
inding uired: Variance Required:
gna , rcR of Bui Inspector Date
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.
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