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Zoning
Miscellaneous Additions,Repairs,Alteradons,etc. Tel.No. �r� Alterations
a rNORTHAMPTON, MASS. 19�' Additions
APPLICATION FOR PERMIT TO ALTER Repair
i Garage
1. Location V► C 1 �1� �-°e Lot No.
2. Owner's name Address i' ✓+C Sry b,-, U
3. Builder's name M OW&L Q -Sy i,VA R— Address '$ I I(.:. e i2s, S �.� ��1l1 V�-
Mass.Construction Supervisor's License No. O S2:,z-I 3L+ Expiration Date y 0 eS bi
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 � ��, etive5 S lS Ole
14. Estimated cost-
���iC%,Cf V
i
The undersignjcert* s tha e above 'tatemcn are true to the best of his, her
knowledge
Signature of responsible appucani
Remarks 2-,p 1Ct t F L,-..),y,cob wS S S-e
I
10. Do any signs exist on the property? YES NO
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 MUST BE COMPLETED, or PERMIT CAN BE DENIED DUE TO
LACK OF INFORMATION.
This Colima to be filled is
by the Building Department
Required
Existing Proposed By Zoning
Lot size
Frontage
Setbacks
- side L• R: L• R:
- rear l
4
Building height
Bldg Square footage
%Open Space:
.(Lot area minus bldg
&paved parking)
pf, -Parking spaces
Loading Docks
Fill:
Avol-time--& location)
13 . Certification: I hereby certify that the informa o con ain herein
Ga
is true a accurate to the best of my knowle e
DATE: APPLICANT'S SIGNATURE
NOTE: lasuanoe of a zoning permit does not relieve an a
9 P pplioant's burden to comply,wittlr,,$A
zoning requirements and obtain all required permits from the Board of Health, Con$ervation- ,a
Commission, Department of Publio Works and other applionbie permit granting authorities: •
�i;, FILE # ;
.c
-7 File No.
ZONING PERMIT APPLICATION (§10 . 2)
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant: Mw-Yz1(-
Address: -. QCQ Telephone: q/ 'j' 6a7-74512
2. Owner of Property:: 'r-e '
Address: L/';- RevCa�c-,ct 1 Telephone:
3. Status of Applicant: Owner Contract Purchaser Lessee
Other(explain): t -
4. Job Location:
s
Parcel Id: Zoning Map# c�2 Parcel# District(s):
(TO BE FILLED IN BY THr BUILDING DEPARTMENT)
5. Existing Use of Structure/Property \40.^--Q
6. Description of Proposed Use/Worgroject/Occup on: (Use additional shee if ng essary):(� (�
�R QXCkC'e- 7
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—'L 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 #
r APPLICANT/CONTACT PE N: ,, PA
ADDRESS,/PHONE: J C1
PROPERTY ,VACATION:
MAP PARCEL: Z NE �'L ,L
THIS SECTION FOR-OFFICIAL USE ONLY:
PERMTT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
Fee Pn*d
'Ridifflng Permit Filled nut
ee Paid
New Cnngtriietinn
iided-
LLOWING 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 Conservati om
Signature of Building for ate
NOTE:lssuanoe of a zoning permit does not relieve an applioant's burden to oompty with all
zoning requirements and obtain call required permits from the Board of Health, Conservation
Commission, Department of Publio Works and other appiioable permit granting authorities. —
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