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Zoning
Miscellaneous Additions,Additions,Repairs,Alterations,etc. Tel.No. -' Alterations
NORTHAMPTON, MASS. / y 19 Additions
APPLICATION FOR PERMIT TO ALTER Repair
Garage
I. Location � c�c� 1 ;VIC A I ot No.
2. Owner's name vu�� "�I r(1 u Address � ��
3. Builder's name Address
Mass.Construction Supervisor's Lice No. �' " 7i� Expiration Date
4. Addition
5. Alteration � � 5'.� o v w✓: ,��do� t.�/ ';�� 3 �� "� ��= �s —
6. New Porch
7. Is existing building to be demolished?
8. Repair after the fire
9. Garage No.of cars Size
0. Method of heating
I. Distance to lot lines
2. Type of roof
3. Siding house
4. Estimated 711 �)
�` The undersigned certifies that the above statements are true to the best of his, her
knowledge and belief.
J,a�
Signature f responsible appucant
temarks
t10. 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 MAST BE COMPLETED, or PERMIT CAN BE DENIED DUE TO
LACK OF INFORMATION.
MI.-% columm bo be filled in
by the Building DePaxtmenb
Required
Existing Proposed By Zoning
Lot size
Frontage
Setbacks - frnnt
- side L: R: L: R:
- rear
Building height
Bldg Square footage
%Open Space:
Lot area minus bldg
&paved parking)
# ?f -Parking spaces
#
of Loading Docks
Fill:
-4vo1-lime -& location)
13 . Certification: I hereby certify that the information contained herein
�{ is true .a d accurate to the best of my know'Iydge.
DATE: T. _ APPLICANT's SIGNATUREA )
NOTE: 1 anoe of a zoning permit does not relieve an aij6plio.ntAs rden to comply with all
zpning requirements and obtain all required permits from the 'ard of Health, Conservation
Commisslon, Department of Public Works and other applicable permit granting authorities.
FILE #
File No.
ZONING PERMIT APPLICATION (§10 . 2)
PLEASE TYPES OR PRINT ALL INFORMATION
1. Name of Applicant: (1�j e
Address: 1 � �,,�;� Telephone:
c,fi✓ck i� '1
2. Owner of Property:. .
Address: Telephone: ' 1—22'
3.3. Status of Applicant: Owner Contract Purchaser Lessee
Other(explain): }
4. Street Address: CX"
Parcel Id: Zoning Map# Parcel# ,_3 '� District(s): Cif l�
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/Property k, r�1--I) C
6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary):
1/1 ilv, -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 4/ 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 V) 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 # 960510 ��
APPLICANT/CONTACT PERSON:
ADDRESS/PHONE:
PROPERTY LOCATION: rllt6I J--�-c - /
MAP ,Q PARCEL: ZONE zll� 1�
THIS SECTION FORAFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FH,I,FD OUT
11nilding Permit Filled nvit
t:-
�.,.
-C C 'Yl . -tic�1
_ r
Striietime
r
THE LLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION'
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 Conservatio ommission
ZZ
Signature of Buil pector Date
NOTE:lasuanoa of a zoning permit does not relieve an applicant's burden to oompiy 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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