32C-145 (7) PERMIT APPLIC�A��TION CHECK LIST
PAGE 32--C PLOT 14-5-- ZONE GACr /0 /� '
�� YES NO DATE
I . ZONING FORM APPLICATION
2 . PERMIT APPLICATIQN
• l
3 . OWN OCCUP E L�c. :o) TF NO �-
3 SETS OF NS /PLQT PLAN
5 . NEW CONSTRUCTION
6 . CURB -CUT
7 . WATER AVAILARILITY FORMS
8 . REMODELING INTERIOR
9 . ADDITION
10 , ACCESSORY STRUCTURE
11 . SIGN / AWNING
12 , PERMIT FEE - CHECK ONLY- - MONEY ORDER
C°
13 , SPECIAL PERMIT -REQUIRED 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. 51 Alterations
a NORTHAMPTON, MASS._��jsN 16 19� Additions
APPLICATION FOR PERMIT TO ALTER Repair
Garage
1. Location ^ Lot No.
2. Owner's name ca>C- Address
3. Builder's name j�1�1 NA L,���� Address BD hog
Mass.Construction Supervisor's License No. Old S its Expiration Date
4. Addition 0 8
5. Alteration Zel:'L AC 6 16 VIA rL W I NIQ/.tYS _*N Y L,
6. New Porch a
7. Is existing building to be demolished? a
S. Repair after the fire O
9. Garage tj I No.of cars Size
10. Method of heating
11. Distance to lot lines
12. Type of roof
13. Siding house
14. Estimated cost:-
The un igned certifies that the above statements are true to the best of his, her
know dg and belief.
r
ignalure of responsible appicani
Remarks
..__��
Date Filed hc)
File No.
ZONING PERMIT APPLICATION (510. 2)
1 . Name of Ap licant: QUA 04�;s
Address : Q Telephone:
2 . Owner of Proper y: .
Address: ' Telephone:
3 . Status of Applicant: Owner Contract Purchaser
Lessee j Other (explainA14�R
4 . Parcel Identification: Zoning Map Sheet# SIC- Parcel# //j,5
Zoning District(s) (include verlays)
Street Address
Required
5 . EXiatincr Proposed by Zoning
Use of Structure/Property c�� _.
(if project is only, interior work, kip o #6)
Building height
-B1dg. Coverage (Footprint)
Setbacks - front
- side L: R:
- rear
Lot size
Frontage.
Floor Area Ratio
.Open Space (Lot area minus
building and parking)
Parking Spaces
Loading
Signs
Fill (volume & location)
6 . Narrative Descri tion of Pro sed Work/Pro 'ect: (Use additional sh e s
if necessary) S
7. Attached Plans: Sketch Plan Site Plan
8 . Certification: Z hereby certify that the inform ion contained herein
is true and accurate to the best of my know. ad e.
Date: d 5 Applicant's Signature:
THIS SECTION FOR OFFICIAL USE ONLY: r
!/ A roved as resented based on information resented
pP P / . . p
Denied as presented--Reason:
S ecial.' Permit and/or Site Plan Required:
l ding fired: Variance Required:
//
gnat e =p-ormit Bull nspector � / \N a e
NOTE: tssuance t relieve an applicants burden to comply wigs all zoning requirements and obtain all roquirod pormits
from the Board of Hoalih,Conservation Commission,Gapattmont of Public Works and otiior applicable permit granting authoritios.
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