32C-204 PERMIT APPLICATION CHECK LIST
?AGE .3 PLOT 1 ZONE I-L-1C ` ES NO DATE
1 . ZONING FORM APPLICATION
2 . PERMIT P I
3 . OW 0
4 . 3 SET PLAN
5 . NEW CONSTRUCTION
6 . CURB CUT
7 WATER
8 . REMODELING
9 . ADDITIO
0 , ACCESSORY - STRUCTURE
11 . SIGN / AWNING
2 ER IT FEE - C - -MONEY ORDER
t�
13 . SPECIAL PERMIT REQUIRED WITH DEED IF APPLICABL
4. UNDER SECTION 7 - C R 780
1 5 . FORM A
16 FILL
COMMENTS :
a
v o•
_ Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. �7 ^ I�� Alterations
NORTHAMPTON, MASS. (;t 4z- 1 19� Additions
APPLICATION FOR PERMIT TO ALTER Gaapa Rgr
Crage
1. Location > e Lot No.
2. Owner's name Address
3. Builder's name
5 a4
Address
Mass.Construction Supervisor's License No. D /s/S) Expiration Date
4. Addition �*
5. Alteration �) y v r 0 C
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
14. Estimated cosL- ( ' 700
The undersigned certifies that the above statements are true to the best of his, her
knowledge
Signature of Nsponsible applcani
r
Remarks o, G
C
i
003366
• y V
Date Filed File No.
Z NI PERMIIT� APPLICATION (510. 2)
1. Name of App icant:
Address : r. C 1.. Tle�lephone: t
2. Owner of Property: t&
Address : * Telephone:
3 . Status of Applicant: Owner Contract Purchaser
Lessee Other (explain: )
4 . Parcel Identification: Zoning Map Sheet# 3.:1C- Parcel# ,
Zoning District(s) (include- overlays) UAC-
Street Address Grp
Required
5. Existin Pro osed b Zoning
Use of Structure/Property
(if project is only interior work, skip to #6)
Building height
%B1dg . Coverage (Footprint)
Setbacks - front
- side L: R L:
- rear ,
Lot size
Frontage .
Floor Area Ratio
. %Open 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 ne essar )
G
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. ' c
Date: 6 Applicant's Signature:
THIS SECTION FOR OFFICIAL USE ONLY:
!/ Approved as presented/based on information presented
Denied as presented--Reason:
S ecial" Permit and/or Site Plan Required:
i ndng R Pi variance Required:
c=
C7 At- �e
gnat o V Building. ector /5a e
NOTE: Issuance of a zoning permit does not relieve an applicant's burden to comply with all zoning ents and obtain all required permits
from the Board of Health,Conservation Commission, Dopartmont of Public Works and othor applicabl oranting authorities.
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