32C-218 (5) PERMIT APPLICATION CHECK LIST
PAGE '-F>2--C PLOT ZONE ^" YES NO DATE
1 . ZONING FORM APPUCATION
2 . PERMIT I
3 . OWNER OCCUPANT IF NOT
4 . 3 SET S PLAN
5 . NEW CONSTRUCTION --
6 . CURB CUT
7 WATER S
8 , REMODELING
9 . ADDITION
10 . ACCESSORY STRUCTURE
11 . SIGN / AWNING
12 . PERMIT FEE - CHECK ONLY - O E 0
13 , SPECIAL - PERMIT REQUIRED WITH DEED IF APPLICABLE
14 . UNDER SECTION - C R 780
15 , FORM
16 . FILL
COMMENTS :
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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No.a%!y7y-97-(q 7 Alterations
NORTHAMPTON, MASS. , -z/" �2J• 19 Additions
APPLICATION FOR PERMIT TO ALTER Repair
Garage
1. Location c (Z ��L_e Lot No.
2. Owner's name f (j(I L�N/,r�� ],I�r� Address,3d " y�� T {u
3. Builder's name . 4,i=x- Address 1A)aa n�). �'1 19h
Mass.Construction Supervisor's License No. Expiration Date t
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 hearing
11. Distance to lot lines p
12. Type of roof n-bi -phihrii gadL.",) -4—
13. Siding house
ar
14. Estimated cost-
The undersigned certifies that the above statements are true to the best of his, her
knowledge and belief./'
kiJYLl nr,TZ�. � rm q rf��
Signature of responsible app scant
Remarks
002249
Date Filed - �
File No.
ZONING PERMIT APPLICATION
I. Name of Applicant: 7
Address Telephone: r�
2 . Owner of Pr9perty: ,a212,,
Address: - Telephone:gff
3 . Status of Applicant: t,/Owner Contract Purchaser
Lessee Other (explain: )
2t
4 . Parcel Identification: Zoning Map Sheet# ��7 C- Parcel# ,
Zoning District(s) (include o erla s), . Ct y`C
Street Address , 3 A41t,
Required
5•
Existincr Proposed —by 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: 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 Description of Proposed Work/Project: (Use additional sheets
if necessary)
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 - i qg - - Applicant' s Signature-', I- , z
THIS SECTION FOR OFFICIAL USE ONLY:
(,Approved as presented/based on information presented
Denied as presented--Reason:
special.' p mit and/or Site Plan Required:
"n 'ng qu ' ed: Variance Required:
g n a e f Bu ' ctor at
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,Consorvation Commission, Departmont of Public Works and other applicable permit granting authorities.
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