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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations
NORTHAMPTON, MASS. 19 Additions
APPLICATION FOR PERMIT TO ALTER Repair
a
Garage
1. Location ® B GC Lot No.
2. Owner's name Xadress
3. Builder's name Address
Mass.Construction Supervisors License No Expiration Date
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
14. Estimated cost-
The undersigned certifi the above statements a tr to the best of his, her
knowledge and
$ignaiure of responsible appicane
Remarks
. � 003308
Date File File No.
NI3IG ERMI A CATI N
0§10 . 9
1 . Name of Applicant;/ y�/� r �- lS
Address: 1210 ld� _e lepho
2 . Owner of Proper
Address :
3 . Status of Applicant: owner Contract Purchaser
Lessee Other (explain )
4 . Parcel Identification: Zoning Map Sheet# 92-c- Parcel# Z/® ,
Zoning District(s) (include o erla j (mod
Street Address ,30 t-
0 ' Required
5. Existincr Proposed —by Zoning
Use of Structure/Property
(if project is only interior work, skip to #6)
Building height
%Bldg. 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 Wor /P ect: Use dit 'on 1 heets
if necessary)
7. Attached Plans: Sketch Plan Site Plan
8 . Certification: I hereby certify that the inform on ontaine a 'n
is true and accurate to the best of my knowle e.
Date: Applicant s Signature, ! �
r T IS SECTION FOR OFFICIAL USE ONLY:
Approved as resented based on information resented
pp p / p
Denied as presented--Reason:
Sp ial'' Perm' and/or Site Plan Required:
d - g Re- i e Variance Required:
94gnatu f Building In or � �U D Ze
NOTE: issuance of a zoning permit does not retiove an applicant's burden to comply with all zoning roqu d ob tain all required permits
from the Board of Health,Conservation Commission,Department of Public Works and ollwr applicable permit granting authorities.
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