29-374 (5) Vwt
Date Filed lc,42A,G File No.
ZONING PERMIT APPLICATION
Zoning ordinance Section 10 , 2
1 , Name of Applicant : (,�'�/���!-� � Il�f�✓°GCie�� r'�7`'
dress : �/;� /,2 ,S Via-sJ-.�a ic��' Telephone; S --3-7D
2 Owner of Property : Cc,r1v&_ ifcr S e ti
Address : / ? / f7-/u�e,t, c nlephone:
3 , Status of Applicant : Owner Contract Purchaser
Lessee Other (e::plain %v�- )
4 , Parcel Identification: Zoning Map Sheet# Parcel#-.
Zoning District (s) _(Z d
Street Address___Z •2 ( IE��a rz',_vN
5 . Compliance with Zoninu: Existing Proposed
Use of Structure/Property � � t
Size of Structure (sa.ft , )
Building height
Building Coverage
Setbacks - front
t side
� rear •
Lot Size
to. r Frontage
Floor Area Ratio
open Space
' Parking Spaces
Loading Spaces
Signs
Fill (volume & location)
Narrative Descrintion of Proposed Work/Project : (Use
additional sheets if necessary)
Z22
7 . Attached Plans : Sketch Plan Site Plan
8 . Certification: I hereby certify that the information contained
herein is true and accurate to the bes�fmy knowledge ,
Date ; �U vZ l''' Applicant � s Signature :�;
THIS SECTION FOR OFFICIAL USE ONLY:
Approved as presented
Denied as presented
Reason for Denial:
Signature of Building Inspector
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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. $ C O Alterations
go NORTHAMPTON, MASS.s % c Z 19a Additions
APPLICATION FOR PERMIT TO ALTER Repair
/ n Garage
1. Location l 7 IE CJi T-1N e ' ✓� Lot No.
2. Owner's name Tl C`c,Ltlzi✓,rj�f`C1 S/r4 NT%� `� rY Address / �/ /` �lr%' ��t/ �° � l�� �`' A 7
3. Builder's named /2 01i / /7��!'�yG"�hi �%-�' Address
Mass.Construction Supervisor's License No. y -5 ,2 41 S Expiration Date f 4 12Z 2 r
4. Addition ,+ /
5. Alteration d)/�e �e, de I/ /n
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:-," 000
s �
The undersigned certifies that the above statements are true to the best of his, her
knowledge and belief.
Signature of responsible applicant
Remarks
PHINTSHOP
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