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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations
NORTHAMPTON, MASS. 7 l-,r-3- 19 Additions
APPLICATION FOR PERMIT TO ALTER Repair_
Garage
1. Location �2 ls�: c�i� Lot No.
2. Owner's name Address
3. Builder's name Address ^S i t/.xpJ
Mass.Construction Supervisor's License No. 1 G f SC.`l Expiration Date (Q — z I-
4. Addition
0
5. Alteration
6. New Porch
7. Is existing building to be demolished?
G
8. Repair after the fire �c
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 certifies that the above statements are true to the best of his, her
knowledge and belief.
1 U n
Signature of responsible app,icane
Remarks
00 0 0 "rig
Date Filed
File No.
ZONING PERMIT APPLICATION
1 . Name of Applicant:
Address:
Telephone: q-22!-0 /,9 /
2 . Owner of Property: .
Address : ��C�ti� � .,,v,, Telephone:
3 . Status of Applicant: Owner Contract Purchaser
Lessee Other (explain )
4 . Parcel. identification: Zoning Map Sheet#3. Parcel# o2J—R,
Zoning District(s) (include overlays)
Street Address d _
Required
5 . Existincr Proposed by Zoning
Use of Structure/Property Altz �e1
(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)
i
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: 7 -- / Applicant's Signature: Adc* p. 5xI ,4A:--,----
THIS SECTION FOR OFFICIAL USE ONLY: r — — — — —
pproved as presented/based on information presented
Denied as presented--Reason:
ecial. Pe mit and/or Site Plan Required:
i Ung ed: variance Required:
r
-7,
gna of Building "ctor l�� ate
NOTE: Issuance o(a.zoning permit does not relieve an applicant's burden to comply with all zoning requirements and obtain all required permits
from the Hoard of Health,Conservation Commission,Department of Public Works and olhor applicable permit granting authorities.
PERMIT APPLICATION CHECK LIST
PAGEA PLOT S Z 0 N E Grt "o .G .+�f a�«s
)LES NO DATE
1 . ZONING FORM APPLICATIOK-.
2, PERMIT APPLICATIOf4
3 OWNER
4-, 3 SETS OF PLANS /PLOT P AN
NEW CONSTRUCTION
6 CURB CUT
WATER- AVAILABILITY
8 . REMODELING INTERIOR
9 ADDITION
ACCESSORY
11 , SIGN / AWNING
12 , PERMIT FEE Udl4sijSONLY — MONEY OR Ek-S-"7�O
3 . SPECIAL D WITH DEED IF APPLICABLE
4 . UNDER 80
15 , FORM A
8 . FILL
COMMENTS:
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