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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations
NORTHAMPTON, MASS. d -'��42 19 Additions
' APPLICATION FOR PERMIT TO ALTER Repair
Garage
1. Location �7 e5_11/N C?,T6
Lot No.
2. Ownersname Ais kE116 ) Ic Address %� '�7�r 1` ^� � ��i✓'fir= '4
3. Builder's name S" ."1 t S -r- 1"� " Address Jr�d
Mass.Construction Supervisor's License No. Oatp S�Yrb Expiration Date Of
I 1'
4. Addition
5. Alteration
6. New Porch
7. Is existing building to be demolished?
S. 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
�a
14. Estimated cost:- 6-()Cj
The undersigned certifies that the above statements are true to the best of his, her
knowledge and belief.
Signature of r sponsible appicant
Remarks
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003367
Date Filed j _ File No.
ZONING PERMIT APPLICATION
1 . Name of Applicant: �--)A,uO
Address:_ _,17 / Q 2 fjrq o. Telephone: SAC--.-ylG
2 . Owner of Property: .Mic Fi ,J 1-
Address : G 7 �lJ, A)C,-m a `' Flo le c L w e4"-Telephone:
3 . Status of Applicant: Owner 11/Contract Purchaser
Lessee Other (explain )
4 . Parcel Identification: Zoning Map Sheet# ;q Parcel# 31
Zoning District(s) (include overl ys�
Street Address z ,
Required
5. Existing Pro osed 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
Frontag#e.
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)
.r .
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.' y�
Date: �' Applicant's Signature:
` r THIS SECTION FOR OFFICIAL USE ONLY: r
� Approved as presented/based on information presented
Denied as presented--Reason:
Special' Permit and/or Site Plan Required:
'n ing re'�4u 'red: variance Required:
- � � -7Z
Signatur6 of Build � Date
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,Conservation Commission, Department of Public Works and other applicable permit granting authorities.
PERMIT APPLICATION CHECK LIST
P ES NO DATE
2
3 . OW O
3 SET LAN
NEW CONSTRUCTION
6 . CURB CUT
T. WATER
8. REMODELING
9 . ADDI ION
0 ACCESSORY C
11 . SIGN -/ AWNING
2 , PERMIT FEE - CHECK ONLY - MONEY 0 DE
3 . SPECIAL PERMIT REQUIRED WITH DEED IF APPLICABL
4 . UNDER SECTION 127 - C R 780
5 . FORM A
16 , FILL
COMMENTS:
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