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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations
NORTHAMPTON, MASS. /'----�'7 I9LL Additions
APPLICATION FOR PERMIT TO ALTER Repair
Garage
1. Location y�L1Crr S t") Lot No.
2. Owner's name T LAddress c�L i �r✓ 2ssi %-
3. Builder's name W1 Address Z-3 "s z- 4'4-fsta&,S AW, ( �yt1 / ,$1�l
Mass.Construction Supervisor's License No. LS [ C 5£S 2 Expiration Date
4. Addition / y
5. Alteration lL1S l� ✓ G-tift is 6. New 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:- Y ' G c
The undersigne ertifies tha e a e statements are true to the best of his, her
k owledge ie7
Signature of responsible appicant
Remarks
10. Do any signs exist on the property? YES NO
IF YES,describe size,type and location:
Are there any proposed changes to or additions of signs intended for the property?YES NO
IF YES,describe size,type and location:
11. ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE DENIED DUE TO
LACK OF INFORMATION.
This co1wa to be filled in
by the Building Department
Required
Existing Proposed By Zoning
Lot size
Frontage
Setbacks
- side L: R: L: R:
- rear
Building height
Bldg Square footage
%Open Space:
(Lot area minus bldg
' &paved parking)
# of -Parking Spaces
# 'of Loading Docks
Fill:
4volume--& location)
13 . Certification: I hereby certify that the information ained herein
is true and accurate to the best of my knowle e
DATE: 7- / APPLICANT's SIGNATURE
?" NOTE: Issuance of a zoning permit does not relieve an iloant's burden to oom wlt
P ply tfi,..aU...
zoning requirements and obtain all required pet m the Board of Health. Conaervation
Commission. Department of Publio Works and other a plioable permit granting authorities:-
,,:: FILE # :.
JAN 2 7 !9y 7
File No. A � I
ZONING PERMIT APPLICATION (§10 . 2)
PLEASES TYPE OR PRINT ALL INFORMATION
1. Name of Applicant:
Address: Telephone:
2. Owner of Property:
Address: � Z�1D,c'TJf,I l�'iGiTklephone:
3. Status of Applica t: Owner Contract Purchaser Lessee
�ther(explain): ,�J%
4. Job Location: ( _ �,{7< c�j C ✓�(1(�'j �%;�%
h
Parcel Id: Zoning Map# Parcel# District(s):
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/Property
6. Description of Proposed Use/Work/Project/Occupabon: (Use additional sheets if necessary):
7. Attached Plans: _ Sketch Plan Site Plan Engineered/Surveyed Plans
Answers to the following 2 questions may be obtained by checking with the Building Dept or Planning Department Files.
8. Has a Special PermitNadance/Finding ever been issued for/on the site?
NO DON'T K NO,::/ YES IF YES,date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO DON'T KNOW YES
IF YES: enter Book Page and/or Document#
9. Does the site contain a brook, body of water or wetlands? NO DON'T KNOW YES
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained Obtained date issued:
(FORM CONTINUES ON OTHER SIDE)
FILE #
JAN 2APPLICANT/CONTACT PERSON.
ADDRESS/PHONE:_�
PROPERTY LOCATION: � Ct '
MAP PARCEL: r ZONE
THIS SECTION FOR-OFFICIAL USE ONLY:
PERK UT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FITLED OUT
Fep Paid
1RIlilding Permit Filled ont
FeepAid ) 4�!
-Rernndeling Tnterinr '46f--Z--
Addition tn F, Z
Accessory Strurtitre
c'
THE F LLOWING ACTION HAS BEEN TAKEN ON THIS AP ICATION: <
Approved as presented/based on information presented
Denied as presented:
Special Permit and/or Site Plan Required under: §
PLANNING BOARD ZONING BOARD
Received &Recorded at Registry of Deeds Proof Enclosed
Finding Required under:§ w/ZONING BOARD OF APPEALS
Received&Recorded at Registry of Deeds Proof Enclosed
Variance Required under: § w/ZONING BOARD OF APPEALS
Received& Recorded at Registry of Deeds Proof Enclosed
Other Permits Required:
Curb Cut from DPW Water Availability Sewer Availability
Septic Approval-Bd of Health Well Water Potability-Bd Health
Permit from Conservatio ommi si
2 i
Signature of Building for Date
NOTE: Issuanoa of n zoning permit does not relieve an appiioant'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.
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