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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. �' y S Y 4� Alterations
NORTHAMPTON, MASS. oZ 9� 19-�Zo Additions
Repair
' APPLICATION FOR PERMIT TO AL ER Garage
1. Location Lo No.
2. Owner's name A dress !
3. Builder's name Address
Mass.Construction Supervisor's Lic se No. (� �?9 Expirati Date — �-0
4. Addition
n
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 certifies that the above statements are true to the best of his, her
knowledge and belief.
Signa of ponsible 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 column to be filled in
by the Bailding Department
Required
Existing Proposed By Zoning
Lot size
Frontage
Setbacks - frnnt
- side L: R: L: R:
- rear
Building height
Bldg Square footage
%Open Space:
(Lot area minus bldg
&paved parking)
.o f. -Parking Spaces
fof Loading Docks
Fill:
'4vol- me--& location)
13 . Certification: I hereby certify that the information contained herein
�f is true and accurate to the best of my knowl dge.
.3
DATE V& 9 APPLICANT's SIGNATURE _XZ)
NOTE: lssuanoa o a zoning permit does not relieve an applioa to comply wlttx,.,all
zoning requirements and obtain all required permits from thl on f Health,, Con$ervatioi
iCommisston, Department of Publio Works and other applicable permit granting authorities:.
FILE # � ,
OCT 3 + 19996 /
File No. 96��'�1� 1
` , . ZMfNG PERMIT APPLIGATXON (§10 . 2)
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Appl' ant:
Address: Telephone: c-2%
L
2. OwnerofPropeg : A-PS-
y
Address: one: �! S
3. Status of Applicant: Owner Contract Pu chaser Lessee
_Other(explain):
4. Job Location: n
Parcel Id: Zoning Map# L Parcel# , District(s); f� J
(TO BE FILLED IN BY THE B ILDING DEPARTMENT)
5. Existing Use of Structure/Property /`' edz�jz'
t
6. Desgtiption of Propo d Use/Work/Proje ccupation: (Use ditio sheets if necessary): Y
JPQ
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 Permit/Variance/Finding ever been issued for/on the site?
NO DON'T KNOW 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)
�r
FILE #
961668
APPLICANTXON�ACT PERSON:
ADDRESSJPHOfM
PROPERTY LOCATION:
MAP PARCEL:— -�U% ZO
THIS SECTION FOR-OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
Fee PAM
Hiii1dimy Permit Folleti 011t
TVLLOWING 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
I/
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 Conservation mm Mon
Signature of Building r ate
NOTE:lasuanoe 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. —
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