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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations
NORTHAMPTON, MASS. 19 Additions
APPLICATION FOR PERMIT TO ALTER Repair
a
Garage
1. Location ArAw%No ("t �UKNL•t' Lot No.
T n /-
2. Owner's name �G 1pp--—- `--- - — Address J� n^,�, l�.�r)"
3. Builder's name , i� /U yN+CL Address S`� Id
Mass.Construction Supervisor's License No. Expiration Date
4. Addition
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 cosL-
The undersigned certifies that the above statements are true to the best of his, her
knowledg and be
r
Signature oft sp nsible appicant
Remarks �C�o UC tSr� t's � Cry �}�_3 _ Pcs-
a.
or-
N
.,Qn
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_rA-
IF YES, describe size,type and location:
11. ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE DENIED DUE TO
LACK OF INFORMATION.
This col— to be filled in
br the Build-g Lltpartment
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)
#, ,_pf -Parking spaces
4 of Loading Docks
Fill:
'_(vol-time -& location)
13 . Certification: I hereby certify that the information contained herein
is true and accurate to the best of my To-11, edge.
_1
DATE: _c, APPLICANT's SIGNATURE
NOTE: Issuance of a zoning permit does not relieve an a oanrs b den to comply with all
e
zoning rquirements and obtain all required permits from the Boa of Health, Conservation
Commission, Department of Public Works and other applicable permit granting authorities.
�4`',; FILE #
Fi 1 e No.
ZONING PERMIT APPLICATION (§10 . 2
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant: —0.'qUl t7 /�julyca
Address:__ 5'r Telephone: F;;� -000 2
2. Owner of Property: ?cis) ISri-P-4 :5 tc
Address: cLMr, Cc trr--f Telephone: "--)Tq a y o
3. Status of Applicant: Owner Contract Purchaser Lessee
Other(explain): /-
4. Job Location: �� ���MO Co"t
Parcel Id: Zoning Map# � � ;% Parcel# In
(TO BE FILLED IN BY THE UILDING DEPARTMENT)
5. Existing Use of Structure/Property '����
6. Descripti n i n
of Proposed Use/Work/Project/Occupation: (Use additional sheets ecessary):
�ti� G;C•v-PKC i/
S
v
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 KNO W___)c
� YES IF YES,date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO DON'T KNOW 'C" YES
IF YES: enter Book Page and/or Document#
9. Does the site contain a brook, body of water or wetlands? NO_/C- 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 #
APPLICANT/CONTACT PERSON:
ADDRESS/PHONE:
PROPERTY LOCATION:
MAP C PARCEL: ZONE
THIS SECTION FOR-OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
MNING FORM FRIED OUT
n L, n
�
THE LLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION-
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 Cons ation iss'
L
Signature o uilding teglor ffate
NOTE:tasuanoe of as zoning permit does not relieve an appiloant's burden to oompty with all
zoning requirements and obtain all required permits from the Board of Health, Conservation
Commisslon, Department of Publio Works and other applioable permit granting authorltles. —
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