29-217 (2) PERMIT APPLICATION CHECK LIST - _*
YES NO DATE
�I
2 .
3 . OWNER OCCUPANT STATEMENT NOT
3 SETS OF PLANS /PLOT PL N
NEWCONSTRUCTION
6 , CURB CUT
7 WATER
8 . REMODELING
9 . ADDITION
0 , ACCESSORY
ti . SI
2 PERMIT E E NLY -
13 SPECIAL I D WITH DEED IF APPLICABLE
4 . UNDER E - CMR 780
5 . FORM A
6 . FILL
COMMENTS :
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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 4 gca, i-P Dr Lot No.
2. Owners name 7r�C1 t T1n -S4-0 n.te,. Address SR tm.-e,
3. Builder's name_(r( 5 .,�1 Address�'7"� l� ��iG.rr�Sf�rer� 1'
Mass.Construction Supervisor's License No. 63--7 S7!? Expiration Date 9!j
4. Addition ��thAI G M kYW?
S. Alteration ^va.r�( �6.«G `/�Cr ,r -s"i 1611 Of, ¢-
6.-Neror-Petrch �- �xc
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: ®d
The undersigned certifies tha e above statements are true to the best of his, her
knowle d Ilief.
Signal responsible app scant
Remarks 54C-4,4-rz.-t C �5
'v
4040'7"7
Date Filed 4— 4 File No.
ZONING PERMIT APPLICATION
1 . Name of Applicant: /
Address : Telephone: 26 k"=
2 . owner of Property: . a
Address : Telephone: � —SF'7-5
3 . Status of Applicant:�owner contract Purchaser
Lessee Other (explain )
4 . Parcel Identification: Zoning Map Sheet# A Parcel# all ,
Zoning District(s) (include ov U s
Street Address
Required
5. EXistincf Proposed by Zonin
Use of Structure/Property
(if project is only interior wor , kip I o #6)
Building height
%B1dg. Coverage (Footprint)
Setbacks - front
- side L: R: L:
- rear
Lot size
Fronta41e.
Floor Area Ratio
oOpen Space (Lot area minus
building and parking)
Parking Spaces
Loading
Signs
Fill (volume & location)
6 . Narrative Description of Proposed Work/Proje (Use additional sheets
if necessary) �e G�, G-/1 -e
a
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 knowle
Date: -d �j�� Applicant Is Si
gnatur
THIS SECTION FOR OFFICIAL USE ONLY r
_ZA' pproved as presented/based on information presented
D.enied as presented--Reason:
special' Permit and/or Site Plan Required:
Finding Required: Variance Required:
s, gnature of B ilding Inspector rA Dat
NOTE: issuance of a zoning permit does not refiove an applicant's burden to comply with all zoning requirements and obtain all required permits
from the Board of Hoalth, conservation commission, Dopattmont of Public Works and otitor applicable pormit i7ranting aulhoritlos.
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