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29-214 (6) T z a cY) f Z 0 !Jl� Z m -3 r v O / Zoning Miscellaneous Additions,Repairs,Alterations,etc. Tel.No.�,:2 Cz 4 cL 17- Alterations NORTHAMPTON, MASS. Q 19 Additions APPLICATION FOR PERMIT TO ALTER Repair ti r Garage 1. Location Y.I Lot N .lei 2. Owner's name Address 3. Builder's name Address Mass.Construction Supervisor's icense No. U © �f Tl 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 cost- U'v The undersigned certifies that the abo tatcments are true to the best of his, her knlief. S at e of r ponstble app icam Remarks ... _ . ....,.ems 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 col== to be filled in by the Bnildiag 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) pf, Parking Spaces of Loading Docks Fill: 4vol-lime--& location) 13 . Certification: I hereby certify that the information contain , herein is true and accurate to the best of my knowle e. DATE: APPLICANT's SIGNATURE NOTE: Amuanoe of as zoning permit does not relieve an piioanr urd oompiy with all zoning requirements and obtain all required permits from the rd of alth, Conservation . Commission, Department of Publio Works and other appiioabla permit granting authorities. FILE # f File ZONING PERMIT APPLICATION (§10 . 2 PLEASE TYPE OR PRINT ALL, INFORMATION 1. Name of Applicant: ro, dZ.,4 Address: Telephone: a 2. Owner of Property:e f P Address: pktone: 3. Status of Applicant: Owner Contract Purchaser Lessee Other(explain): —1 4. Job Location: Parcel Id: Zoning Map# '--419 Parcel# �� District(s):_ � /G (TO BE FILLED IN BY THE BUILDING DEPARTMENT) 5. Existing Use of Structure/P rope rty ��� ,�� 6. De3SYption of Proposed Use r ro•ect/Occ lion: (Use additional sheets ' 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 Permit/Vadance/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? N0_4 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) +irk" FILE 4. 3 199-0 APPLICANT/CONTACT PERSON: ADDRESS/PHONE: -�4� � ► 02. PROPERTY LOCATION: MAP 129 PARCEL: t0NE__ZZ THIS SECTION FOR-OFFICIAL,USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOS D REQUIRED DATE 7.QMNC FORM FTT.T,FD OUT Fee Pahl Rnildin2 Permit Filled Alit u Arresgnry Strnrtime 3 Si-k of Plan-, /Pint Plan THE OLLOWING ACTION HAS BEEN TAKEN ON THIS AI? 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 Co ission a Signature of Building ec ate NOTE:Issuance of at zoning permit does not relieve an applicant's burden to oomply with all zoning requirements and obtain all required permits from the Board of Health, Conservation Commission, Department of Pubiio Worlcs and other applioeble permit granting authorities. n �.v.a+ re V, o 06. CD ° C' o• 0 o o 0 MO rn LO c pp0 ��`p1 O O !D N Er CA E- b'ly �• fA0 CD W CS fD b CD cr tz 5r g P- � ° d ( o C C D a. �y C o y. (CD 5 Q b ag `�° (D ° l 1 CD CDEr w 5 n 21 0 CD CfQ C) .. � 55 C9 i o o 0 ° < ga a d O A �. 1:51 � � o o c d ~ O ° O 0 O = w ~' 0 4 W s (I 5'Q 0 p OM M N � Q •5 � 5 �'' �'' Ln kD Z D' tTj W N � T 5 y I1 � I1 � ❑ 'p � � °o Q 9 � oa � uo o 3 b s y `❑ rQ o po CD