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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations
NORTHAMPTON, MASS. 31 19 °' 7 Additions
APPLICATION FOR PERMIT TO ALTER Repair
Garage
1. Location 37/ /-Jecel-.'5,,dr K c lc Lot No.
12. Owner's name z"` ��r��c� Address `37/
3. Builder's name /° �j ,r s t Address /r-
Mass.Construction Supervisor's License No. / Expiration Date
4. Addition
5. Alteration
6. New Porch d ''f /L' �.r ros��/ :c f w -�i Z/ -,4-, A o,.o� �� -�'r�• y.ec-1
7. Is existing building to be demolished? /,�>16 � 10 r`if /�'Lca:c"� ��t v r'te 41'°11 6-
1- C L`'``7/ye)'L/
8. Repair after the fire
9. Garage No.of cars Size
10. Method of heating
11. Distance to lot lines /;7 `"" ' 30` / � �;' 3 i Fr
12. Type of roof
13. Siding house
cy G
14. Estimated cost:- v. c 6 0
The undersigned certifies that the above statements are true to the best of his, her
knowledge and belief.
ignaiure of responsible appicani
Remarks
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PLOT PLAN
In accordance with Article XI of the 1oni.ng Ordinance, an application for a .
Zoning Permit muat include a Plot Plan. The following characteristics of the
parcel must be shown.
1. Dimensions of the lot.
2. Locations and size of all buildings.
3. Average finished grade of all structures existing and proposed.
4. Use of all buildings existing and proposed.
5. Set Backs as indicated on the enclosed plan.
Abuttors Name
Lot No.
Lot Ft.
-4s
•/D �
Rear and �
Abuttors �r 4 '3 C) Abuttors
Name Name
Lot No. rU l O Lot No.
V
_-----_. Its
If this is a 4. Sideyard
House Sideyard If this is a
corner lot write �s�v corner lot, write
in the name of the
in the name of the
o other street.
other street.
w �
Set Back
� �QQ'
o a
a
Lot Aq f Ft.
�P r-u� �•� ��S�qtr�.ti c
Name of Street
Indicate location of garage or accessory buildings with a dashed line.
Indicate location of Sewer hook–up 5
List all past plans, applications, permits, variances etc. and corresponding dates that
hove been processed by this office.
I certify that the enclosed application and plot plan are complete and correct.
Signature 2of�Owner , a e
� c
PageNo. —Lot No. .2 '�
� • a
10. Do any signs exist on the property? YES NO i/.
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 co2a�s to be 1.`i21ed in
by the BniZding Department
Required
Existing Proposed By Zoning
l- 7
Lot size TZ5:--
Frontage C
Setbacks - frnnt 67
- side L: 9'0 F R: L: 6a R: l 5
- rear
� 6
Building height
Bldg Square footage
p P
°/O en Space: r
(Lot area minus bldg a
&paved parking)
pf. Parking Spaces
f fof Loading Docks
Fill:
'4vol-ume--& location)
13 . Certification: I hereby certify that the information contained herein
is true and accurate to the best of my knowledge.
l
D21TE: APPLICANT's SIGNATURE
NOTE: Issuance of a zoning permit does not relieve an appeoanra burden to oomply_wittfi,,,4�j1,-=•
zoning requirements and obtain all required permits from the Board of Health. Convervation.
iCommission. Department of Public Works and other applicable permit granting authoritles:_:
! '. FILE #
APR File 2 No '
.
BONING PERMIT APPLICATION (§10 . 2)
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant: � 0
Address: `� A)f4 5 f Telephone:
2. Owner of Property: L< „mil✓ /J""/C
Address: 27/ /3<'u'� si��c C",�z�(e Telephone: � ��—C
3. Status of Applicant: Owner Contract Purchaser Lessee
Other(explain):
4. Job Location:
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/VVork/Project/Occupabon: (Use additional sheets if necessary):
7. Attached Plans: Sketch Plan to-' 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 Perm itNa ria nce/Findi ng 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 t/ 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)
h
p. .... FILE
APR 2 ;j J a �j;7;S' 6,
APPLICANT/CONTACT PERSON: -
ADDRESS/PHONE: ' !�
PROPERTY OCATION: 391 - f72f . yo
MAP PARCEL: ZONE Le
THIS SECTION FOR�OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
7.ONIFNC-FORM VII.I.E.11 OUT
Fee P-ged
Rnilding Permit Filled 0ijt
,eC
Additinn to Existing
THE LLOWING ACTION HAS BEEN TAKEN ON THIS AP ICATION:
Approved as presentedfbased 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 Conservation Immisslo
el/s
Signature r Dat
NOTE:Issuance of 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 Publio Works and other applicable permit granting authorities.
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