29-002 (4) 0
C n
CrJ �
O �
E
a
z
s v � o
d
v
I
GG Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. J 0 °` Alterations
a NORTHAMPTON, MASS. /� � 0 1 Additions
APPLICATION FOR PERMIT TO ALTER Repair C
Garage_IL
1. Location k, L-f j til ✓y',h Lot No. r,
2. Owner's name z t Q IV I , I ` Address_[
3. Builder's name I�j '�Y�_ t;�� �3'� Address_
Mass.Construction Supervisor's License No. QD.! 20.j Expiration Dateo 6/S Q 41 1,
4. Addition
5. Alteration
6. New Porch
7. Is existing building to be demolished? /,V
8. Repair after the fire
9. Garage No.of cars Size--
10. Method of heating &0—,-I) fr�rG�
11. Distance to lot lines
�j
12. Type of roof
13. Siding house
14. Estimated cost J� a 0
The undersigned certifies that the above statements are true to the best of his, her
knowledge and belief.
Signature ojresponsible appicani
Remarks
001011
Date Filed �r� r "� File No.
ZONING PERMIT APPLICATION (910 , 2 )
1 . Name of Applicant ;
Address : 5 B r,t.) Telephone : - f�
2 . Owner of Property: 0 / '-
Address ; . '' f f- / ; fJI�1�.�i't4'iJ Telephone : -
3 . Status of Applicant : Owner Contract Purchaser
Lessee Other (explain :_ -7.c/
IJ
4 . Parcel Identification : Zoning Map Sheet# L41 Parcel# 2- ,
Zoning District (s) (include qverlay
Street Address
Required
5 , Exiptin,0 ProiDos.ed bv Zoning
Use of Structure/Property
(if project is only interior rIe skip 1 to G)Building height
height
%B1dg . Coverage (Footprint)
Setbacks - front
- side L: Z: R:
- rear
Lot size _
Frontage
Floor Area Ratio
%Open Space (Lot area minus - "
building and parking)
Parking Spaces
Loading
Signs
Fill (volume & location)
6 . Narrative Description of Pro sed Work/Project : (Us additional sheets
if necessary) �G r �� ' co , -/ ,
/
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 knowledge . `
Date :� s Applicant ' s Signature : ! �Gt� ,�'
r
THIS SECTION FOR OFFICIAL USE ONLY:
Approved as presented/based on information presented
Denied as presented--Reason :
S ecial' Permi and/or Site Plan Required :
nd ' g Requ ' ed :oe Variance Required :
S gnat re o Building Ins r ._. � Date
NOTE: issuance of a zoning permit does not relieve an applicant's burden to cornply with all zoning requirements and obtain all required permits
from the Board of Health, Conservation Commission, Depmrlrnent of Public Works and other applicable permit granting aulhorilios•
/TT)-
k
� PLOT AIT APPLICATION CHECK LIST
P A G E {4- 1 0 K(-�
YES NO DATr=
ZONI,NG FORM APPLICATION
2 . PERMIT APPLICATION
3 , OWNER OCCUPANT STATEMENT / LIC 1I IF NOT
r
4 . 3 SETS OF PLANS /PLOT PLAN
5 , NEW CONSTRUCTION
6 , CURB CUT
7 . W619B AVAILABILITY 0 S
8 , REMODELING INTERIOR
9 ADDITION
0 , ACCEQSORY STSUCTURE
11 . SIGN AWNING
,f
2 , PERMIT FEE - ,CHEQK .ONLY O 0 D `0
13 , SPECIAL PERMIT REQUIRED WITH DEED IF APPLICABLE
A , UNDgR UNDER SECTION 12 - CMR 78.0
16 . FORM A
16 , FILL
POMMENTS :
,:�� � .�..,�:' -" i •. 'f m..,.z is 'r��`�` "",�£'a „'s`�-,�..:$ a�+'Y !' ,f�,"-` G
� r..- #a �' (ate �. a ^�'`�"�,��' a -. :•,
i
*;. `„x A: '` �' 4 r '•' 2f �aa ear ry .i .,, .� e a '° ,a'3�;°A$ '; a r,. �'C?4 r'1€"
c
s
Qn
rt x
� �, �• �, ° �' 5r ° o G � �
rt y
o n
�• $ � � N U
G C (D lC
ril
CA
y rS 0
as �, � Z � m
5 pFyoo
t�H 0
° Qgacn :3, u
cn CD PV
con
0
oc� o
5 5 5
� 5 y
d `
Qn
s bQ 5 UQ
CA
rl. 050 5, 05q UQ
� � �• � ; Oo egg.
to
H
5 (IQ n
CrJ g• � � °A � p
vv y : z