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35-054 (6)
PERRMIT APPLICATION CHECK LIST PAGE PLOT 5-4 ZONE 5AZ q5 YES NO DATE 1 . ZONING FQRM APPLICATION C� Q 2 . PERMIT APPLICATION 3 . OWNgR OCCUPANT # TF NO 4 . 3 SETS OF S PLAN 5 . NEW CO ST UC IO 6 . CURB CUT 7 . WATER A S 8 . REMODELING 9 , ADDITION 10 , ACCESSORY STRUCTURE 11 . SIGN G 2 . PERMIT FEE - CHECK ONLY - MONEY 0 D 0 13 . SPECIAL PERMIT REQUIRED-W-ITH DEED IF APPLICABLE 14 . UNDER SECTION 27 - CMR 780 15 . FORM 16 , FILL COMMENTS : t. d- 1 u" a z -v o I or •.► ii v � 0• a 3 0 Z 71 7Z 1 r/ > X Z m _a Zoning Miscellaneous Additions,Repairs,Alterations,etc. el. Alterations aNORTHAMPTON, MASS. 19 Additions APPLICATION FOR PERMIT TO ALTER Repair �/ p Garage 1. Locations 7 ��Y�ri� Lot No. 2. Owner's name (1'l l CL��✓✓1t �s�tZ06KK Address 3. Builder's name .TGS45Pt+ ( -57VW 6ffj Address 334 k6tVryt lW KQ fir;GtJ C /`1 Mass.Construction Supervisor's License No. ©T 99 ea Expiration Date a6 ,Qr„ 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 S r R t P of O E!O& yAp nD W Pt Y.,L M00 13. Siding house ,p 14. Estimated cost G ' l The undersigned certifies that the above statements are true to the best of his, her knowledge and belief. Signature of responsible app,icanl Remarks f�IM i v Date Filed �' % 003291 File No. ZONING PERMIT APPLICATION I . Name of Applicant: T0 5 P fY L �e Address:_33 lMA Telephone: 5-y - s0 5- 2 . Owner of Property:_ fV11(e /3)&ores Address : qs y�g Telephone: 3 . Status of Applicant: Owner Contract Purchaser Lessee Other (explain ) 4 . Parcel Identification: Zoning Map Sheet# j5 ' Parcel#_ S)4 , Zohi.ng District(s) (include ov rlays) Street Address ,5 Required 5• ExistincT Proposed bv Zonincr Use of Structure/Property (if project is only interior work, skip to #6) �r Building height %Bldg. Coverage (Footprint) f Setbacks - front - side L: R: L: R: - rear Lot size Frontag$. Floor Area Ratio %Open Space (Lot area minus building and parking) Parking Spaces Loading Signs Fill (volume & location) 6 . Narrative Description of Proposed Work/Project: (Use additional sheets if necessary) STgtp oFT' e,,( n 'r 7 . Attached Plans: Sketch Plan Site Plan S . Certification: I hereby certify that the information contained herein is true and accurate to the best of my knowledge. / Date: _9L? Applicant's Signature:. THIS SECTION FOR OFFICIAL US ONLY: LApproved as presented/based on information presented Denied as_ presented--Reason: Special' and/or Site Plan Required: 'nd ng Re fired: Variance Required' /�/L �� S _ gna ur, f uI nspector_ "63 . D t. NOTE: Issuance of a zoning permit does not relieve an applicant's burden to comply with all zoning requirements and obtain all required permits from the Board of Health,Conservation Commission, Departmont of Public Works and other applicable permit granting authoritios. �.w.�•� FW- ri cr W UP y w A g• .". f'S agog° 300 � 0 �: w � aoJ o o' 2D a En rt 5 G FD O p x O a � n 5 5 s 0 � � � cr. o• � o o a' � � (� o ac 5 cro o o, �' o � rn C�7 ,,r � 5 p o, •d d c� � c c� 5 ° Q' 5 (IQ G rjQ UQ Li °ILI' QO s y © rJQZS c � con �l