35-084 (2) > >
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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations
NORTHAMPTON, MASS. 19 Additions
APPLICATION FOR PERMIT TO ALTER Repair
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Garage
1. Location P,, ' �' J 1 i Lot No.
2. Owner's name n - LAj Address I sV 7 I1, /'Z 4',
3. Builder's name Address /.. cY
Mass.Construction,upervisor's i license No. o�a —l Expiration Date_� J
4. Addition S � ,�'4r« ,3611
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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:- sf7i
The unders , d certifies that the above statements are true to the best of his, her
knowled d f.• /
Signature of responsible app,icant
Remarks 7 � 1
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10. Do any signs exist on the property? YES NO X
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 column to be filled in
by the Building 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)
of Parking Spaces
ffof Loading Docks
Fill:
.4 vol-time -& location)
13 . Certification: I hereby certify that the information contained herein
Gj is true and accurate to the best of my knowledge.
DATE: APPLICANT's SIGNATURE
NOTE: Issuanoe of a zoning permit does not relieve an applicant's burden to oompty witFt,,atl-
zoning requirements and obtain all required permits from the Board of Health, Conservation
Commission, Department of Publio Works and other applloable permit granting authorities...
FILE #
File No.
ZONING PERMIT APPLICATION (§10 . 2)
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant:
I c � • 110 I
Address: _Telephone: q 13—(_7_53— � ���S
2. Owner of Property:
Address: r L Telephone: "� ���i rJo
3. Status of Applicant: _Owner Contrac4reheser Lessee
Other(explain):
4. Job Location: 13-1 t
Parcel Id: Zoning Map# �-,JJ Parcel# 7 District(s):
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
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5. Existing Use of Structure/Property r%�;(r,Ii
6. Des ription f Proposed Use ork/Pr ject/Occupation, ( fie additi nal sheets if n essa ):
e.
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 PermitNadance/Finding ever been issued for/on the site?
NO DON'T KNG°:tir 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 /� 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)
FILE #
MAR 13 ,1 - �
APPLICANT/CONTACT CANT/CONTACT PERSO : �"
ADDRESS/PHONE: /.�� �/t)1.
PROPERTY LOCATION: za&dt
xd— Q
MAP &,. � PARCEL: ZONE
THIS SECTION FOR�OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM MLED OITT
Fee P51irl JS
Type of Cmqtrurtinn-
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T15 A'OLLOWING ACTION HAS BEEN TAKEN ON THIS AP ICATIOM
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
!Perm m C rva ' n
1
Signature of Building hispeafdr 15ate
NOTE:Issuance of a zoning permit does not relieve an applicant's burden to compty with all
zoning requirements and obtain all required permits from the Board of Health, Conservation
Commission, Department of Public Works and other applioable permit granting authorities.
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