35-095 (2) PERMIT APPLICATIQN CHECK LIST
PAGE PLOT �`'` ."ZQHE ��, � YES NO DATE
ION
2h
3 . OWN OCCUPANT 0
4 . 3 SETS OF S /PLOTPL
5 . NEW CONSTRUCTION
6 . CURB CUT
7 . WATER S
8 . REMODELING INTERIOR
9 . ADDITION
10 . ACCESSORY STRUCTURE
11 , SIGN WNI G
1 2 , PERMIT FEE - ONLY - MONEY OBQEE
13 . SPECIAL - PERMIT REQUIRED WITH DEED IF APPLICABLE
14 , UNDER SECTION 127 - CMR 780
15 , FORM A
16 , FILL
COMMENTS :
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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. C -a Alterations
NORTHAMPTON, MASS. �� 19
C Additions
Repair
ti r
APPLICATION FOR PERMIT TO ALTER
_ i Garage
1. Location \\ C� `nc 1 <� 1\14imt sc t Lot No.
2. Owner's name .l tT 11 _ d kKi\e _Address
` 1 s rt
3. Builder's name �J G�+ t ,` Address
Mass.Construction Supervisor's License No. v A 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-
The undersigned certifies that the above statements are true to the best of his, her
know7'A'd 7ef.
Sig ature of responsible app icant
P � �
Remarks
n
�� 002 � i)
Date Filed � / ( � y'j 4 File No.
'�T—ZONING PERMIT APPLICATION (§10 . 2)
I. Name of Applicant: c ,
Address: U - Telephone:
2 . Owner of Property:
Address : ! Telephone:
3 . Status of Applicant: Owner Contract Purchaser
Lessee Other (explain: )
4 . Parcel Identification: Zoning Map Sheet# 3 Parcel# ,
Zoning District (s) (include oxer a s)
Street Address
5 .
by Required
Existing -, Proposed Zonin
Use of Structure/Property �rc�
(if project is only interior work, skip to #6)
Building height
%B1dg. Coverage (Footprint)
Setbacks - front
- side L: R: L: 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 Descripio of Proposed Work/Project: (Use additional she s
if necessary)
��• � ����� E�d� ����,n:� a� �r�� �: �,
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: �� (,%� . Applicant's Signature: -
THIS SECTION FOR OFFICIAL USE ONLY:
j,' Approved as presented/based on information presented
Denied as presented--Reason:
Special* Permit and/or Site Plan Required:
Finding R7 ired: Variance Require :
gnat e Bui ld�n� Inspector- Da
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, Dopartment of Public Works and other applicable permit granting authorities.
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