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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. G� Tel.No. Alterations
aNORTHAMPTON, MASS. ` 19 Additions
APPLICATION FOR PERMIT TO ALTER Repair
/'•-/� Garage
6
1. Location TI 0 N#L 9JZ _ NO L- L.S // Lot No.
2. Owner's name M I C Address O—1 'Ro t1 szer,k 0 LAS_K o .
3. Builder's name Address O Q 9T - N t Tt7V.-
Mass.Construction Supervisor's License No. ' Expiration Date "3 '�•�
4. Addition
5. Alteration t�C�l�:
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. Estim d cost:-
1.5� c-0 Q The undersigned certifies that the bove statements are true to the best of his, her
knowledge arAbelief. 0
�n ignature of responsible apps ant
W
Remarks
w
0.S pT
Date Filed c' File No. �Iq - 0-4c)
ZONING PERMIT APPLICATION (§1,,0..2)
I . Name of Applicant:
Address : , LD d Telephone:
2 . Owner of Property: tC LM k1
Address : �' Ke Telephone:
3 . Status of Applicant: Owner _ Contract Purchaser �..�►
Lessee t h e r (explain:- "�D� Q!¢..,(11111q-- Q7�1 rt•/'�t, },
4 , " Parcel Identification: Zoning Map Sheet# z,? Parcel# o4o ,
Zoning District (s) (include ov r ay )
Street Address
. 5 . Required
Existing Pro os d b Zoning
Use of Structure/Property
(if project is only interior work, skip to #6)
Building height
%B1dg. Coverage (Footprint)
Setbacks - front
- side j R L R
- rear
Lot size
Frontage
Floor Area Ratio
%Open Space (Lot area minus
building and parking)
Parking Spaces
Loading
S i gars
Fill (volume & location)
6 . Narrative Description of Proposed Work/Project: (Use additional sheets
if necessary) M C �'t .9
o v,6... -
7 . Attached Plans : V---'sketch Plan Site Plan
8 . Certification: I hereby certify that the information cont ined herein
is true and accurate to the best of my knowled
Date: !3 -2, Applicant ' s Signature:
Z _ THIS SECTION FOR OFFICIAL, USE ONLY: _pproved as presented/based on information presented SEP ?
Denied as presented
easo or enial:
:
igna re of B ' ding Inspector Date
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 Ideaith, Conservation commission, Department of Public Works and other applicable permit granting authorities.
7/92 FXAS
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PERMIT APPLICATION CHECK LIST
PAGE Q� 9 PLOT G 40 ZONE Cl F'A/ YES NO DATE
1 . ZONING FORM APPLICATION
2 . PERMIT APPLICATIONV
3 . OWNER OCCUPANT STATEMENT LIC , # IF NOT It �� � L L.� 3
4 . 3 SETS OF PLANS PLOT PLAN
5 . NEW CONSTRUCTION
6 . CURB CUT
7 . WATER AVAILABILITY FORMS
8 . REMODELING INTERIOR
9 . ADDITIO
0 , ACCESSORY STRUCTURE
1 . SIGN AWNING
12 . PERMIT FEE - CHECK ONLY - MONEY ORDER ^. � `--
13 . SPECIAL PERMIT REQUIRED WITH DEED IF APPLICABLE
14 . UNDER SECTION 127 - CMR 780
15 . FORM A
16 . FILL
COMMENTS :
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