29-022 (2) zz-
.PERMIT APPLICATION CHECK LIST
PAGE 2'f PLOT 2aZONE U`eg' R I �, YES NO DATE
1 . ZONING FORM APPLICATION
2 . PERMIT APPLICATION
3 . OWNER OCCUPANT STATEMENT L C. # IF NOT 0)v
4 . 3 SETS F S PLAN�-�
5 . NEW CONSTRUCTION
6 , CURB CU
7 . WATER VAI 0 S
8 . REMODELING INTERIOR
9 . ADDITION
10 . ACCESSORY STRUCTURE
11 . SIGN / AWNI
12 , PERMIT FE - CHECK ONLY - MONEY ORDER t3lZ' v
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. Alterations
NORTHAMPTON, MASS. 19 Additions
APPLICATION FOR PERMIT TO ALTER Repair
a
Garage
1. Location P I C K o 2 y 'O I U t FLokE(OcE Lot No.
2. Owner's name C HAAS ES b` A N r✓ Ty>ti N So N Address 9 H /6/,, 00y D(� , F LOAFA)C-t
3. Builder's name T,-FFAE\/ D O rl E Address 2 FI S K r rh I l t NI
Mass.Construction Supervisor's License No. O 9 3 0 9 47 Expiration Date `l �'�y `7 `f
4. Addition V F�ri
5. Alteration
6. New Porch
7. Is existing building to be demolished? N d
8. Repair after the fire
9. Garage E k I S-T)N C- No.of cars Size
10. Method of heating FH
11. Distance to lot lines
12. Type of roof
13. Siding house
14. Estimated cost:- $-15 000
The undersigned certifies that the above statements are true to the best of his, her
kn ledge and belief.(DU Signature of responsible app,icam
Remarks
u
Date Filed_ //�Q�9) File No.
ZONING PERMIT APPLICATION (510 . 2)
1 . Name of Applicant: -Te Fiag ff p 0`n
Address : Telephone: 6t J- 92 yY
2 . Owner of Property: CA(Ae&9 -2##4004 01376
Address :-. 9 Awia Dof -Telephone : s&y_ «p*
3 . Status of Applicant: - Owner Contract Purchaser
Lessee Other (explain: )
4 . Parcel Identification: Zoning Map Sheet#�_ Parcel#
Zoning District(s) (include ov lays) _,.
Street Address
Required
5 . Existing Proposed by Zoning
Use of Structure/Property
(if project is only interior work, skip to #6)
Building height 8
46B1dg. Coverage (Footprint)
Setbacks - front 2. 30
- side L:_�� o L._ R: a ' 4- 1`J '
- rear
Lot size
Frontage
Floor Area Ratio
oopen Space (Lot area minus
building and parking)
Parking Spaces
Loading
Signs
Fill (volume & location)
Narrative Description of Proposed Work/Project : (Use additional sheets
��
if necessary) A, -v zr .ex ye/ oem'A Of-' .Z .r&!� cA&
•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 LY:
/_`�
Approved as presented/based on information presented
Denied as presented--Reason:
Special' Permit and/or Site Plan Required :
4di aeq d: Variance R quired;
ti�
S gnatdi ng__ s ector_ at
NOTE: Issuance irtg permit d relieve an applicant's burden to comply with all zoning requirements and obtain all required permits
from the Board of Health, Conservation Commission, Department of Public Works and other applicable hermit granting authorities.
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