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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No.tJ�G'' C7 4 I Alterations
NORTHAMPTON, MASS. 5-- 5-- 19-2"1 Additions
APPLICATION FOR PERMIT TO ALTER Repair
/ Garage
1. Location r I e,*- WV o rX /�/r i l� Lot No.
2. Owner's name >. ee2 r g e 4 L Address 31
3. Builder's name if Ai-. c!24/ Address 1i 0 h v�STJV LIT S)', Al c -�
Mass.Construction Supervisor's License No. 0111-17 ,1 Expiration Date df-q 5�// 2S—
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 F/A,o 1- L *5 S �'/ �n/
13. Siding house
14. Estimated cosL- j f/3 p v
The undersigned certifies that the above statements are true to the best of his, her
knowledge and belief.
s
Signature of responsible app,icanl
Remarks
Date Filed ,` oo�' `� i
� File No.
ONI/N�G PERMIT APPLICATION (510 . 2)
1 . Name of Applicant:
Address:,9r - a-7- :5Z� Telephone:
2 . Owner of Property: 62 ,e L L
Address : 3J Telephone: 6 o o
3 . Status of Applicant: Owner P/,*-C-ontract Purchaser
Lessee Other (explain: )
4 . Parcel Identification: Zoning Map Sheet# Zcf Parcel# 9 ,
Zoning District (s) (include overlays)
Street Address w c act
Required
5 . Existinq Proposed by Zoning
Use of Structure/Property
(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 Description f Prop sed Work/Project: (Use additional sheets
if necessary)
.1
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 :_... S/9�_ Applicant' s Signature
THIS SECTION FOR OFFICIAL USE ONLY:
yApproved as presented/based on information presented
Denied as presented--Reason :
S ial- Permi and/or Site Plan Required:
ng Re ed. variance Required:
S gnat of uilding or Da
NOTE: Issuance of a zoning permit does not rolleve 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 permit granting authorities.
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