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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations
NORTHAMPTON, MASS. 1 9 Additions
APPLICATION FOR PERMIT TO ALTER Repair
Garage
1. Location �e Q g aQ ua,n //P Lot No.
2. Owner's name ��'✓r]c-e Nt e-,L Address ( O r Q IC n Ad
3. Builder's names Rte �� ��Cr.,� Address 14 1)
Mass.Construction Supervisor's License No. 05-3-26 :3 Expiration Date
4. Addition
5. Alteration 6tn /6k 9—cco—of :4cicsor,— r-j :'wC 4j1&"-g1ff Vt-jrJ.-."T
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
1 knowledge and belief.
Signaru ojresp ,.61, "picon!
Remarks
v
Jv. avrn
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Date Filed_ 4/.) - /T ao�50
_ File No.
ZONING PERMIT APPLICATION (510.2)
1 . Name of Applicant: LA �7 ��Telephone:
Address:_ .�,
2 . Owner of Propert
Address: Telephone: s'F,,' y;-/o,3
3 . Status of Applicant: Owner Contract Purchaser
Lessee Ot er (explain: )
4 . Parcel Identification: Zoning Map Sheet# Parcel# I ,
Zoning District(s) (include verl s) (A, d-'
Street Address
Required
5 . Existinq Proposed by Zoning
Use of Structure/Property vN_�e_
(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 Descri tion of Proposed Work/Project: (Use additional sheets
if necessary) i'�r► Is s rr,. 1 -P1 .-- &J-h V-
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:
__z,�4proved as presented/based on information presented
Denied as presented--Reason:
Special` Permi _and/or Site Plan Required:
' ding Req s r Varianc$ Required:
S gnatur uil nspector DdteZ
NOTE: Issuance of a zoning permit does not rellove 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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PERMIT APPLICATION CHECK LIST
w Y - DATE
,_. NO
2 . F�
3 . OWNER OCCUPANT STATEMENT IF NOT
4 . 3 SE PLAN
5 . NEW CONSTRUCTION
6 . CURB CU
7 . WATER AVAILABILITY FORMS
8 . REMODELING INTERIOR
9 . ADDITIOW
10 . ACCESSORY STRUCTURE
11 . SIGN / AWNI
12 . PERMIT E
- - �` Y - 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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