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. PERMIT APPLICATION C ECK LIST
q ( 2- c,( - 'ff 3 2 �
PAGE �t PLOT � ZONE � YES NO DATE
1 . ZONING FORM APPLICATION �_'��� �
2 . PERMIT APPLICATION
3 . OWNER OCCUPANT STATEMENT LIC. # JF NOT ( `�
4 . 3 SETS OF PLANS OT PLAN
5 . NEW CONSTRUCTION
6 . CURB CU
7 . WATER VAIL BI T FORMS
8 . REMODELING INTERIOR
9 . ADDITIO
10 . ACCESSORY STRUCTURE
11 . SIGN / AWNING
12 , PERMIT FEE — CHECK ONLY — MONEY ORDER il 3060 L-
13 . SPECIAL PERMIT REQUIRED WITH DEED IF APPLICABLE
14 . UNDER SECTION 127 — CMR 780
15 . FORM
16 . FILL
COMMENTS :
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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations
NORTHAMPTON, MASS. l 67 ` 1 q Additions
'. APPLICATION FOR PERMIT TO ALTER Repair
,[ Garage
1. Location Y�3 ✓�� �ti': 1}7? /GZ� Lot No.
2. Owner's name ,/�JI1,Gf ,f�YIE3ca fU,} Address_ �7?1�
3. Builder's name 0//C� jkrz -1n' °���Jr►C�/- C Address_ PoAoX
Mass.Construction Supervisor's License No. _—Expiration Date
4. Addition I Z .0V A d itl'
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5. Alteration f ' t //�►`t �[ '�f�" 'n
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 � c.5 3-S
12. Type of roof
13. Siding house
14. Estimated cost:- I d Q L,
T The undersigned certifies that the above statements are true to the best of his, her
X/ knowledge and belief.
L r Signature of responsible app icon!
Remarks �'°G/ s r✓�T / r /} "✓ i -� 4 CrJt /n�� ✓�r�- '�<S !'►� /fCsL _
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VALLEY HOME IMPROVEMENT, INC. SHEET NO. OF
320 Riverside Drive P.O. Box 60627
NORTHAMPTON, MASSACHUSETTS 01060 CALCULATED BY DATE
TEL (413) 584-7522
FAX (413) 585-0820 CHECKED BY DATE
SCALE
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„. PROCWT2*1(5xg0 Sheers)205-1(PM*)®®Ix.,GrDW,Mass.01/71.To Ordr PHO MLL FREE IA067Z5-M .'
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Date Filed " File Nd� J r
ZONING PERMIT APPLICATION (§10 . 2)
1 . Name of Applicant: '1 �C' % /7 !u�z r'�'�7 lrjSc.s�t�J�� �Tl p2
1 .
Address : �; ;�'��f:Siole J ,j A-)/Y /ro627 Telephone: 5t�/-
2 . Owner of Property: i-t�� c�i(,�� - /0&, / All, .rc'!
Address : Y2,2 ,2Lj ,2d . /L'-rf1/hl9 p —Telephone:
3 . Status of Applicant: Owner Contract P rchaser
Lessee -either (explain: L1 )
4 . Parcel Identification: Zoning Map Sheet# Z-�� Parcel#
Zoning District (s) (include 9/m,_'M erla tCK'A-
Street Address 3L ,
Required
5 . Existinq Proposed —by Zoning
Use of Structure/Property - / i
(if project is only interior '41i wo k, sk ' to #6)
Building height
%B1dg. Coverage (Footprint)
Setbacks - front
- side L: Z%,Y c/ R: o1 ' L: R: `
- rear �—r
Lot size G Uc? L
Frontage
Floor Area Ratio
%Open Space (Lot area minus
building and parking)
Parking Spaces
Loading
Signs
Fill (volume & location)
6 . Narrative Description of Proposed Work/Project : (Use additional sheets
if necessary) Y I :S'jl'e-w j C-4�,-
tp
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
Approved as presented/based on information presented
Denied as presented--Reason :
Special' Permit and/or Site Plan Required :
Finding Required: Variance Required :
Signature of Building Inspector � U" - Date
I
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, Department of Public Works and other applicable permit granting authorities.
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