31B-052 PERMIT APPLICATION CHECK LIST
PAGE Z PLOT ' ZONE �/ , 2 � �= ES NO •AT
/�
1 , ZONING FORM APPLICATION
2 , PERMIT APPLICATION
3 , OWNER OCCUPANT I 0
4 . 3 SETS OF S PLAN
5 . NEW CONSTRUCTION
6 . CURB CUT
7 , WATER S
8 , REMCDELING INTERIOR -
9 , ADDITIO
10 , ACCESSORY STRUCTURE
11 . SIGN / AWNING
12 , PERMIT FEE - - MONEY 0 E
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. t�� `�Z-2y Alterations
a NORTHAMPTON, MASS. F/.2�19 3 Additions
APPLICATION FOR PERMIT TO ALTER Repair
I�! 7^ Garage
1. Location '� Not r� 5 A ,,�.�t/ Lot No.
2. Ownee s name 3 et f+ c ce Lea i�1 G$A Address_ '�l :L Ne, j 1 57— 171, rril� -",r'rV 07
3. Builder's name (Al j!s -t-v r-, I&z s &cL-. .,,/I.tf;.Address / 3 C auZ Sr C c�.9Thyt�,.-��r.� In
Mass.Construction Supervisor's License No. (73 Z e&q _Expiration Date n/ 9 G
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
13. Siding house a /� �� "� i
14. Estimatedcost:-
lThe undersigned certifies that the above s to nts are true to the best of his, her
knowledge and b
Signature of responsible appucan!
Remarks ��t
U
0016
Date Filed 3 File No.
ZONING PERMIT APPLICATION (§10 . 2)
1 . Name of Applicant:
Address : J :3 r-k,,,0±0m P,, Telephone: C-g Z. S-2. L
2 . Owner of Propert c,r? •c�u r/�G kt,C yt,
Address : . �I ,-rt, <, /l ,� Telephone :
3 . Status of Applicant: Owner Contract Purchaser
Lessee Other (explain: )
4 . Parcel Identification: Zoning Map Sheet// 3/ Parcel# ,
Zoning District (s) (include overlays) C-�
Street Address V 2. ,
Required
5 . Existin Proposed —by Zoning
Use of Structure/Property 2
(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 of Proposed Work/Project : (Use additional sheets
if necessary)
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 Applicant' s Signature :
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -ZApproved THIS SECTION FOR OFFICIAL USE ONLY:
as resented based on information resented
p / p
Denied as presented--Reason:
ecial' Permit and/or Site Plan Required:
ing R it d: Variance Required :
i.gnatu e Buildi spector ate
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 tho Board of Health, Conservation Commission, Department of Public Works and other applicable permit granting authorities.
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