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j Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. r " Alterations
NORTHAMPTON, MASS. 19 Additions
a APPLICATION FOR PERMIT TO ALTER Repair
Garage
1. Location / 3 � 3 <1 Lot No.
2. Owner's name ' A g,--' Address I ,�3
3. Builder's name r r t j - c.a-ems. Address Y�' c -� -per-� � �rA- c n'
Mass.Construction Supervisor's License No. ! Q O %' Expiration Date 6 �' -
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 G'`'�/ ] ems�.� i1 � �— 2cto—� -E-
13. Siding house !
14. Estimated cost- t
The undersigned certifies that the above statements are true to the best of his, her
knowledge and belief.
Sign Lure of responsLble app icanl
Remarks
mow
10. Do any signs exist on the property? YES NO�' �
IF YES,describe size,type and location:
Are there any proposed changes to or additions of signs intended for the property?YES NO
IF YES,describe size,type and location:
11. ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE DENIED DUE TO
LACK OF INFORMATION.
This =7— to be filled in
by the Bailding Department
Required
Existing Proposed By Zoning
Lot size
Frontage
Setbacks
- side L: R: L: R:
- rear
Building height
Bldg Square footage
%Open Space:
(Lot area minus bldg
&paved parking)
pf. "Parking Spaces
of Loading Docks
Fill:
Avol-ume--& location)
13 . Certification: I hereby certify that the .information contained herein
is true and accurate to the best of my knowledge.
_1
DATE: l---/ J^ APPLICANT's SIGNATURE ct c
NOTE: Issuanoe of s zoning permit does not relieve an appli nre bu en to oomply.with,�i�l
z®ning requirements and obtain all required permits from the Board f Health., Con$ervation s
Commission. Department of Publio Works and other applioabla permit granting authorities.
,;, FILE #
NOV 1 19% Fi 1 e No.
ZONING PERMIT APPLICATION (§10 . 2)
PLEASE TYPE 'OR PRINT— ALL INFORMATION
1. Name of Applicant: �Y
Address:� Telephone:�5J�2 —C- 3
2. Owner of Property: d�
Address: .7 Telephone:
3. Status of Applicant: Owner Contract Purchaser Lessee
Other(explain):
4. Job Location: /:3
Parcel Id: Zoning Map# Parcel# District(s):
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/Property
6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary):
R
7. Attached Plans: Sketch Plan Site Plan Engineered/Surveyed Plans
Answers to the following 2 questions may be obtained by checking with the Building Dept or Planning Department Files.
8. Has a Special Permit/Variance/Finding ever be/en"issued for/on the site?
NO DON'T KNOW ✓ YES IF YES,date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO DON'T KNOW YES
IF YES: enter Book Page and/or Document#
9. Does the site contain a brook, body of water or wetlands? NO DON'T KNOW YES
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained Obtained ,date issued: _
(FORM CONTINUES ON OTHER SIDE)
FILE
r
PI NT/CONTACT PERSON: .�2 � y'
ADDRESS/PHONE: l `
PROPERTY LOCATION:
MAP - PARCEL: ZONE ,
THIS SECTION FOR�OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM MLED OUT
Fee pflod
Fee pnid 2
a49
THE,FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION- k
Approved as presented/based on information presented
Denied as presented:
Special Permit and/or Site Plan Required under: §
PLANNING BOARD ZONING BOARD
Received&Recorded at Registry of Deeds Proof Enclosed
Finding Required under:§ w/ZONING BOARD OF APPEALS
Received& Recorded at Registry of Deeds Proof Enclosed
Variance Required under: § w/ZONING BOARD OF APPEALS
Received&Recorded at Registry of Deeds Proof Enclosed
Other Permits Required:
Curb Cut from DPW Water Availability Sewer Availability
Septic Approval-Bd of Health Well Water Potability-Bd Health
Permit from Conservatio om is
Signature of Building Ins or Date
NOTE: Issuanoe 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 Publio Works and other applicable permit granting authorities.
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