35-180 (3) PgRMIT APPLICATION CHECK
PA' ZONE YES N O ATE
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0 WNER-- OCCUPANT STATEMENT �:ilF NOT '
A, 3 SETS OF PLAN� /PLQT PLAN
NEW CONSTRUCTIQN
6 CURB CUT
FORMS
8 . REMODELING INTERIOg
9 ADDITION
10. ACCESSORY STRUCTURE
SIGN / AWNING
12 , PERMIT FEE CHECK ONLY g" 15_Z.� 2 1
3 , SPECIAL - PERMIT UI IF APPLICABLE
4 . UNDER g
5 FORM
6 , FILL
COMMENTS:
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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations
4
NORTHAMPTON, MASS. 19 Additions
APPLICATION FOR PERMIT TO ALTER Repair
Garage
1. Location 0- (T— F10! PAC.1Z Lot No.
2. Owner's name IT r,5, 1� L ,n o �'G�t�Q� Address "R i-YU L)a–&, ic
3. Builder's name Z),)Y►Pi t✓t. o SkA Address �01Ac)C.K 5T Lc-c-,(Q
Mass.Construction Supervisor's License No. 0 3 Expiration Date � �5�
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
I2. Type of roof
13. Siding house
14. Estimated cost:-
60 The undersigned certifies that the above statements are true to the best of his, her
knowledge an belief
i
7 Signature of responsible appucant
Remarks WlOL�U
00 `'5
Date Filed q File No.
ZONING PERMIT APPLICATION (910 . 2)
1 . Name of Applicant: ` h/01 w S q
Address :__ 5 rnLC.,LJ/ LW d� Telephone:
2 . Owner of Property: VYV7t> Lq-)
Address : (> Telephone:
3 . Status of Applicant: Owner Contract Purchaser
Lessee Other (explain: )
4 . Parcel Identification: Zoning Map Sheet# 5 Parcel#
Zoning District (s) (includ uer;l5ys)
Street Address V2
Required
5 . Existincr Fro posed 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 of Proposed Work/Project : Use additional sheets
if necessary) e nr 62a �, ti rl
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: , ' c Applicant's Signature: c�
ZApproved T H S I SECTION FOR O FF A U ICIL SE ONLY as presented/based on information presented
Denied as presented--Reason:
S ecial- Per and/or Site Plan Required:
ftirg Req re Variance Required:
Srgnaturdoof uildin ector ' t
NOTE: Issuance of a zon unit 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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