35-179 (5) PERMIT APPLICATION CHECK LIST
PAGE ���' PLOT j � ZONE �l r7 > U f _y ,' YES NO DATE
i-pP o
l . ZONING FORM APPLICATION 1 f4- `> -
2 . PERMIT APPLICATION z�
3 . OWNER OCCUPANT STATEMENT LIC . # IF NOT Jq,- (7 �-;1'616 6 ,
4 . 3 SETS OF PLANS /PLOT PLAN
5 . NEW CONSTRUCTION
6 . CURB CU
7 . WATER AVAILABILITY FORMS
8 . REMODELING INTERIOR
9 . ADDITION
10 . ACCESSORY- STRUCTURE
11 . SIGN AWNING
12 . PERMI FEE - CHECK ONLY - MONEY ORDER
13 . SPECIAL PERMIT REQUIRED WITH DEED IF APPLICABLE
14 . UNDER SECTION 127 - CMR 780
15 . FORM A
16 . FILL
COMMENTS:
1Y ,rn, «� �r •y I r F,� =
a > Q
b �
C �•
v bo' r
� � a
-h
E.
�• O
s c
v y
Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations
a NORTHAMPTON, MASS. i// ; 19`7'3 Additions
Repair
APPLICATION FOR PERMIT TO ALTER
Garage
1. Location 7 P1 Ale UAe-44�X 46 ." -AV`°oA Lot No.
G r-0 L.x Rs Ao;,U
2. Owners name )C,4'Y M O tJ D Sr-Id Address 7 PIN 1A Z_c A-7 -
3. Builder's name ZAP,11 y Ye�V r5c/&" Address 1'1 41g T r," YT/11 e-7` o e7 5
Mass.Construction Supervisor's License No. o Expiration Date
4. Addition
5. Alteration (`,f r-> ImM /04,Y4.. 1*,°,AVJ S a N0
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 A 5 P,a A
13. Siding house fl! ka in i4+✓o
14. Estimated cost:-
The undersigned certifies that the above statements are true to the best of his, her
knowledge and belief.
.„� i1 '
ignature of responsible app,ican!
Remarks
� �^ ^ \
��` ^ )
'Z-
0 0 0 99 01
V
Date Filed ✓, "10
File No.
ZONING PERMIT APPLICATION (910 . 2)
L
1 Name of Applicant :
Address :
—Telephone : 5 z'/ y o_"'
2 . Owner of Property: C te?
Address : Telephone : 6
3 . Status of Applicant : Owner Contract Purchaser
Lessee other (explain :
4 . Parcel Identification : Zoning Map Sheet# Parcel#
Zoning District (s) (include overlays)
Street Address-
Required
5 . Existinq Proposed -by Zoning
Use of Structure/Property
(if project is only interior work, skip to #6)
Building height
%Bldg . 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
43
if necessary) pu-l�toIC ��Lo 6AI fX157-111,
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 .
_A
Date : Applicant' s Signature :
- - - - - - - - - - -- -
THIS SECTION FOR OFFICIAL USE ONLY7.
Approved as presented/based on information presented
Denied as presented--Reason :
pecial' Permit and/or Site Plan Required :
4"�'l and/or OL
?in ing q red : Variance Required :
ZZ
t f
4cginatdl-�'e 'of Bu ng Inspector
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 Roard of Health, Conservation Commission, Depattmont of Public Works and othor applicable pormit granting authorities.
nn i.5'
ono '°,� � � o o y � °
x N
�p J
0 > '� O � O � � L1. (� O � •as 0 oo't�
ri 05
�u��u Q' En
�c �. �, 110 (D x
co
E CD W m y rI'r
ID
rt
° yL
cfl
y �, UQ
rl
o `°
C) o
o y
° ° ° cr ° LTI
p 5 Q � " " 0 5' N �
y 5 p 0 ►d d � J
5 w
H E� �
Z c ' , G� j w N p
Q 'n
vor � va p ° n cn ►rJ
y C7. C G R. G O' b� �yt 4 O N E O'rq V
CJQ
CD
o• o J p
CD
N
E
,� � s �,�� ��� F �� '� ��, �, fir �'3 �� ��"� •�"�a
M"
d
a
R�1
E§dsr p a"'� 8 x� r ;� ,•�� $,��', ��� c°�'�`.p%'�s t 9 ��. �e y �. "�.^ a��,. .� � �a fir€- k: ���ANC �a" t f
� 7XV ;
-
�� �
--
Q
a
r 4
r
x ;t
a
p
• �r
A
a
e
I, «w
� � f
a
t
i
s' �A
am
low
awm
Vol
orm
c