35-194 (3) PERMIT APPLICATION CHECK LIST
PAGES PLOT �j�ZONE YES NO DATE'
1 , ZONING FORM APPLICATION
2 . PERMIT I
3 . OWNER OCCUPANT NOT
4 . 3 SETS OF S PLAN
5 . NEW CONSTRUCTION
6 , CURB CUT
7 , WATER V S
8 , REMODELING
9 . ADDITION
10 , ACCESSORY STRUCTURE
11 . SIGN AWNING
12 , PERMIT FEE- - - MONEY 0
13 . SPECIAL PERMIT UI ED WITH DEED IF APPLICABLE
14 . UNDER SECTION 127 - C R 780
15 . FORM A
16 , FILL
COMMENTS :
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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. � Alterations
a NORTHAMPTON, MASS. ` 191 ._ Additions
APPLICATION FOR PER IT TO ALTER Repair
Garage
1. Location ���� �z f /4 � Lot No.
2. Owner's name � i��1 Address____
3. Builder's named /%t�/UZ4e6 i Imo/ rim = Address f 4j4�'� /'�'l�Y A
Mass.Construction Supervisor's License No. _—Expiration Date -7 ZI(,AQa_
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 .9/�V Ad?ky/
13. Siding house
14. Estimated cost:-
:
The undersigned certifies that the above statements are true to the best of his, her
` �j knowledge and belief.
Signature of responsible app ant CSC
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Date Filed X7 3 File No.
ZONING PERMIT APPLICATION (910 . 2)
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1 . Name of Applicant: C/Y�/ •�� �/j,-f� ui �� ��
Address : Telephone:
2 . Owner of Property: A40,e� f'
Address : �2 weYZK0,4K Telephone : 57& - e-)l
/Y0"t w �r /; Contract
3 . Status of Applicant: Owner Contract Purchaser
Lessee Other (explain: )
4 . Parcel Identification: Zoning Map Sheet# ?� Parcel#
Zoning District(s) (include ove ays
Street Address
�,�
Required
5. Existing /7 Pro nosed by Zoning
Use of Structure/Property -fit e
(i£ 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)
r ;2
7 . Attached Plans : Sketch Plan Site Plan
8 . Certification: I hereby certify that the information contained herein
is true an accurate to the best of my knowledge.
Date : C- ? Applicant' s Signature:
THIS SECTION FOR OFFICIAL USE (YNLY:
Approved as presented/based on information presented
Denied as presented--Reason :
S cial' Permi and/or Site Plan Required:
n Requ ' ed' variance Re tui'red:
0V
gnature Building r l(J `Iq rfa t
NOTE: issuance of a zoning pe it does not reliove an applicant's burden to comply with all zoning requirements and obtain all required permits
from the Board of Health,Conservation commission, Depaitmont of Public Works and other applicable permit granting authorities.
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