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PERMIT APPLICATION CHECK LIST
PAGE PLOT 2. - ZONE - ES NO DATE
1 . ZONING FORM APPLICATION L.
2 . PERMIT APPLICATION
3 . OWNER OCCUPANT STATEMENT LIC. # IF NOT
4 . 3 SETS OF PLANS PLAN
5 . NEW CONSTRUCTION
6 . CURB CU
7 . WATER V I I T FORMS
8 . REMODELING INTERIOR
9 . ADDITIO
10 . ACCESSORY STRUCTURE
11 . SIG AWNING
1 2 . PERMIT FEE - CHECK ONLY - MONEY ORDER `''
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. �'�j 6 S Alterations
NORTHAMPTON, MASS. 19 Additions
APPLICATION FOR PERMIT TO ALTER Repair
a
Garage
1. Location �R`�Ij3$2��► i Ar?& Lot No.
2. Owner's name 1"14(2&Z_ez' FE(e!2 I S Address 9 96y/ ig,( f 12y1 LAAlL
3. Builder's name mil= t2�434 )�` Address 3z Y IRi 51-
Mass.Construction Supervisor's License No. C> I `� Expiration Date
4. Addition
5. Alteration El&I 5H 3 R 5&,�J ELI t-
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 140T 1,16 1&{G
11. Distance to lot lines
12. Type of roof
13. Siding house
14. Estimated cost L.�'Vo o
The undersigned certifies that the above statements are we to the best of his, her
knowledge and belief.
'AAA tt
Signature of responsible app icant
Remarks
i q
r.� 002250
Date Filed File No.
ZONING PERMIT APPLICATION
I . Name of Applicant: —
Address: 3L ur sr-- Telephone:
2 . Owner of Property: I`JA12 G,EET p7&12)?1,5
Address : -F pp,., Telephone :
3 . Status of Applicant: Owner Contract Purchaser
Lessee Other (explain : _C,� ;-*yZ�q�± - -Z )
4 . Parcel Identification: Zoning Map Sheet# Parcel# Z ,
Zoning District(s) (include overlay ) �j
Street Address .r ,: ,.
Required
5• Existing Proposed - by Zonin
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)
57-21,-
•r
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: Applicant's Signature: ?
—T THIS SECTION FOR OFFICIAL USE ONLY:
`' Approved as presented/based on information presented
Denied as presented--Reason:
special' Per 't and/or Site Plan Required:
d' g Re u ' e variance Required: ,
gnatu 'Vu i1ding //Date,'
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 Board of Health,Conservation commission, Depattmont of Public Works and other applicable permit granting authorities.
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