35-236 (7) PERMIT APPLICATION CHECK LIST
PAGE' PLOT ONEW ES NO DATE
1 . ZONING FORM APPLICATION
2 . OERMIT APPLICATION
3 . OWNER CCU 0
4 . 3 SETS OF S PLAN
''�
5 . NEW CONSTRUCTION
6 . CURB CUT
7 WATER FORMS
-
8 . REMODELING
9 . ADDITION
10 , ACCESSORY STRUCTURE
11 , SIGN / AWNI
12 . PERMIT FEE - MONEY O D y
13 . SPECIAL PERMIT UI ED WITH DEED IF APPLICABLE
14 . UNDER SECTION 127 - C R 780
15 , FORM
16 , FILL
COMMENTS :
WMWA J-
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JOB
JEFFREY BOTT CONTRACTING CO. SHEET NO.
32 Pine Street CALCULATED BY DATE
FLORENCE, MA 01060
(413) 584-9269 CHECKED BY DATE
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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. FS�>y �rd-5 Alterations
az"""'PTO1 NORTHAMPTON, MASS. 10 /� 19'13. Additions
APPLICATION FOR PERMIT TO ALTER Repair
Garage
1. Location J�/1 C.,4n4_7y Lot No.
2. Owners name MS � t5 UiJE I M�4tfy+��` r=Addr ss_ 'EY441 BL,e (_
3. Builder's name JEf-__FrZE 4 T�S,0 )T Address_3,12: 'P1 J.C-:
Mass.Construction Supervisor's License No. —Expiration Date 1�1 �
4. Addition
5. Alteration 1 B_ 1,P i H V P 12.DD WIN I k! Gigf?16t 6 E_ �L.) M OAA rr-)-. J 1(.(J LA C1
6. New Porch /J 0 _
7. Is existing building to be demolished?
8. Repair after the fire A)O
9. Garage A,)0 No.of cars Size
10. Method of heating Am- lJ qT:�-fr
11. Distance to lot lines C
12. Type of roof t=1 BB?r GC.A 55 I.YJ
13. Siding house CF-pkzc ,c,1,1} c)V�12�
14. Estimated cost:- q13 H
The undersigned certifies that the above statements are true to the best of his, her
1 '1 knowledge and belief. 4-
S 8 n e esponsible appicant
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Date Filed File No.
ZONING PERMIT APPLICATION (910 . 2)
1 . Name of Applicant: �TD? f?Bj f5'07r
Address : ?`Z >,yg -�- Telephone:p 5 y
2 . Owner of Property: )1S.
Address : �_- /1 /�2 Telephone : 6F;'
3 . Status of Applicant: Owner Contract Purchaser
Lessee Other (explain:
4 . Parcel Identification: Zoning Map Sheet# S � Parcel# � 7,
Zoning District (s) (include overla
Street Address G Zc °z d,
Required
5. Existinq Pro Dosed by Zoning
Use of Structure/Property t
(if project is only interior work, kip 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) jE;yi(,o Iq /A/ Tf1,7-,
L L_Ir
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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 : (a) `3 Applicant's Signature : AL_ r_01�1
THIS SECTION FOR OFFICIAL USE ONLY:
li Approved as resented based on information resented
p / p
Denied as presented--Reason :
S ecial' Pe it and/or Site Plan Required :
i ' g ed: variance Required:
gnatu of Buil nspector 7mcnu NOTE: Issuance of a zoning permit does not relieve an applicant's burden to comply with all zoning roqui 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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