35-207 (9) PERMIT APPLICATION CHECK LIST
PA E 5 PLOT , ZONE ES NO DATE
1 . ZONING FORM LI IO
2 . PERMIT P I
3 . OW 0 �-
4 . 3 SETS OF S PL N NEW CONSTRUCTION
6 . CURB CUT
7 WATER S
8 . REMODELING INTERIOR 1
I
9 . ADDITION
10 , ACCESSORY STRUCTURE
11 , SIGN AWNING
12 . PERMIT FE - - - MONEY ORDER
13 . SPECIAL PERMIT REQUIRED WITH DEED IF APPLICABLE
4 . UNDER SECTION 127 - C R 780
15 . FORM
16 . FILL
COMMENTS :
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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Zg Alterations
NORTHAMPTON, MASS. ze& 19 y Additions
' Repair
• APPLICATION FOR PERMIT TO ALTER
Garage
1. Location M Lot No.
2. Owner's name,Tp�,E
3. Builder's name
Mass.Construction Supervisor's License No. 046�>6 2=:�k Expiration Date
4. Addition
5. Alteration
6. New Porch L
7. Is existing building to be demolished?
8. Repair after the fire
9. Garage — No.of cars Size
10. Method of heating 14QAIEf---
11. Distance to lot lines W.2 WAA(&
12. Type of roof �%��(i�
13. Siding house
14. Estimated cos "j C7o�- C7
The undersigned certifies that the above statements are true to the best of his, her
knowledge and lief.
Signatur of responsible app cant
Remarks ��C„�Ti �� �F._Glc. �6j� L C, �zF� 2 //is�
1�2c-1 w<LL c y7'�Llticr, f ohl A!�;�rr4- 6P-A(C�
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Date Filed r 0 0 6 "10
File No.
ZONING PERMIT APPLICATION (§i0.fl
I. Name of Applicant: �i((f
Address: 7,W L ,�` �
Telephone:
2 . -Owner of Property: .q CL
Address: g - Telephone:
3 . Status of Applicant: Owner C ntra t Purchaser
Lessee Other (explain
4 . Parcel Identification: Zoning Map Sheet# a.5 Parcell ..; %o
Zoning District(s) (include ove lays) SR
Street Address �! -
Required
5• Existin /, Pro nosed by Zonin
Use of Structure/Property
(if project is only interior work, sk&p t #6)
Building height
%B1dg. Coverage (Footprint)
Setbacks - front -F t
- side L:�jfiR: L: R: cif
Lot size - ream
Frontage.
Floor Area Ratio
• %Open Space (Lot area minus
building and parking)
Parking Spaces
Loading
Signs
Fill (volume & location) _
6. Narrative Descriptio of Proposed Work/Pro, e t: (Use additional sheets
if necessary) e
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:
- - - - - - - - -
THIS SECTION FOR OFFICIAL USEfONLY:
//
{/Approved as presented/based on information pr esented
Denied as presented--Reason:
Special'* Permi and/or Site Plan Required:
ndi Requ ' ed• Variance Req ired:
�S gnatur o,,f' ilding or D e
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,Department of Public Works and other applicable permit granting authorities.
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