36-010 (2) t M c -�
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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations
a NORTHAMPTON, MASS. 19 Additions
APPLICATION FOR PERMIT TO ALTER Repair
r
r-- Garage
1. Location_, �<.I e—A G6(,., L e , 1-o Lot No.
2. Owner's name j W101 S Address C,!- &i:�c d Gl a. pn
3. Builder's name_ DVC_1 ' '.tli Lpn-J Address
Mass.Construction Supervisor's License No. /��2r(a /!pl4l Expiration Date 1L;9– 2-2
4. Addition
5. Alteration <4P(4-am) ArJ Dq
6. New Porch 2(
7. Is existing building to be demolished? A)Q
8. Repair after the fire ti D
9. Garage iiC-s' No.of cars 1 Size
10. Method of heating
11. Distance to lot lines 1
12. Type of roof t-iri P� 0
13. Siding house bk i��d
14. Estimated cost:-.I
The undersigned certifies that the above statements are true to the best of his, her
knowle ge and f.
Signature of res ible app icant
Remarks A/1 AS JJC /JC � T Sl� �•�,/ S S
10. Do any signs exist on the property? YES NO
IF YES, describe size,type and location:
Are there any proposed changes to or additions of signs intended for the property? YES NO 1`
IF YES,describe size,type and location:
11. ALL INFORMATION MAST BE COMPLETED, or PERMIT CAN BE DENIED DUB' To
LACK OF INFORMATION.
Thi- c07— to be filled in
by the Rmi.lding Departwent
Required
Existing Proposed By Zoning
Lot size
Frontage
Setbacks - front
- side `
L: a R: ?(3 L: R:
- rear /od
Building height )6'
Bldg Square footage A✓,� },y /lo o
%Open Space: A� pik 3�
(Lot area minus .bldg`
&paved parking)
#, 0f -Parking spaces
# %. f Loading Docks
Fill:
'4vol-time--& location)
13 . Certification: I hereby certify that the information contained herein
G is true and accurate to the best of my knowledg
DAVE: - APPLICANT's SIGNATURE�_L )1211
NOTE: Issuanoe of a zoning permit does not relieve an applioanva bur en �tao&ompty with all
zoning requirements and obtain atl required permits from the Board of Health, Conservation .
Commission, Department of Public Works and other applicable permit granting authorities.
`:`. „ FILE #
APR 9
File No
�z6jO -ING PERMIT APPLICATION (§10 . 2)
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant: Qy o / J,�x 1'\A0,Vt(7
Address: /L_ C t- L? r -1 to Telephone: (j 4LI _,q c� Y 0
2. Owner of Property: .���ca2�
Address:�� _OA SA (K r_ ,. Telephone:
3. Status of Applicant: Owner Contract Purchaser Lessee
I
�( Other (explain): Cihierglyz
4. Job Location: ( �� , R J LE r7
Parcel Id: Zoning Map# s _ Parcel# C'% District(s):
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/Property �j_)h � S
6. Description of Proposed UseA'Vor roject/Occupation: (Use additional sheets if necess ) 1
-ain tgC JZ1. H
7. Attached Plans: Sketch Plan Site Plan Engineered/Surveyed Plans
Answers to the following 2 questions may be obtained by checking with the Building Dept or Planning Departrnent Files.
8. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO DON'T KNOW YES IF YES,date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO DON'T KNOW k YES
IF YES: enter Book Page and/or Document#
9. Does the site contain a brook, body of water or wetlands? NO i1 DON'T KNOW YES
IF YES,has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained Obtained ,date issued:
(FORM CONTINUES ON OTHER SIDE)
_ FILE #
vn l
AP* " JNT'ACT PERSON.
ADDRESS/PHONE.rin
PROPERTY LOCATION:
MAP PARCEL: ZONEC�.
THIS SECTION FOR OFFICIAL USE ONLY:
PERNUT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
Addition to Eirisfing
D,�ner/Drrnpnnt Statement
THE F OWING ACTION HAS BEEN TARN ON THIS AP ICATION:
pproved as presentedibased on information presented
Denied as presented:
Special Permit and/or Site Plan Required under: §
PLANNING BOARD ZONING BOARD
Received & Recorded at Registry of Deeds Proof Enclosed
Finding Required under:§ w1ZONING BOARD OF APPEALS
Received& Recorded at Registry of Deeds Proof Enclosed
Variance Required under: § w/ZONING BOARD OF APPEALS
Received&Recorded at Registry of Deeds Proof Enclosed
Other Permits Required:
Curb Cut from DPW Water Availability Sewer Availability
Septic Approval-Bd of Health Well Water Potability-Bd Health
Permit from Conservation Comm' I
0.
zz 9
Signature of Building Inspec Date
NOTE:Issuanoa of at zoning permit does not relieve an appiloanYs burden to oompty with all
_ zoning requirements and obtain atl required permits from the Board of Health, Conservation
Commission, Department of Publio Works and other appitoable permit granting authorttles. _
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