36-018 (3) a
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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations
NORTHAMPTON, MASS. 1 q Additions
APPLICATION FOR PERMIT TO ALTER Repair
2 �—A Garage
1. Location �711 ,A�''A ef?7(`/'�,���,,mt t �� � �" Lot No.
2. Owner's name HALZX �tifW y Address
3. Builder's named II"l Address
Mass.Construction Supervisor's License No. �R Expiration Date
4. Addition
5. Alteration R� IQE l:�OL4T4 :FA6APF-
6. New Porch
7. Is existing building to be demolished? 1�b
S. Repair after the fire
9. Garage Q.&) No.of cars Size
10. Method of heating
11. Distance to lot lines
l2. Type of roof
13. Siding house
14. Estimated cosL-
The undersigned certifies that the above statements are true to the best of his, her
knowledge and befief. r
gnoture responsible app,icon!
Remarks
10. Do any signs exist on the property/? YES_ NO PIA
IF YES,describe size,type and location:
Are there any proposed changes to or additions of signs intended for the property?YES NO
IF YES,describe size,type and location:
11. ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE DENIED DUE TO
LACK OF INFORMATION.
This coltmm to be filled in
by the Enilding Department
Required
Existing Proposed By Zoning
Lot size
Frontage
Setbacks -frnnt
- side L: R: L: R:
- rear
Building height
Bldg Square footage
%Open Space:
(Lot area minus bldg
&paved parking)
of Parking spaces
of Loading Docks
Fill:
vol-time--& location)
13 . Certification: I hereby certify that the information contained herein
is true and accurate to the best of my knowled e.
_1.
DATE: '3- 12-( lo' APPLICANT'S SIGNATURE
NOTE: Issuan a o a zoning permit does not relieve applioant' burda to oomply with all
zoning requirements and obtain all required permits from the Eldard of Health, Conservation _
Commission, Department of Publio Works and other applicable permit granting authorities.
FILE #
a
Lt
2 0 1996 File No. C f.
DEPT Of BUILDING lN(S r;` ` ING PERMIT APPLIGA.TION (§10 . 2)
F,m NORTHAPAPTON,ktA Oi666 'PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant:
Address: 9A VVALN - r -5 Telephone:
2. Owner of Property: BA& (9�\(M
Address: 277 JD(ZV5l 4LON Telephone:
3. Status of Applicant: Owner Contract Purchaser Lessee
Other(explain):
4. Job Location: ?i?7 DL�;-T 4�a-LEo �rLIUC
Parcel Id: Zoning Map# _ Parcel# C/z District(s):
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/Property V-�i I I�e-�� lc <d `-
��a
6. Description of Proposed Use/Work/Project/Occupabon: (Use additional sheets if necessary):
R56I DF RUTH FACAPE-
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 Department Files.
8. Has a Special Permit/Vadance/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 YES
IF YES: enter Book Page and/or Document#
9. Does the site contain a brook, body of water or wetlands? NO K 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
j MAR 2 0 6%
Aj
1ACT PERSON: C yC `l '' rc% ✓
PROPERTY LOCATION:
MAP PARCEL: / ZONE
THIS SECTION FOR OFFICIAL USE ONLY:
PERNIIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED 0111
Fop PAid
Bvii1ding Permit Filled mit
�'' r.j
\ h
THE LLOWING ACTION HAS BEEN TARN ON THIS AP ICATIOM
Approved as presented/based 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:§ w/ZONING 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 Co a tion Corn Ion
- 2
Signature of Building hispectoyll, Date
NOTE:lssuanoa of a zoning permit does not relieve an applioant's burden to oompty with all
zoning requirements and obtain all required permits from the Board of Health, Conservation
Commission, Department of Publio Works and other appiioable permit granting authorities. —
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