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/ r /�/ Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. y c- 7J Alterations
NORTHAMPTON, MASS. - 19 ef�l Additions
Repair
APPLICATION FOR P RMIT TO ALTER
(Garage),--:i4 61.-
1. Location 167q Lot No.
2. Owners name Address 7 r' 7t� '
3. Builder's name I,, Address
Mass.Construction Supervisor's License No. Expiration Date
4. Addition
5. Alteration
6. New Porch
7. Is existing building to be demolished?
8. Repair after the fire
No.of cars Size
10. Method of heating
11. Distance to lot lines
12. Type of roof
13. Siding house
14. Estimated cost:-
The undersigned certifies that the above statements are true to the best of his, her
knowledge and belief. /
l Signature of responsible applicant
Remarks
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D8PAA'rMSN'1' O1+ BU1LDINO 1NSPEarIONS
212 Main Stroet ' Alunicipnl Building '
INSPECTOR Northampton, Mass. 01060
AS A HOMEOWNER I UNDERSTAND THAT I MAY APPLY FOR AND RECEIVE
A BUILDING PERMIT FOR A HOME OR ADDITION I INTEND TO LIVE IN,
I ALSO UNDERSTAND THAT I AM RESPONSIBLE FOR KNOWING THE STATE
BUILDING CODE AND ZONING ORDINANCE OF THE CITY OF NORTHAMPTON,
BEING A.HOfr1ErOWNER AND NOT A PROFESSIONAL CONTRACTOR IN NO WAY
ABSOLVES ME OF ANY RESPONSIBILITY TO INSURE THAT ALL FACETS
• OF THE RULES AND REGULATIONS ARE COMPLIED WITH.
� <- C' File Nq•, ,
Date riled , - •
ZONING PER141T APPLICATION
Zoning ord,i/n�a/nce Sebtion 10 . 2�
]. . Name of Applicant : / L. ���� ✓`
Address : r • a / Telephone : .✓ /
2 Owner of Pr.operty ; J 0/,=
Address : 0'7° aLj ' Telephone : _
3 Status of Applicant ; O"iner. Contract Purchaser
Lessee Other (explain : )
4 . Parcel Identification : ,Zoning. Map Sheet#._ ,�r� Parcel# ,
Zoning Districts) '
Street Address
Y
5 . Compliance' with Zoning : -Existing Proposed
Use of Structure/Property
Size of Structure (sq . ft , )
Building height
Building Coverage
Setbacks - front ' 'r
01- ..side
(� - rear
Lot Size
Frontage
Floor Area Ratio
k Open Space
Parking Spaces
Loading_ Spaces
signs .,
Fill (volume & Location)
6., Margaatite Description of 'Proposed Work/Project ; (Use ,
addit�dnal sheets if..necessary)
7 , Attached Plans : Sketch Plan Site Plan .
a , Certi€ica• ion ; I hereby certify that theih�grmation, contained
herein is true and accurate to the bes of my .knowlgdge ,
a
Date 5_1�< _ Applicant ' s Signature : �� �T -t'
TH2S�— - -N^FOR OFFICIAL USE ONL`l^ -- - - - - - _ ... ... ... .. _
LIZ. -Approved as presented
Denied as presented
Reason for Denial ;
'Y
Signature of Building Inspector, _� Date
1.
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