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Zoning
Miscellaneous Additions.Repairs,Alterations,etc. Tel.No. Alterations
NORTHAMPTON, MASS. 19 Additions
APPLICATION FOR PERMIT TO ALTER Repair
Garage
7
/Location 22 � uc z/�JJ -La/c /0 aGL'of No.
Owner's name S,�r�.� �J�',—J`�, Address
3. Builder's name � X�l!C-rl Address 0G
Mass.Construction Supervisor's License No. 4gggi& ,Ll ��_Expiration Date ��
4. Addition
5. Alteration S�/`i^r 4 / /- '
6. New Porch
?. Is existing building to be demolished?
8. Repair after the fire
9. Garage No.of cars Size
10. Method of heating
11. Distance to lot lines
12. Type of roof
13. Siding house
,rt stimated cost:- e
The undersigned certifies that the above statcments are true to the best of his, her
knowledge and belief.
t// \�'1 S�gnatu�e j�esponsible appicane
Remarks
Date Filed � v � � �
File No.
ZONING PERMIT APPLICATION (§i6. fl
n �
1 Name of Applicant:
Address : 110 Telephone: 6 ^E
q, aic
Owner of Propert .
Address : * C— z Telephone:
3 . Status of Applicant: Owner Contract Purchaser
Lessee Other (explain )
4 . Parcel Identification: Zoning Map Sheet# 3(' Parcel# Iii
Zoning District(s) (include 9�rer1 s) C I
Street Address 'ice [,Zlh
Required
5.
Exis tincr Pro nosed by Zoning
Use of Structure/Property
(if project is only interior work s)d'p to 6)
Building height
oBldg. Coverage (Footprint)
Setbacks - front
- side L: R: L:`
- rear
Lot size
Frontage.
Floor Area Ratio
. topen 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) r
.r .
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 . ZL5��
THIS SECTION FOR OFFICIAL UONLY:
Approved as presented/based on information presented
Denied as presented--Reason:
Special** Permit and/or Site Plan Required:
i ding a tu ' ed: Variance Required:
gn a of Buzl n c or ` Date
NOTE: Issuance of a zoning parrnit does not relieve an applicant's burden to comply willi all zoning requirements and obtain all required permits
from the Board of Hoalth,Conservation Commission, Department of Public Works and other applicable permit granting authorities.
PERMIT APPLICATION CHECK ,LIST
PAGE 3(- PLOT 87 ZONE WZ- gay, � A � �� ES NO DATE
1 . ZONING FORM L C IO
2 . PERMIT I
3 . OWNER OCCUPANT STAT EMENT LICA IF NOT �-
3 SETS OF PLANS /PLOT PLAN
NEW CONSTRUCTION
6 . CURB CUT
7 WATER
8 . REMODELING
9 . ADDITION
0 , ACCESSORY STRU
11 . SIGN / AWNING
2 , PERMIT FE - C - MONEY ORDER
70355 l-
13 . SPECIAL PERMIT REQUIRED WITH DEED IF APPLICABL
4 . UNDER SECTION 127 - CMR 780
15 . FORM A
6 . FILL
COMMENTS :
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