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36-113 (3) PERMIT APPLICATION CMCC�C LIST L YEs NO DATE PAGE ? PLOT �� '� ZONE iK �c � r%�r t r , 1 ZONING FORM APPLICATION i -7 2 , PERMIT APPLICATION 3 OWNER OCCUPANT STATEMENT / LIC tt IF NOT 4, 3 SETS OF PLANS /PLOT PLAN 5 NEW CONSTRUCTION - 6 , CURB CU — 7 . WATER AVAILABILITY FORMS 8 , REMODELING INTERIOR 9 ADDITION 10 . ACCESSORY STRUCTURE 11 SIGN / AWNING 2 ER I FEE - CHECE ONLY - MONEY ORDER -11--6- 4;q � 3 `' /�-7 Iq 13 SPECIAL PERMIT REQUIRED WITH DEED IF APPLICABLE 15 , FORM A _ 16 , FILL — COMMENTS ; a Y o c a v b o r a E. M 77 (o Z a C; O 1 � Zoning Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. y — 3 2 y/ Alterations a NORTHAMPTON, MASS. �r .� `� 19 .3 Additions APPLICATION FOR PERMIT TO ALTER Repair Garage 1. Location 10 L3 h G D kg f 01�,0 C i r C/-f-- Lot No. 2. Owners name / d r i QL S Tz° k/ a- r-T Address j 7 s r©a 3. Builder's name r e r df /t,,' Address !2/ C Li*-S 7-A/117- sZ77 FL d Mass.Construction Supervisor's License No. ® / y a?2/ Expiration Date 4. Addition AZ J 5. Alteration /l!e R/ f" a o --Y 6. New Porch_ Al I) 7. Is existing building to be demolished? JV 4 8. Repair after the fire 9. Garage_ 41 No.of cars Size 10. Method of heating 11. Distance to lot 11 es 12. Type of roof 60 — &e lje:!� L.ASS S w 9 S 13. Siding house l4. Estimated cost:- �D 4 0 The undersigned certifies that the above statements are true to the best of his, her knowledge and belief. ��r (r Signature of responsible app,icant Remarks faxe.' 001150- Date Filed �S File No. ZONING PERMIT APPLICATION (§10 . 2 ) 1 . Name of Applicant: 0,44- t� Address : I/ C 11 ,r_., S y-- ,61 T- En L_p 5 ephone: 2 . Owner of Prope�rty:_ Q10,r Address : 7 S�e fJ�- 1 Te lephone ;s � � S S YQ_S 7 3 . Status of Applicant: Owner Contract Purchaser Lessee Other (explati.n t ) 4 , Parcel Identification : Zoning Map Sheet# '3(o Parcel# Zoning District (s) (include erl ys) ,�, tkkf+- Street Address �-7 r Required 5 . Existing i Pro nosed by zoning Use of Structure/Property w-, (if project is only interior-' war , tbkip o #G) Building height %B1dg. Coverage (Footprint) Setbacks - front - side L: R, L: R: - rear Lot size Frontage Floor Area Ratio %Open Space (Lot area minus building and parking) Parking Spaces Loading Signs Fill (volume & location) 6 , Narrative Description of Proposed Wor)c/Project : (Use additional sheets if necessary) ,� _� iN f- a / 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 : --T -/- - - - _ - -THIS SECT O IN `OR 0fFfCI A L US E ONLY: - - - - - - - - - Approved as presented/based on information presented Denied as'presented--Reason : S ecial' Permit and/or Site Plan Required : ng R u ' ed: _ Variance Required ; gnatu o - Bui ec or - -- �" to NOTE: Issuance of a zoning peril 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, Dapartmonl of Public Works and other applicable permit granting authorities. ! i �� r+ n won owo owe � Q � z cn � o � OtE � � d A�e r � N y N OD v - O w CD CD o A b g t7 b C� Q CD f �l CD