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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations
NORTHAMPTON, MASS. (Jw 8 19-26
Additions
4
% �!
' APPLIa CATION FOR PERMIT TO ALTER Repair
Garage
1. Location Z-- W o c,D5 o t D o 0-1' 00-F- oiQ Lot No.
2. Owner's name -DON tq i C.L Y Address 3 Z FOODS 11.OY470
3. Builder's name k6g>1kT ttNt4 '$1k 1'L�W�L-C_ Address 44L
Mass.Conswcuo Supervisor's License No. Expiration Date t0
4. Addition
5. Alteration �e�Use tZ S�o►� o-- o t`l k�vJ iStk� It" a y V Il�l4o i i tom: 0.("m.
6. New Porch
7. Is existing building to be demolished?
8. Repair after the fire
9. Garage No.of cars Size
10. Method of heating zib re-%p a oo'E lJ�E+t►2
11. Distance to lot lines
12. Type of roof
13. Siding house ,,{�
14. Estimated cost:- 1N li-1 0O 0 , 100
The undersigned certifies that the above statements are true to the best of his, her
knowledge and belief.
Signature of responsible app,icant
Remarks
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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
IF YES,describe size,type and location:
11. ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE DENIED DUE TO
LACK OF INFORMATION.
This colvma to be filled in
by the Building 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)
.0-f-Parking Spaces
of Loading Docks
Fill:
'4trol-time--& location)
13 . Certification: I hereby certify that the information contained her
is true and accurate to the best of my knowledge.
DME: - `� APPLICANT's SIGNATURE
NOTE: Isau no of a zoning permit does not relieve an ppli ant's burden to oomp with all
zoning reci ire ents and obtain all required permits f m t e Board of Health, Conservation
Commission, Department of Publio Works and other apoUsirmbla permit granting authorities,
L) FILE #
File
ZONING PERMIT APPLICATION (§10 . 2)
PLEASE TYPE OR PRINT ALL -INFORMATION
1. Name of Applicant: ) (Jpf� J&N
-t-4- V_t
Address: y`�"t')
Telephone: 2�� O Z�
2. Owner of Property: UJ i t ' �.
Address: (Telephone: y 7d E
3. Status of Applicant: Owner Contract Purchaser Lessee
_Other(explain): Ca,' =6t&c-74O 01--
4. Job Location- 3 Z Weeds PC �
Parcel Id: ; Zoning Map# - air Parcel#_ .j a District(s):
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/Property
6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary):
t
`LrZvq
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/Variance/Finding ever been ' ued 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 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 # 9 G!15 3 ''�
2 4 1996
APPLICANT/CONTACT PERSON: ,t;40
ADDRESS/PHONE:
PROPERTY LOCATION: ,,�,( �'1
MAP PARCEL: ,_57 C;� ZONE
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM MLED OUT
Building Permit Filled 011t
Addition t
ArrPSCnry Strnrtime
i-�
TI ,E LOWING ACTION HAS BEEN TAKEN 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
I/
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 C mission
Signature of Bui ect to
NOTE: lasuanoa of at zoning permit does not relieve an appiioant's burden to oomply with all
zoning requirements and obtain all required permits from the Board of Health, Conservation
Commission, Department of Publio Works and other applicable permit granting authorities.
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