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Date Filed File No,
, .L i lorrx?rc� FAM111 APPnICATION
'C, Ioni.ng
6.x(I i11 a1)c0 SeGi ion 10 , 2
1 , Name of A )ID IJ.cant ; __Lv --, � Pr`l _
_<
Addr. e s s ; _ A� f Telephone :
2 , Owner. of Prover. t:y ;
Addr. ess ; ,Cow, Telephone :
3 , Status oi.' A)D0..1 i.cant. ,/c'on'tract Purchaser
LQss0C. Other (explain : )
q ,
Parcel Ident.i.f i cati^on ; :Zoning Map Sheet# 36 Parcel' 14)4 ,
Zoning District ( s) � U lam` Y3
Street Address v 12
5 , Compliance• with Zoni.nu ; Existing Proposed
Use of Structure/Property ON e h. M (e
Size of Structure (sq , ft . cj /may
Building height _ _ I -) �
-o Building Coverage
Setbacks - f. •ont 0 `
side i?�+ hx �;0* `✓`�! `C¢
{1 - rear
Lot Size
Frontage
1�L_
Floor Area Ratio T �c Z 2 y S' SAS C7-
% Open Space
Parking spaces
Loading Spaces
signs
Fill (volume & location)
6., Nargatieve Description of Pr. onosed Work/Pro� ectf (Use '
addita final sheets if necessary) O e CA
O jYt
7Y Attached Plans ; y _ sketch Plan Site Plan
8 , Certification ; 2 hereby certify that the ih�ormation, contained
herein is true and accurate to the best of my knowledge ,
Date : r Js_ l/ Applicant ' s Signature :
THIS - SECTION�FOR�OrrICIAL USE ONLY- _ y _ _ _ - _ _ _
'Approved 'as presented
Denied as presented
Reason for Denial :
Y
Signaure of building :inspector. , Date. y l��
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Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations
so NORTHAMPTON, MASS. j / 19 Additions ,(APPLICATION FOR PERMIT TO ALTER Repair
Garage_ L-
1. Location i" 1�- tr/ J?R Lot No.
2. Owner's nameTa 'r in )-?n1(_) Address -,2 j c Az f 5; i , P i2
3. Builder's name J)Q l 1) Address I� P, 7 �� �llt�ic, M A,
Mass.Construction Supervisor's License No. 7 / Expiration Date O T -
4. Addition (_77
5. Alteration
6. New Porch
7. Is existing building to be demolished?
8. Repair after the fire )(i d
9. Garage 6-f-,
f No.of cars e.,- e (! Abt Size
10. Method of heating
11. Distance to lot lines
12. Type of roof E i-T(,), le C
13. Siding house V i w >)
14. Estimated cost:-
The undersigned certifies that the above statements are true to the best of his, her
i I knowledge and belief. / X
✓fL U�{. / \—`777 Signature of responsible applicant
Remarks
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