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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations
NORTHAMPTON, MASS. 19 Additions
APPLICATION FOR PERMIT TO ALTER Repair
St- /� Garage
1. Location 102 J t-r,Jl R-4 9 9--,J Lot No.
2. Owner's name gn55C Address 9,yg�
3. Builder's name 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
9. Garage No.of cars Size
10. Method of heating
11. Distance to lot lines
12. Type of roof
13. Siding house
14. Estimated cost-
The ed certifies that the above statements are true to the best of his, her
kn wledge an) A L
' r
tie Signature o esp nseble app icant
Remarks Ui24� ijL"t�.,s.
n
e
10. Do any signs exist on the prop rty7 YES NO L/
IF YES,describe size,type and location:
Are there any proposed changes to or additions of signs intended for the property?YES NOS
IF YES, describe size,type and location:
11. ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE DENIED DUE TO
LACK OF INFORMATION.
This col— to be fi22ed in
by the Bui2d=g IJePnrtment
Required
Existing Proposed By Zoning
Lot size
Frontage
Setbacks - front
- side L: R: L: R:
- rear
Building height
Bldg Square footage
%Open Space:
Lot area minus bldg
&paved parking)
#
of -Parking Spaces
of Loading Docks
Fill:
(vol-iime--& location)
13 . Certification: I hereby certify that the information contained herein
is true and accurate to the best of my ledge.
.1
DATE: I- y, (f APPLICANT's SIGNATURE
NOTE: lasuanoe of a zoning permit does not relieve an applioants bur n to oomply with all
zoning requirements and obtain all required permits from the Board of ealth, Conservation
Commission, Department of Publio Works and other applloable perm granting authorities.
?!:„ FILE #
MAY 1 5 199
File No.
ZONING PERMIT APPLICATION (§10 . 2)
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant:__ -� JU�,(� I Jw^^t t
Address: '-5-Co l i tlt� -5�►" Telephone:
2. Owner of Property: V ecwj 5'Xj-
Address: i± / ��' �,} Telephone: ',(,' 6430
V
3. Status of Applicant: Owner Contract Purchaser Lessee
Other(explain):
4. Job Location: Iii =1V1140 Parcel Id: Zoning Map# _ Parcel#�l District(s):
(TO BE FILLED IN BY THE BUILDING DEPARTMENTI
5. Existing Use of Structure/Property
6. Description of Proposed rUselWork Droject/Occupation: /se)additioLnal sheets if necessary):
�l Nj�_��I�f'e�l�'dis.wl l✓i.�.[IL
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 PermitNadance/Finding ever bee
NO DON'T KNOW ever
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 ocument#
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 # U J
AV I' CONTACT PERSON:
ADDRESa/PHONE
PROPERTY LOCATION:
MAP PARCEL: NE.n�
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
Fee Paid
Addition tn Existing l r, ��
THE F
y&LOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION
Approved as preseuted/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
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 Commiss'
Signature of Building Inspec ffat4
NOTE:lssuanoe of a zoning permit does not relieve an appiioant's burden to oomply with all
zoning requirements and obtain ail required permits from the Board of Health, Conservation
Commission, Department of Publio Works and other appiioable permit granting authorities.
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