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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations
NORTHAMPTON, MASS., 19—Z,/,
Additions
APPLICa ATION FOR PERMIT TO ALTER Repair
Garage
1. Location 1 /r 1 Lot No.
2. Owner's name /YI Y, 11 s Address
3. Builder's name /AiVC ` Addle sl�� .�Z�E� C�f, 7
Mass.Construction Su rvisoo�r''s License No. e'd6236) `� Expiration Date
4. Addition 162 (,?�� f',►''f -S tr7�5c- 56201"L
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 ")/,o _
12. Type of roof /7 11 C// tf 4,U � 2,t.�►L
13. Siding house &j 51 4.) LS L^
14. Estimated cosL-
The undersigned certifies that the above statements are true to the best of his, her
knowledge and belief.
Signature of responsible app,icant
Remarks
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 col— to be filled in
by the Building Department
Required
Existing Proposed By Zoning
Lot size -i
Frontage
Setbacks - front
- side L: R: L: r�R•
- rear
Building height
Bldg Square footage
'Open Space:
(Lot area minus bldg
&paved parking)
-Parking Spaces
Loading Docks
time--& location)
r
rtification: I hereby certify that the information contained herein
true and accurate to the best of my knowledge.
APPLICANT's SIGNATURE
uanoe of a s zoning permit doe not relieve an applioants urden to comply With, �1
iuirementa and obtain all required permits from the Board of Health. Convervation
►n. Department of Publio Works and other applionble permit granting authorlties::
FILE #
DEC 171996
File No.
ZONING PERMIT APPLICATION (§10 . 2)
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant: AMC lAh'
/J
Address: - 2 ' � L J;O Telephone: .5���. 7S-d
2. Owner of Property:
Address: c? o4- Telephone: Itf6 712 V
3. Status of Applicant: Owner Contract Purchaser Lessee
Other(explain):
4. Job Location: n2 ?Z
Parcel Id: Zoning Map# Parcel# c,9/-5/ District(s): 7�5/C')/�)
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/Property S)
6. Descri ptiR n of Proposed U eNVork/Project/Occupation: (Use additional sheets if necessary):
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 issued 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 DONT KNOW YES
IF YES: enter Book Page and/or Document#
9. Does the site contain a brook,body of water or wetlands? NO c� 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 # t , 3 07 �V
t � I �
DEC 1 7 1996
APPLICANT/CONTA T PERSON: "Wvs&
ADDRESS/PHONE:/,e-),/) RA—VI
PROPERTY LOCATION: pC Lp'J211 °Y71 y
�I�GGI�
MAP (p PARCEL: /' ZONE
THIS SECTION FOR-OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM MLED OITT
'Rivilding Permit Filled plit
— �
Fee Paid Addition to Existing G t'—y—
O 0 CJZ)
THE LLOWING ACTION HAS BEEN TAKEN ON THIS AP ICATION:
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
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 m'ssi
Signature of Building Inspeor IYate
NOTE: Issuanoe of to zoning permit does not relieve an applioant's burden to oompty with all
zoning requirements and obtain all required permits from the Board of Health, Conservation
Commission, Department of Publio Works and other applionbie permit granting authorities.
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