36-227 (3) E MIT I/eCppAT--II�O-- CHECK LIS
PAGE 73( PLOT 9dlZONE � J �l tc 7,/ P,, Ja,, YES NO DATE
1 . ZONING C IO !
2 . PERMIT
3 , OWNER OQCUPANT STATEMENT LICJ IF NOT Z--
3 SET S /PLQT PLAN
5 . NEW CONSTEUCTION
61 CURB CUT
7 WATER
8 . REMODELING
9 . ADDITION
10 , ACCESSORY STRUCTURE
11 , SIGN / AWNING
12 . PERMIT FEE - CHECK ONLY - MONEY ORDER C,
13 , SPECIAL REQUIRED WITH DEED IF APPLICABLE
14 . UNDER SECTION 7 - C R 780
15 , FORM
16 . FILL
COMMENTS :
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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations
NORTHAMPTON, MASS. �a�. 191t Additions
APPLICATION FOR PERMIT TO ALTER Repair
Garage
1. Location 5?- LANE Lot No.
2. Owner's name Z>A V I b t •SNC4L K jKI FA�E N Address S4M 9
3. Builder's name 0614. Address 409 000W CARIKS r0EW6
Mass.Construction Supervisor's License No. 0 3 1 2-49 Expiration Date 9/30 95—
4. Addition v O S F"
5. Alteration A-V 7— g4ld Stn S /�sb TL�� 1 q 2 51= CUcp�� s a F
6. New Porch k-F—7—ug j >C- , STi4-12S . �E�G� /3 o SF
7. Is existing building to be demolished? /JO
8. Repair after the'fire 01
/V _
9. Garage cd No.of cars Size
10. Method of heating_ faz UAT-m2
11. Distance to lot lines rp"tirr- 9') 5 S 1 D 6- ,SD
12. Type of roof 2 J[3 R 0Y2. , LSLYIf32�A�11[S
13. Siding house r-eb A-P— CIL 4-P60
14. Estimated cost-0 3 1 z Z,5d,
The undersigned certifies that the above statements are true to the best of his, her
`` knowledge and belief.
V�
Slgnarure of responsible appicant
Remarks
• (VIM
00357 `'
Date Filed File No.
ZONING PERMIT APPLICATION (910. 2)
I . Name of Applicant: 1,)EiL- doms.T-6 c
Address., _}off i1Jo72.�1- F',a-eeM,- PL:-_ -Telephone: 5''8'4-o
F4.o 2e7Vcr✓',, -M4 .
2 . Owner of Property: _t>"f D
Address:,5�Z 4.7ie�7 .t3c:�er2Y L-A. Telephone: 7SE-57•osfS�}
3 . Status of Applicant: Owner Y/Contract Purchaser
Lessee Other (explain )
4 . Parcel Identification: Zoning Map Sheet#,_ Parcel#,
Zoning District(s) (include overlays)
Street Address -�
Required
5. Exis-tincr Proposed by Zoning
{ Use of Structure/Property
(if project is only interior work, skip to #6)
Building height
!.-' Bldg. Coverage (Footprint)
Setbacks - front (1 d
- side L: 54 U L: 5U R: jo
- rear 1 '
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 work/Projegt: (Use additional sheets
if necessary) ,V&7t,) .SUA,)2o6r4j /R2 sF♦ 4�xrsZZL� p.1.A4-(2W 4wctoS6b
F V A 67 v DY/ % 92 sr) y ?eZoG,4-re 17 FcK ,0A) I s-' �_-c00p b.J?-, FL0VrE'
. ,4.M A �-�a_ ,D - 7<,, S?�i411�S
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:
THIS SECTION FOR OFFICIAL USE ONLY:
Approved as presented/based on information presented
Denied as presented--Reason:
Special' Permit and/or ite Plan Required:
Finding Re 'red: Variance Required:
e/zo/w
\
S, gnature o ul ding Inspector Da
NOTE: lssuanee of a zoning permit does not relieve an applicant's burden to comply with all zoning roquiroments and obtain all required permits
from the Board of Hoalth,Consorvation Commission, Dopaitmont of Public Works and oUwr applicablo permit granting authoritlos.
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