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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations
1 NORTHAMPTON, MASS. �? _19 � Additions
APPLICATION FOR PERMIT TO ALTER Repair
Garage
1. Location G-,body Lo No.
2. Owner's name s J� U�fxf Address_ �1.14g/%lS
3. Builder's name � �Ctif . � �<' '���y Address .
Mass.Construction Supervisor's License No. L3/3 i el l _Expiration Date
4. Addition
5. Alteration ��/ v�%
6. New Porch
7. Is existing building to be demolished?
8. Repair after the fire
9. Garage No.of cars Size
l0. Method of heating
l 1. Distance to lot lines
l2. Type of roof
13. Siding house
14. Estimated cost:-
The undersigned certifies that the above statements are true to the best of his, her
knowledge and belief.
Signature of responsible 6 I Iant
remarks Ski r,G� F'.C'fS�` ra7lGYI <�
Or
79
10. Do any signs e)dst 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.
rhta column to be filled to
by thr Bulldln9 Department
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 I
# of Loading Docks
Fill:
(volume & location)
13 . Certification: I hereby certify that the information contained herein
is true and accurate to the best of my knowledge.
Date:- Signature: C
NOTE:Issuance of a zoning permit does not relieve an applicant's burden to comply with all zoning requirements
and obtain all required permits from the Board of Health,Conservation Commission,Department of Public Works
and other applicable permit granting authorities.
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�UL 3 199 k File No. �9J
��� 2:ffRK1T. APPLICATION (§10. 2)
NIM
LEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant: ' .�
Address: ���fr? '��'G��� �. Telephone:
2. Owner of Property: � 4'
Address: YTS` < � Telephone:
3. Status of Applicant: Owner G_�ontract Purchaser__Lessee
Other (explain):
4. Street Address:
Parcel Id: Zoning Map# 5 Parcel# 1JrV 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):
7. Attached Plans: Sketch Plan Site Plan Engineered/Surveyed Plans
An 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 DONT 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 #
APPLICANT/CONTACT PERSON: 4j A;
ADDRESS/PHONE: Zr/,S f
PROPERTY ?LOCATION: �2 // a`ap Mz> t/e
MAP PARCEL: ZONE ` lc
THIS SECTION FOR OFFICIAL USE ONLY:
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM <FLED OUT Fee PaiBuilding Per ✓ 9/�/� j
Fee Paid
Type of Construction: s�jPla rc ��°S�Zti�CL/_
New Construction
Remodeling Interior / Addition to Existing
Accessory Structure
Building Plans Included:
Owner/Occupant Statement or License #
3 Sets of Plans / Plot Plan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS ZONING APPLICATION:
v 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 from DPW
Permit from Conservation Commission
oe
Signature of Bu" di g Inspector Dat
NOTE: Issuance of a zoning permit does not relieve an applicant's burden to comply with all zoning requirements and obtain all required
permits from the Board of Health,Conservation Commission,Department of Public Works and other applicable permit granting authorities.
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