25A-048 (7) PERMIT APPLICATION CHECK LIST
PAGE �e2� PLOT 5� ZONE CC% '!=� �r YES NO DATE
1 . ZONING FORM APPLICATION
2 , PERMIT APPLICATION
3 . OWNER OCCUPANT -STATEMENT I NO
4 . 3 SETS OF S /PLOT PLAN
5 , NEW CONSTRUCTION
6 , CURB CUI
7 , WATER S
8 , REMODELING
9 , ADDITIO
10 . ACCESSORY STRUCTURE
11 , SIGN / AWNING
12 , PERMIT FE C - MONEY 0 E Y,�)
c
13 , SPECIAL PERMIT E UI D WITH DEED IF APPLICABLE
14 . UNDER SECTION 127 - C R 780
15 . FORM
16 . FILL
COMMENTS :
' a u
tii�Y �Y
Date Filed .,t�/-3 File No.
ZONING PERMIT APPLICATION (510 . 2 )
1 . Name of Applicant: JChIIIJ c rle4�
Address : _56, J7'w`0 lL C r� Telephone: 5;:c/ - Y`0_7
2 . Owner of Property:'I Y'A
Address : t� Ctos, 4 <,r Telephone : Sg'�r- d g%17
3 . Status of Applicant: Owner ✓ Contract Purchaser
Lessee Other (explain : )
4 . Parcel Identification: Zoning Map Sheet# ,_)5/4 Parcel# ,
Zoning District (s) (include ov' rlays)
Street Address v ,
Required
5 . Existin Proposed by Zonin
Use of Structure/Property
(if project is only interior work, skip to #6)
Building height
%B1dg. Coverage (Footprint)
Setbacks - front
- side L: R: L: R:
- rear
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 Wor /Pr ject : (Use additional r sheets
if necessary) .1.-!VS- -4 0 7 U, ni u CEAe e't4 C��� A C10L'J S
Y
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 : a'2 I j 3 Applicant' s Signature: )
- - - - - - - - - - - - - - - - - - - - - - _ T - - - - - - - - - - - - -
/ THIS SECTION FOR OFFICIAL SE ONLY:
v Approved as presented/based on information presented
Denied as presented--Reason :
Special* Permit and/or Site Plan Required:
V' di equired: Variance Required :
re of Bui nspector ` "� Date �3
NOTE: Issuance of a zoning permit does not Wave 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.
it, 71-
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(�/" Zoning
Miscellaneous Additions,Repairs,Alterations,etc. p Tel.No. J 6T, Alterations
a NORTHAMPTON, MASS. 7° 19 Additions
APPLICATION FOR PERMIT TO ALTER Repair
Garage
1. Location r eo a Lot No.
2. Owner's name_ ( _eA I U1 Address_ �/ Co's
3. Builder's name �h 0j C-0 �` - Address ,�t, D wl L L l c S �E�I�S 'Win
Mass.Construction Supervisor's License No. )C %� �/L'�C1Cti —Expiration Date 010S
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:-4P asx
The undersigned certifies that the abov ements are true to the best of his, her
;^%a, know] dg d belief.
Signature esponsible appicant
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