25A-075 (8) ,�ppPERMIT APPLICATION CHECK LIST
PAGE o PLOT ZONE M- 6 6-q o` YES NO DATE
ZONING FORM APPLICATION 2'
2 . PERMIT P (�
OWNER OCCUPANT E LICJ IF NOT
3 SETS OF S PLAN
NEW CONSTRUCTION
Q . CURB CUT
WATER BI I FORMS
8 . REMODELING INTERJOR
9 . ADDITION
0 , ACCESSORY STRUCTURE
11 . SIGN AWNING
2 . PERMIT FEE - CHECK ONLY - MONEY RDER b37jD
13 . SPECIAL PERMIT REQUIRED WITH DEED IF APPLICABLE
14 . UNDER SECTION 127 - CMR 780
15 . FORM A
16 . FILL
COMMENTS :
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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations
NORTHAMPTON, MASS. 19 Additions
so
APPLICATION FOR PERMIT TO ALTER Repair
Garage
1. Location ��� —Ca /���' � I"- /�<=/' �//�� ���Y / J'i" Lot No.
2. Owner's name 14V%0_ J',, ' Address
3. Builders name ddress
q Z�
M
1144 f
ass.Construction Supervisor's License No. piration ate d
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 coo O O'
The undersigned certifies that the above statements are true to the best of his, her
knowledge and belief.
/ a
Signature of responsible app,icani
Remarks
Date Filed / � 3 _ vim" 000650 File No.
ZONING PERMIT APPLICATION (§10. 2)
I . Name of Applicant: .&/j e-� �ic r'�.C, ,g•� /� � y��P ,�; "�, .� ,
Address: O - CL Telephone:
/.0 C,ae 0 ��' Xo ,(V-
2 . Owner of Property: �,7,7
Address: /��� i�,�ia,. �la� ,� Telephone:
3 . Status of Applicant: owner Contract Purchaser
Lessee Other (explain: )
4 . Parcel Identification: Zoning Map Sheet#.;)S� Parcel# 7J�,
Zoning District(s) (include ADverlays u-►� i
Street Address ,
Required
5 . Existing Proposed -by Zoning
Use of Structure/Property
(if project is only interior work, skip to #6)
Building height
%B1dg. Coverage (Footprint)
Setbacks - fro
- side 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 Work/Project: (Use additional sheets
if necessary)
7 . Attached Plans : Sketch Plan Site Plan
8 . Certification: I hereby certify that the information contained herein
is true an accurate to the best of my knowledge.
Date: 2� Applicant's Signat e:
- - - - - - - - -r - - - - - - - -
THIS SECTION FOR OFFICIAL USE ONLY:
V_-Approved as presented/based on information presented
Denied as presented--Reason:
Special Permit and/or Site Plan Required:
Pnylring qui ed: Variance Required:
S,ffgnat4 e of Build ' inspector '' , 1 Date
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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