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Fi 1 e No.
DEPT OF 8tl1LfJIf�G INSPECTIOfiS
NO
P, IVA 01060
ZONING PERMIT APPLICATION (§10 . 2)
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant: JCS h u yll 11 SKA
Address: S ) )Iwo c- S t L&,L! �Telephone: S2 -/
2. Owner of Property: ry) 1-�)C P,.1,.Y\
Address:_ 1b_ /'a uio hcrd 'A (7 )6'0 Telephone:
3. Status of Applicant: Owner Contract Purchaser X Lessee
Other(explain):
4. Street Address:
Parcel Id: Zoning Map# of Parcel# [.�9-3 District(s):
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
'-'2 41
5. Existing Use of Structure/Prope �r
6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary):
E,p(ceo (2Grc� p c.s7s r T:!:,W cuter Cx;M y 4 &W o csz s'Te-p S
Pc o i2cw mar ,,A6c -,
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 Fifes.
8. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO 11-11 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 # age
APPLICANT/CONTACT PERSON: t/ �� & AA/—J -33
ADDRESS/PHONE: C z ,-
PROPERTY LOCATION:
MAP PARCEL: 2,5 ZONE ///()-1-3
THIS SECTION FOR-OFFICIAL USE ONLY:
PERMIT APPLICATION CHECIMST
ENCLOSED REQUIRED DATE
7,C)NING FORM M.T.FD OUT
Fee PRid
lRivildin 14-d Alit
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yA
NewCnnytrirtinn
! �
pnnt Statement
THELLOWING ACTION HAS BEEN TAKEN ON TS AP ICATION- `
A TI
US
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
Se tic Approval-Bd of Health Well Water Potability-Bd Health
rmit fro nse tion Commission
111f3
961 of B ' g ector ate
NOTE:lssumnoe of a zoning permit does not relieve an a lloanYs burden to oomply with all
zoning requirements and obtain all required permits from the Board of Health, Conservation
Commisslon, Department of Publio Works and other appiioable permit granting authorities. _
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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations
NORTHAMPTON, MASS. 19 Additions
Qk APPLICATION FOR PERMIT TO ALTER Repair
Garage
1. Location 10- 4D 1 li b s rd 4.R. n ci f-4 c-.� t," c Lot No.
2. Owner's name m c V,;VV1 Address I lo b C r cl Q k
3. Builder's name _ 0 S k jo Address Dom^ S3 1S
Mass.Construction Supervisor's License No. C? 4 S a Expiration Date r.2 S
4. Addition
5. Alteration Rp&O(c l)Cn t.fi� �!057S ? p i.e:A LCZ14X °f— P(I Ippa c0 S'?Q PS ,
Qy na�,;1 e' �q U�,►�clec ,
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:-
ocx-)• CCU The undersigned certifies that the above statements are true to the best of his, her
knowledge and belief
WL FIIM�A
Signature of responsible app lcant
Remarks