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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations
NORTHAMPTON, MASS. Igo October 1995 Additions
APPLICATION FOR PERMIT TO ALTER Repair
Garage
1. Location 10 112- H u bbard Ayenve. Lot No.
2. Owners name K ar%Ana I•\CKt M Address SAME
3. Buildeisname SaM J. Gahr�el Address 4S 'B,4a Street F_as-I•hamD_, -ion
Mass.Construction Supervisor's License No. 044541 Expiration Date 5. 12.• 900
4. Addition
5. Alteration Rebuild ex',stinu rh;mneV 4002 w4h new back anj new lead ma4er flash
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:-$&-75•n0
The undersigned certifies that the above statements are true to the best of his, her
know an belief.
Sig Lure of responsible app,lcam
Remarks -RWD tlA eXl511na Cklmnev -fop 10.1 neo 66r-Y, And new lead maser
t�dS�n�na
10. Do any signs exist 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:
II. ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE DENIED DUE TO
LACK OF INFORMATION.
12d& calnmm to be ;E112ed in
by the Bai2ding Department
Required
Existing Proposed By Zoning
Lot size
Frontage
Setbacks -frnnt
- side L: R: L: R:
- rear
Building height
Bldg Square footage
%Open Space:
(Lot area minus bldg
&paved parking)
# of Parking Spaces
# of Loading Docks
Fill:
(volume & location)
13 . Certification: I hereby certify that the infoio contained herein
is true and accurate to the best of my knowl;10 dge'c
DATE: IQ APPLICANT's SIGNATURE
NOTE: Ise anoe of a zoning permit does not relieve a :1 an burden to omply with all
zoning requirements and obtain all required permits from the Board of Health. Conservation
Commission. Department of Publio Works and other applioable permit granting authorities.
FILE #
Fi 1 e No.
ZONING PERMIT APPLICATION ff 1 o'
PLEASE TYPE OR PRINT ALL INFOR14A
1. Name of Applicant: `l A m Gab r l a l
Address: 4S R6 Telephone: 1527 - I y54
2. Owner of Property: ariana MCk l it
Address: IQZI-Z N\leti Je. Telephone:
3. Status of Applicant: Owner _Contract Purchaser Lessee
Other(explain):
4. Street Address: 't'�A.Mr-_
Parcel Id: Zoning Map# � Parcel# / District(s): �iT ✓� L
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/Property
6. Description of Proposed UseMork/Project/Occupation: (Use additional sheets if necessary):
b ��I1 Pxis�ina chimn-4i 40D will new 6--IL anc r1eW
lea& ma_' er --
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 Files.
8. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO DON'T 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)
pr%r)
FILE
x
APPLICANT/CONTACT PERSON:
ADDRESS/PHONE: C16,27
PROPERTY LOCATION:
MAP _5/} PARCEL: �,� ZONE Ll/
THIS SECTION FOR-OFFICIAL USE ONLY:
PERNUT APPLICATION CHECKLIST
ENCLOSED REQUIRED DA
Rvii1ding Permit Filled nvit
G/
Th E LLOWING ACTION HAS BEEN TAKEN ON THIS AP ICATION' `
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 Sewer Availability
Septic Approval-Bd of Health Well Water Potability-Bd Health
Permit from Conservation is io
d
Signature of Building or Da e
NOTE:tssumnoa of a zoning permit does not relieve an applioant's burden to oomply with all
zoning requirements and obtain all required permits from the Board of Health. Conservation
Commission, Department of Publio Works and other appiioable permit granting authorities.
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