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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. 5 � Alterations
NORTHAMPTON, MASS. 7X If 197-L�, Additions
APPLICATION FOR PERMIT TO ALTER Repair
Garage
1. Location Lot No.
2. Owner's name Address
3. Builder's name C J i�A�l►'Z b Address_12g el-f66--C ST, tf-s0 7-,q1"
Mass.Construction Supervisor's License No. 06 6 30 Expiration Date 5zw
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 6 LA
13. Siding house
14. Estimated cost:-
ZQ26, The undersigned certifies that the above statements are true to the best of his, her
knowledge and belief.
Signature of res onsible appicant
Remarks
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:
11. ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE DENIED DUE TO
LACK OF INFORMATION.
This cola= to be filled is
by the Banding Department
Required
Existing Proposed By Zoning
Lot size
Frontage
Setbacks
- side L: R: L: R:
- rear
Building height
Bldg Square footage
%Open Space:
(Lot area minus bldg
&paved parking)
#1 .:f -Parking Spaces
# of Loading Docks
Fill:
=(vol-ume--& location)
•13 . Certification: I hereby certify that the information contained herein
is true and ccurate to the best of my knowled e.
DATE: �� _ APPLICANT's SIGNATURE
NOTE: Ise 64/6f a zoning
g permit does not relieve an applioant's bard to oomply
zoning requirements and obtain all required permits from the Board of Health. Con$ervation.;�,
Commiasion. Department of Publio Works and other appiioable permit granting authorWes: .s
Lit"
.;,i. FILE
1
File No.
ZONING PERMIT APPLICATION (§10 . 2)
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant:
Address: I?2 6AI GG n0. Telephone: O/ 70
2. Owner of Property: Il/
Address j!Z 5 oF1_;-Hr- /t VE A/Y0 Telephone:
3. Status of Applicant: Owner Contract Purchaser Lessee
Other(explain): 00�f w� �Ok-��rJGiu�t
4. Job Location: 3E Swf/_*n i1•�— /lam T d h
Parcel Id: Zoning Map# Parcel# District(s):
11
(TO BE FILLED IN BY THE BUIL ING DEPARTMENT)
5. Existing Use ofStructure/P rope rtyCC. � -
6. Description of Proposed UseMlork/Project/Occupation: (Use additional sheets if necessary):
2 U F=T tz 06)F-
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)
FILE
APPLICANT/CONTACT PERSON: .5 9
ADDRESS/PHONE: 7 ' 4,�A-7<7
PROPERTY LOC TION:
MAP � /� PARCEL: ZONE_�GL
THIS SECTION FOR-OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
Ft-t- Pnid
u t,
�' ✓i) ��
T OLLOWING 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 C ission
Signature of Building Inspect Da e
NOTE:Issuanoe of as 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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