25A-087 E.RMIT APPLICATION CHECK LIST
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PAGE ' �4 �. E NO DATE
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1 . ZONING FORM APPLICATION
2 . PERMIT APPLICATION
3 . OWNER OCCUPANT LIC.# IF NOT
4 . 3 SETS OF PLANS /PLOT PLAN
5 . NEW CONSTRUCTION
6 . CURB CU
7 . -WATER VAI FORMS
8 . REMODELING INTERIOR
9 . ADDITIO
10 . ACCESSORY STRUCTURE
SIGN / AWNING
2 . PERMIT FEE - CHECK ONLY - MONEY ORDER
13 . SPECIAL PERMIT REQUIRED WITH DEED IF APPLICABLE
4 . 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
APPLICATION FOR PERMIT TO ALTER Repair
a
Garage
1. Location d /iCA, Lot No.
2. Owner's name 41JI, od Address
3. Builder's name �`�!��✓� Address /M0
Mass.Construction Supervisor's License No. '-'�S J -S ��( Expiration Date
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 cosL-
The undersigned certifies that the above statements are true to the best of his, her
knowledge and belief
Signature of responsible app lcam
JC
Remarks
0028
Date Filed 49�1 File No.
ZONING PERMIT APPLICATION (510 . 2)
1. Name of Applicant:
Address: ,��; ' �E/ �f c' Telephone: ,; 4-J� -7 4
2 . Owner of Propert
Address Telephone:
3 . Status of Applicant: Owner Contract P rchaser
Lessee Other (explain. Z �, )
4 . Parcel Identification: Zoning Map Sheet# '255� arcel#
Zoning District (s) (include over ays) �
Street Address
Required
5 • Existinq , Proposed by Zo in
Use of Structure/Property
(if project is only interi work, ip 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 Work/Project : (Use additional sheets
if necessary)
7
7 . Attached Plans: Sketch Plan Site Plan
8 . Certification: I hereby certify that the information c ntained herein
is true and accurate to the best of my knowledge.
1 /
Date: , Applicant's Signature,
THIS SECTION FOR OFFICIA USE ON Y:
Approved as presented/based on information presented
Denied as presented--Reason:
S ial' Per 't and/or Site Plan Required:
g R u ' e Variance Required:
� .`r 5 gnat of-Bui etor Date
NOTE: Issuance of a zoning permit does not relieve an applicant's burden to comply wills all zoning requirements and obtain all required permits
from the Board of Health,Consorvation commission, Dapartmont of Public Works and other applicable pormil granting authorilios.
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