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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No.— Alterations
NORTHAMPTON, MASS. 1 g Additions
APPLICATION FOR PERMIT TO ALTER Repair
1 r
Garage
1. Location V�� ^, �J Lot No.
2. Owner's name—) ✓., Vy t`s e Address S 0 ►�a�o ✓
3. Builder's name A "k e"S-f- Address R o-�nj ( (-U I
Mass.Construction Supervisor's License No. j 6 Expiration Date_ Jwa,, . Z6-fit
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 cost:- G O O O. v 6
The undersigned certifies that the above statements are true to the best of his, her
knowl dge and belief.
..Grp
Si azure of responsible app,icani
Remarks
r '
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 MAST BE COMPLETED, or PERMIT CAN BE DENIED DUE TO
LACK OF INFORMATION.
This colamm to be filled is
by the Building Department
Required
Existing Proposed By Zoning
Lot size
Frontage
Setbacks -front
- side L: R: L: R:
- rear
Building height
Bldg Square footage
%Open Space:
(Lot area minus bldg
&paved parking)
# ,pf Parking spaces
j� of Loading Docks
Fill:
4vo1-time--& location)
13 . Certification: I hereby certify that the information contained herein
is true and accurate to the best of my kno ledge.
DATE: 0 Z� �� APPLICANT's SIGNATURE
NOTE: issuance of a zoning permit does not relieve an appiioant's bap(rdqAV to comply wlt4,,adl
zoning requirements and obtain all required permits from the Boa of Health, Conservation
Commission, Department of Pubiio Works and other applioable permit granting authorities,:,
FILE #
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` 9cll)
File No.
ZONING PERMIT APPLICATION (§10 . 2)
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant: "k-evs�
Address: I4R L Telephone:_ 5 H 3— 1_S Z 3
2. Owner of Property: ySv'e" 1" a✓.`S K
Address: 5 D T;�"�' y Telephone:
3. Status of Applicant: Owner Contract Purchaser Lessee
Other(explain):
4. Job Location: Sa ley ��l
Parcel Id: Zoning Map#_,_,2 :�_-N Parcel# /47 District(s): ��C
(TO BE FILLED IN BY THE BUILDING DEPARTMENT
5. Existing Use of Structure/Property S'!:� ( C .
6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary):
Y--..V o O O C>S "c— "' 4� w C`! l--L.
c
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 Per it/Vadance/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 ocument#
9. Does the site contain a brook body f water or wetlands? NO ,DON'T y � N 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)
I - � �o ; A I
FILE # a '1 �� rr
APPLICANT/CONTACT PERSON:
ADDRESS/PHONE: ' .
PROPERTY LOC TION: '� J
MAP PARCEL: �2 J) ZONE
THIS SECTION FOR-OFFICIAL,USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
70NTNC FnRM FTT T FT) 01IT
Fee Pahl
lRililding, Permit Fillrd opt
�.
New C'nnctrnctinn 4
Addition t
3 Setc of Plans /Pint Plan
THE fPLLOWING 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
!Pe it from Cons ion
�t
Signature of Building Wector ate
NOTE:Issuance of a zoning permit does not relieve an applicant's burden to oomply with all
zoning requirements and obtain all required permits from the Board of Haalth, Conservation
Commission. Department of Publio Works and other applicable permit granting authorities. —
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