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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. `l 3 Alterations
a rNORTHAMPTON, MASS. I g Additions
APPLICATION FOR PERMIT TO ALTER Repair
Garage
1. Location K S If)/I/`,''J T Lot No.
2. Owner's name z6:0 Zil A,, ry l d L Address
3. Builder's name 13 xrf1N 6L).411 Address IS) A�'2dYSi/9TF_
Mass.Construction Supervisor's License No. f/:3 i l 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 cost- d if f. , 00
The undersigned certifies that the above statements are true to the best of his, her
knowledge and belief.
1
G2�
Signature of responsible app!cant
Remarks -5 i�� i� C e r S/r%L j ,¢'o€��ir� /.v/ i?4I Z1
Al t' JAJ �ti`r`�J�'✓�19,711 S-,7 "'v:; Le"-S' ( %��►l /YQ
Ale ✓�' Ci/�C� rJPn1T C�J��;7 .-,'I�ct6V w CL ✓ CJlE' �� �/�/� �✓/IJAC
Lie
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 N07,,�L
IF YES,describe size,type and location:
11 ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE DENIED DUE TO
LACK OF INFORMATION.
This cols to be filled in
by the 8ailding 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
' &paged parking)
of -Parking Spaces
of Loading Docks
Fill:
:-(vol-time--& location)
13 . Certification: I hereby certify that the information contained herein
is true and accurate to the best of my knowledge.
APPLICANT's SIGNATURE
NOTE: hasuanoe of a zoning permit does not relieve an applioanYs burden to comply witfx,.,etl
e ..
zoning requirements and obtain all required permits from the Board of Health. Conservation
Commission. Department of Publio Works and other applioabla permit granting authoritles:..
FILE # -.
' 2 8 67
Fi 1 e NO.
ZONING PERMIT APPAL" I CATION (§10 . 2
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant: 3 g,dti 4zl&
Address: /S3 91Yfs role- �L a a, Telephone:
2. Owner of Property: I11MW 7AII
Address: f Telephone:
3. Status of Applicant: Owner Contract Purchaser Lessee
Other(explain):
4. Job Location: e
Parcel Id: Zoning Map# yLS/� Parcel# District(s): CY
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/Property AP-Sir`40A,'
6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary):
x i S/,.i f G�'at�f= ,��>/ Sys c' /o�I-�/j/�,./i9Sf
O c°_C c:e -S ell �,agP l�c',i'
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/Vadance/Finding ever been issued for/on the site?
NO DON'T KNO!A.l 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? N0-7,�— _ 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)
�w a; - •� >� it ��)
FILE #
APk]&C-ANT/CONTACT PERSON: z
ADDRESS/PHONE: j
PROPERTY LOCATION: �2
MAP PARCEL: ZONE
THIS SECTION FOR-OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM EMLED OUT
Type of Consinirtion-
Acres,,nm4 Structure
3 Sets cif PlAns I Plat Plan
d �
THE 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 mission
Signature of Building Insp Date
NOTE:lasuanoe of a zoning permit does not relieve an applioant'a burden to oompty with all
zoning requirements and obtain all required permits from the Board of Health, Conservation
Commisalon, Department of Publio Works and other applioable permit granting authorities.
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