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PERMIT APPLICATION CHECK LIST
RA i �" " r YES NO DATE
ZONING
: �,
2
3 . OWNER OCCUPANT E 0
4 . 3 SETS 0 _: OT PLAN
5 . NEW CONSTRUCTION
6 . CURB CU
7 . WATER AVAILABILITY FORMS
8 . REMODELING INTERIOR
9 . ADDITION
10 , ACCESSORY STRUCTURE
11 , SIGN AWNING
12 , PERMIT FEE ...n ONLY — MONEY 0 '� •
13 , SPECIAL PERMIT REQUIRED WITH DEED IF APPLICABLE
14 . 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. �l 19_Y__ Additions
o a
APPLICATION FOR PERMIT TO ALTER Repair
Garage
1. Location �iyJ �," ' !1 Lot No.
2. Owners name ��r � x 1 ; ,�✓ �„1?, -< 'wAd 9 ess� / ks
3. Builder's name 1jW/_4 U "� 1�N' Address .�lfl
Mass.Construction Supervisor's License No. � .'���� _ _Expiration Date
4. Addition J aa
5. Alteration Fr/ (,A r' o 2�,(- ✓✓` �� .7'� ��'w^';
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 /° r'�3
11. Distance to lot lines
12. Type of roof
13. Siding house
14. Estimated cost:- 1 j� Tpo
The undersigned certifies that the above statements are true to the best of his, her
knowledge and belief. f
/ Signature of response le app,icant
Remarks
905 001 ?J Date Filed -�
File No.
ZONING PERMIT APPLICATION (§10 . 2)
1 . Name of Applicant: //� '�,�� %i, +�� �'+ AWIK�71 /V r /1J
Address : t ,� i��w�.�1; fN Telephone:
2 . Owner of Property:_ _P_ C&- )—
Address : - Telephone :
fr,774A/ i 1�,111�,'
3 . Status of App ican : owner Contract Purc aser
Lessee Wither (explain : /',1,y7X&_77T,,- )
4 . Parcel Identification : Zoning Map Sheet# - S Parcel# t� ,
Zoning District (s) (include overl�s) E -Z
Street Address .,
Required
5. Existinq Proposed -by Zoning
Use of Structure/Property ,, r,.r�
(if project is only interior work, skip to #6)
Building height
%B1dg. Coverage (Footprint)
Setbacks - front
- side L: R: L:
- rear
Lot size
Frontage 4
Floor Area Ratio-,
%Open Space (Lot area minus
building and parking)
Parking Spaces
Loading
Signs
Fill (volume & location)
6 , Narrative Description of Proposed Worl Project : '. (Use additional sheets
if necessary) !'—e z Zo 2r .;7" /r 1'
�� � '���," e✓,N� � i` t/rN. � per,.
NO /i��2 Ci V %y i ;�1�,r (�� �/�' /u r°r`° 'Or
7 . Attached Plans : t/ Sketch Plan Site Plan
8 . Certification : I hereby certify that the information contained herein
is true and accurate to the best of my knowledge .
Date : Applicant' s Signature : ' = fv
THIS SECTION FOR OFFICIAL USE ONLY: _
y Approved as presented/based on information presented
Denied as,presented--Reason :
Special' Permit and/or Site Plan Required :
Findingl7equired: Variance Required;-
?� —
� ,
Eri
gnat e of Bu ng Inspector Date
NOTE: Issuanco of a zoning pormit does not rollave an applicant's burden to comply with all zoning roquiromonls and obtain all required pormils
from the Board of Health, Consorvalion Commission, Depattrnonl of Public Works and other nppiicabio permit granting nulhorillos.
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