25-015 (57) PERMIT APPLICATION CHECK LIST
PAGES b'1J PLOT ' 11 ZONE C �(�rLftcz�npCGr�" Airpnr� YES NO DATE
Ij Pa.
1 . ZONING FORM APPLICATION
2 . PERMIT P LIC
3 . OWNER OCCUPANT STATEMENT Z LIC . # IF NOT
4 . 3 SETS OF PLANS PLOT PLAN
5 . NEW CONSTRUCTION
6 . CURB CU
7 . WATER AVAILABILITY S
8 . REMODELING INTERIOR
9 . ADDITION
10 . ACCESSORY STRUCTURE
1 . SIGN Z AWNING
12 . PERMIT FEE - CHECK ONLY - MONEY ORDER o a 00 G---
13 . SPECIAL PERMIT REQUIRED WITH DEED IF APPLICABLE
14 . UNDER SECTION 127 - CMR 780
15 . FORM A
16 . FILL T7 I
COMMENTS :
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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations
NORTHAMPTON, MASS. jQ .2 19 Additions
so APPLICATION FOR PERMIT TO ALTER Repair
Garage
1. Location � �� �TCypU/ / =f �6�!` Lot No.
Se s/
2. Owner's name 7e-Y7 l7tTi!` 11` />�i�i'Z�IU G1 A . s i `�tf
3. Builder's name
�l�g- 13T1X um co Address
Mass.Construction Supervisor's License No. Expiration Date
4. Addition �i�lZ�=17 Oi.� d� i T..�UT 01:'-: U/�tUO JS $ice-S I-- d a0 i V0Vh1-flF-
5. Alteration-FOOD 577 E. F0- 44- (5-Orl ll"z:ol-twilrPo -
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:-
Th unde 'gned certifie that the above statements are true to the best of his, her
k wl d Pqie f.
Signature of responsible app,icant
Remarks f f V'7.--f rW R 010 C.3 C-= 2i,i-I 11 -PP,02-oX 2U' X 30' ai2i)
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a�'w�i.r2r
0003'x' .'
Date Filed /0 File No.
ZONING PERMIT APPLICATION (§10 . 2)
1 . Name of Applicant: C 0co ot= yLab*'L �Y ,
Address: Telephone: �^
2 . Owner of Property: j`�ft(�y ,ly�Z t� Af12-i'b1CP — Lyrt:!�n o
Address: Telephone:
3 . Status of Applicant: Owner Contract Purchaser
Lessee Other (explain: )
4 . Parcel Identification: Zoning Map Shee _
Zoning District (s) (include overlays)
Street Address t4nrrk0-r ,oi nrt
Required
5 . Existincr Proposed by Zonin
Use of Structure/Property
(if project is only interior work, skip to #6)
Building height
%B1dg. Coverage (Footprint)
Setbacks - front
- side 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) Gt crzr ,v ar= 7Z,-iuL5 CAF t>Hv4c1,s
( aUgt ��rl ✓�GtS � £ S �r� �=vz -
C-r) Ce --Cb,i-n-Y-),)C�L
7 . Attached Plans : Sketch Plan Site Plan
8 . certification: I hereby certify that the informa ' n contained herein
is true and accurate to the best of my knowle e
Date: Applicant ' s Signature: "x,4—
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
-' THIS SECTION FOR OFFICIAL USE ONLY:
'
c--"Approved as presented/based on information presented OCT 0
r, D ied a presented
ea n f r Denial
ignat e of Building Inspector Date
NOTE: Issuance of tiTBuning p rmit does not relieve an applicant's burden to comply with all zoning requirements and obtain all required permits
from the Board of Hoalth, Conservation Commission, Department of Public Works and other applicable permit granting authorities.
7/92 FXAS