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17A-292 (3) T � D �! > _ yo Z xI' ...j �► m � r v O a Zoning Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. 6-��3`12 Alterations NORTHAMPTON, MASS. Au4 1 19 q5; Additions ' APPLICATION FOR PERMIT TO ALTER Repair Q ii L � Garage 1. Location 99 Wl Cam` 0Q k T ImaLE ` Lot No. 2. Owner's name 4-V 6 Address �� i t�C�P9'�" Qv , 'F(pP 4--& 3. Builder's name Address E ` Mass.Construction Supery is License No. t 11 Expiration Date 4. Addition �lo C1�1��1 b' CAP vPtloj Poo 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:- The undersigned certif' at the above statements are true to the best of his, her knowledge and bell S,g ure of response fe app icana Remarks S ay V i I 1 • y � ii Y .7 4 t. 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 MUST BE COMPLETED, or PERMIT CAN BE DENIED DOE TO LACK OF INFORMATION. Th_ie column to be fi led in by the Building Department Required Existing Proposed By Zoning Lot size Frontage Setbacks - - side L: R: L: 4-10 R: - rear / Building height t4/A- Zy/ Bldg Square footage ,N 0- -L io 1121 D "f_3- %Open Space: (Lot area minus bldg &paved parking) 0) # of Parking spaces I� T A # of Loading Docks fj Fill: (volume & location) 13 . Certification: I hereby certify that the i ation contained herein is true and accurate to the best of my J.p d DATE: �j� �� APPLICANT's SIGNATURE NOTE: Issuanoe of a zoning permit does not relieve aoan s 2urdevkto oompty with all zoning requirements and obtain all required permits from the and of Health, Conservation Commission, Department of Public, Worics and other a plioablei0pormit granting authorities. FILE I File No. ZONING PERMIT APPLICATION (§10 . 2)' PLEASE TYPE OR PRINT ALL -INFORMATION 1. Name of Applicant: O C..,w Address: go Wlrvet D(Z . Telephone: 2. Owner of Property: Address: ( ', ��� Telephone: �� 3. Status of Applicant: Owner Contract Purchaser Lessee Other(explain): 4. Street Address:__YI? ��C'��� �(✓ Parcel Id: Zoning Map#--J% Parcel# District(s): (TO BE FILLED IN BY THE BUILDING DEPARTMENT) S. Existing Use of Structure/Property �tv �tkm Ilo 6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary): We ym)R to 4e -- ,mymw R 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/Variance/Finding ever been issued for/on the site? NO X 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 Document# 9. Does the site contain a brook, body of water or wetlands? NOI_ 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) 4 ,. � _ _.. _. _ _ _ _. _ _.. _ _ K � 4/e FILE # 4 APPLICANT/CONTACT PERSON: ADDRESS/PHONE: A PROPERTY LOCATION: MAP J7 . PARCEL: ZONE THIS SECTION FOR!OFFICIAL USE ONLY: PE_RMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE 1RPP paid Z t Arregyn THEI,LOWING ACTION HAS BEEN TAKEN ON THIS AP ICATI < 'i Approved as presented/based on information presented Denied as presented: Special Permit and/or Site Plan Required under: § 1 J 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 Con ervation Co --- ion Signature of Building Inspe Date NOTE:issuanoe of a zoning permit does not relieve an applioant's burden to oomply with all zoning requirements and obtain all required permits from the Board of Health, Conservation Commission, Department of Publio Works and other appiioable permit granting authorities.