17D-017 (4) t, cr)
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Zoning
Miscellaneous Additions, Repairs,Alterations,etc. / Tel.No. " t� � Alterations
NORTHAMPTON, MASS. / 3 tej2 v Additions
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APPLICATION FOR PERMIT TO ALTER Repair
Garage
1. Location (ZS STr W T�L-C�j;IJCr— Lot No.
2. Owner's name bU &Mq P-0?- Address SAMF
. Builder's name t' Address �^
Mass.Construction S up,.-rvisor's License No. Expiration Date
4. Addition
5. Alteration t fy STS UL N EW WU=6M - kt i Tl-i I IN(, R Q(fl
6. New Porch
7. Is existing building to be demolished? N o
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 certifies that the le star ents are true to the best of his,
knowledge and belief.
Signature
`14 rrsp b(cappuca
..emarks __
4
File#BP-1999-0928
APPLICANT/CONTACT PERSON GERSHUNY LISA GALE&EDYTHE M
ADDRESS/PHONE 125 STRAW AVE
PROPERTY LOCATION 125 STRAW AVE
MAP 17D PARCEL 017 ZONE URB/WP
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Buildi Permit Filled out
Fee Paid
Typeof Construction: REMODEL KITCHEN NEW FLOORING GYPSUM BOARD INSULATION FIXTURES
HEATING ELECTRICAL ADD 1 ST FLR BATH TO EXISTING 3/3/00
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included• -
Owner/Statement or License
3 sets of Plans/Plot Plan
THE F OWING ACTION HAS BEEN TAKEN ON THIS APPLICATION:
pproved as presented/based on information presented.
00*- 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 Board of Health Well Water Potability Board of Health
Permit from Conservation ission
Signature of Building Official Dat
Note: Issuance of a Zoning permit does not relieve a applicant's burden to comply with all zoning
requirements and obtain all required permits from Board of Health,Conservation Commission,Department
of public works and other applicable permit granting authorities.