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03-002 Application_Stephen S. and Marion D. LapienskiPermit Application Today's Date: 12/23/2010 Owner Stephen S. and Marion D. Lapienski 4 Linseed Hill Road West Hatfield, Massachusetts 01088 Applicant Stephen S. and Marion D. Lapienski 4 Linseed Hill Road West Hatfield, Massachusetts 01088 413 - 247 -5654 hleaton @aol.com City of Northampton department: No Work Location Information How many lots involved in the project: 4 Map / Block Lots of all lots in project: 03 -002, 03 -034 Deed Book of all lots in project: Book 2099, Page 283 Project work address: 0 Coles Meadow Road City/ State/ Zip: Northampton 01060 Zoning District: RR, WP, WSP Application for following Permit Types ❑ Planning Bd. Special Permit w/ Site Plan ❑ Planning Bd. Special Permit w/ MAJOR Site Plan NO Special Permit ❑ Planning Bd. Major Site Plan Approval (No Special Permit), including 40R projects ❑ Subdivision Preliminary ❑ Planning Bd. Special Permit w/ Site Plan for flag lots ❑ Planning Bd. Site Plan (NO Special Permit) ❑X Approval Not Required Plans ❑ Subdivision Definitive with Preliminary Approved ❑ Subdivision Definitive with no Preliminary Approved ❑ Zoning Board Special Permit ❑ Appeal of Building Commissioner- Zoning ❑ Variance ❑ Historic District (Elm St) Determination of Appropriateness ❑ Wetlands Notice of Intent IF state wetlands ❑ Wetlands Request for Determination OR Resource Delineation ❑ Wetlands Certificate of Compliance reauest ❑ Subdivision Definitive Amendment ❑ Zoning Board Finding ❑ Comprehensive Permit (40B) ❑ Demolition (Demolition Delav) ❑ Central Business Architecture ❑ Wetlands Notice of Intent IF ONLY local wetlands ❑ Wetlands Amendment or extension 210 Main St., Rm. 11, City Hall, Northampton, MA 01060 (413) 587 -1262 Total Fee Amount: Existing Use Vacant land and Residential Planned Use Residential Detailed Project Information Number of Plan Pages:1 Approval Not Required Description: See plan Files Uploaded: Approval Not Required: Autocad: LAPIENSKI5ACAD2000.dwg Tiff or PDF: LAPIENSKI5ACAD2000.pdf $250.00 By typing my name in the signature box, I certify that all the information above is accurate to the best of my knowledge, I am the property owner or have permission from the property owner to apply for this permit. I also grant permission to the City of Northampton to inspect the proposed work Signature: Randy E. Izer Date Signed: 12/23/2010 210 Main St., Rm. 11, City Hall, Northampton, MA 01060 (413) 587 -1262 Fee Information Approval Not Required Plans - $250 /plan page $250