PermitApplication_MassDOTPermit Application
Todav's Date- 12/28/2010
Owner
Applicant
MassDOT
MassDOT
811 N. King Street
811 N. King Street
Northampton, Massachusetts 01060
Northampton, Massachusetts 01060
413 -582 -0543
timothy.meyer @state.ma.us
City of Northampton department: No
Work Location Information
How many lots involved in the project: 1
Map / Block Lots of all lots in project: 08 -011
Deed Book of all lots in project: n/a
Project work address: 811 N. King St
City/ State/ Zip: Northampton 01060
Zoning District: HB /SR/RI
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)
❑ 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
❑X 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
Fee Information
Wetlands Notice of Intent IF state wetlands (WPA Form 3) $167.5
$100 plus city share of state fee
Total Fee Amount: $167.50
Existing Use
MassDOT Administration Building
Planned Use
Tree cutting in front of building and toward exit ramp of 191; tree planting in same general area.
Filed Abbreviated NOI, Form 4, not on City's list above.
Detailed Project Information
Wetlands Description: Tree cutting and planting only. Using Form 4 abbreviated Notice of Intent.
* ** This online form could not be submitted without checking "permit type" but an Abbreviated NOI
does not appear to be listed, so I checked the most similar form type. MassDOT, a state agency is
exempt from local by -laws and fees. Fee being submitted is $67.50. Thank you.
Files Uploaded:
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: Robert Natario Date Signed: 12/28/2010
210 Main St., Rm. 11, City Hall, Northampton, MA 01060
(413) 587 -1262