43-128 (2) File # MP- 2010 -0079 f Q
APPLICANT /CONTACT PERSON WRIGHT BUILDERS
ADDRESS/PHONE 48 Bates St (413) 586 -8287
PROPERTY LOCATION 53 GREENLEAF DR
'[AP 43 PARCEL 128 001 ZONE SRO00Z //WSP II
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ONING FO ILLED OUT e ir„ „ _ ,/ ,
Fee Paid 19�
Building Permit Filled out
F ee Paid
Typeof Construction: ZPA - ADDITION
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 FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INF RMATION PRESENTED:
Approved Additional permits required (see below)
PLANNING BOARD PERMIT REQUIRED UNDER: §
Intermediate Project: Site Plan AND /OR Special Permit with Site Plan
Major Project: Site Plan AND /OR Special Permit with Site Plan
ZONING BOARD PERMIT REQUIRED UNDER: §
Finding Special Permit Variance*
__ 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 Commission Permit from CB Architecture Committee
Permit from Elm Street Commission Permit DPW Storm Water Management
�1:3 / t o
Signa a of Building Official Date
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 and other applicable permit granting authorities.
y
* Variances are granted only to those applicants who meet the strict standards of MGL 40A. Contact the Office of
Planning & Development for more information.
iJi AY 1 1 1010 = 4 1 D IO File No.
Zf XINO PERMITAPPLICATION (§Y "o.2)
Please type 'or pit all information and return this form to the Building
Inspector's Office with the $15 filing fee (check or money order) payable to the
City of Northampton
1. Name of Applicant: p � �
Address: �S Sf /IlorJ 41 �y Telephone: -
2. Owner of Property:
Address: 5-3 /(�/�Z Zi4 WXV -. Telephone:
3. Status of Applicant: Owner Contract Purchaser Lessee �erplain)_ ,_
4. Job Location: � P Q .S' G' r1y�
Parcel Id: Zoning Map# Parcel# District(s):
In Elfin Street D>fstr>tct = IniCentral Business District t
(TO REFILLED °IN;`BYTHE -BUILDING DEPARTMENT)` .
5. Existing Use of Structure/ Property: Srt / 2 2S/
6. Description of Proposed Use /Work /Project /Occupation: (Use additional sheets if necessary):
7. Attached Plans: Sketch Plan X Site Plan Engineered /Surveyed Plans
R. Has a Special Permit /Variance /Finding ever been issued for /cn the site?
NO _ .. �\' 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? NO 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)
W:\Documents\ FORMS\ original \Building- Inspector\Zoning- Permit - Application- passive.doc 8/4/2004
I
P
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. Will the construction activity disturb (clearing, grading, excavation, or filling) over 1 acre or is it part of a common
plan of development that wilt disturb over 1 acre? YES NO A
IF YES, then a Northampton Storm Water Management Permit from the DPW is required.
12. ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE DENIED DUE TO LACK OF INFORMATION
This column reserved
for use by the Building
Dep artment
EXISTING PROPOSED REQUIRED BY
ZONING
Lot Size
Wj 82 sy ., 39,
Frontage 14 33 5/{ 3 3 /. f
Setbacks Front 3 7,q IF.
Side L: rid R: Z� ` L: z R: ZI L: R:
Rear Z SD I -�-- Z JD , f
Building Height
Z g , f�
Building Square Footage
Z/ 5 2 sy fit• 2 t
% Open Space: (lot area
minus building & paved 3Sj �v Sry F¢ 3 5, a� Sy
p arking �'� 9 �v d ( 90
# of Parking Spaces
# of Loading Docks_
Fill:
(volume & location) A
13. Certification: I hereby certify that the information contained herein is true and accurate to the best of
my knowledge.
Date: _ 7 4151 1() 41%!7 Applicant's Signature ?"/1
NOTE: Issuance of a zoning permit does not relieve an pplicant's burden to omply with all zoning
requirements and obtain all required permits from the Board of Health, Conservation Commission,
Historic and Architectural Boards, Department of Public Works and other applicable permit granting
authorities.
W:\ Documents\ FORMS\ original \Building- Inspector\Zoning- Permit - Application - passive.doc 8/4/2004