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02-022 File # MP- 2012 -0016 APPLICANT /CONTACT PERSON WRIGHT BUILDERS ADDRESS/PHONE 48 Bates St (413) 586 -8287 (116) PROPERTY LOCATION 639 NORTH FARMS RD MAP 02 PARCEL 022 001 ZONE RR(100) //WSP THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out Fee Paid Typeof Construction: ZPA - ADD COVERED PORCH & STAIRS 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 FO WING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON IN O ATION 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 from Elm Street Commission Permit DPW Storm Water Management Signa re 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 works and other applicable permit granting authorities. * Variances are granted only to those applicants who meet the strict standards of MGL 40A. Contact the Office of Planning & Development for more information. Mr_ Ur_IV C ' AUG - 3 201! _ File No. m RMIT APPLICATION ( §10.2) Please type or print 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: W kl & H II bUIL7 - i 0 c Address: 4 (5 A 5 5 i . 1J d . A tit rri 0P3 Telephone: 4%3 j570(; ` :�5z-b 2. Owner of Property: � Ic 1A Ag M L,,L I0U rah 1J [\L-1 1J1 ZAut Art Address: (O N o r T 0 r A 2 MS ,L D , Telephone: 4 (3 60 i5 —a t D l 3. Status of Applicant: Owner Contract Purchaser Lessee_ Other (explain) ✓ 4. Job Location: (c - 5 9 t ©,2TN r ACzatS �-� t FW QCNC C Parcel Id: Zoning Map# Parcel# District(s): In Elm Street District In Central Business District (TO BE FILLED IN BY THE BUILDING DEPARTMENT 5. Existing Use of Structure/ Property: 1 D LE FA Itn L-{ + 2t-SO C>E7JCC 6. Description of Proposed Use /Work /Project /Occupation: (Use additional sheets if necessary): A- ti 0 Ct, VELrZe= ? c} ! d (r•1 r2ta2 (1. C IJ o A - S 1 a a I rJ c LJD k tj c, To C 1Z t TC ri G>� a M A's i (z cS A71A . 7. Attached Plans: Sketch Plan Site Plan ✓ Engineered/ Surveyed Plans _ 8. Has a Special Permit /Variance / Finding ge ever been issued for /on the site? NO DONT KNOW " YES IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO DONT 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 \origin ]\Building- Inspector\Zoning- Permit- Application- passive.doc 8/4/2004 i 1 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) ovgf 1 acre or is it part of a common plan of development that will disturb over 1 acre? YES NO 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 Department EXISTING PROPOSED REQUIRED BY ZONING Lot Size `i.h G2G ✓e`i 4.5 �A� ✓eS Frontage Setbacks Front 5 35' f 5i55' t Side L: 3� r t R: 14 r,' L: - 3 a } R: 146 ' L: R: Rear Building Height Building Square Footage Z 2lu S 5 Z Sao 5a 1= % Open Space: (lot area minus building Et paved parking # of Parking Spaces �J # of Loading Docks NIA NIA Fill: N ,A Ij'A volume Et location 13. Certification: I hereby certify that the information contained herein is true and accurate to the best of my knowledge. Date: lb zit N Applicant's Signature �✓ NOTE: Issuance of a zoning permit does not relieve an applicant's burden to comply 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 \origina ]\Building- inspector\Zoning- Permit- Application- passive.doc 8/4/2004