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18C-108 (2) 10. Do any signs exist on the property? YES C IF YES, describe size, type and location: Are there any proposed changes to or additions of signs intended for the property? YES ONO._ IF YES, describe size, type and location: 11. ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE DENIED DUE TO LACK OF INFORMATION. This column to be filled in by the Building Department Required Existing Proposed By Zoning Lot size Nk 1 Frontage 11 Setbacks - frnnt - side L: R: L: - rear Building height Bldg Square footage %Open Space: (Lot area minus bldg &paved parking) # of - Parking Spaces #- of Loading Docks Fill: (vol -ume -& location) 13. Certification: I hereby certify that the information contained herein is true and accurate to the best of my kno edge. DATE: jZ( 63 APPLICANT'S SIGNATU 1. .ms- NOTE: Issuanoe of a zoning permit does not relieve an appiioanta burden to oomply with a zoning requirements and obtain all required permits from the Board of Health, Conservation Commission, Department of Publio Works and other applioable permit granting authorities. FILE # File No. ZONING PERMIT APPLICATION 2) PLEASE TYPE OR PRINT ALL INFORMATION 1. Name of Applicant: SC.vd 1 Q V) I`vz. _ Address: 1 � 4 S. a Telephone: 58 L J 2b . S 2. Owner of Property: m, YYI. C__ S .v, _ 1Q (( Q r' c:_.�i 1(�, ♦ v Telephone: . �0 4 L9 U S S? Address: � � p � ._.�.� 3. Status of Applicant: Owner Contract Purchaser Lessee Other (explain): Ci_ - L<L -t ' > %' 4. Job Location: .____ �,___. Parcel Id: Zoning Map# Parcel# District(s): (TO BE FILLED IN BY THE BUILDING DEPARTMENT) 5. Existing Use of Structure/Property 6. Description of Proposed Use/V11 k/Project/Occupation: (Use additional sheets if necessary): 6Th C. .1 as VY> 1�1 0 T 7. Attached Plans: Sketch Plan Site Plan Engineered /Surveyed Plans Answers to the following 2 questions may be obtained by checking with the Building Dept or Planning Department Files. 8. Has a Special PermitNariance/Finding ever been issued for /on the site? —C..) 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 wetlan 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) Date Filed 4a51';-*; NY6 File No.A J - MAY G 2003 , . REGISTRATION OF HOME OFFICE /OCCUPATION ( §10.2 & 11.11) WittIT'.'theJ Building Inspector 1. Name of Applicant - $ Ocrtth UC. Address: - 11 ( -)ff .' l S 2. Owner of Property: CO C _ elephone: ;) �{ ( `; l (o ' Address: r `L%1 y A_ n t i� Le''':) 3. Status of Applicant: Owner Contract Purchaser Lessee Other (explain: l.", it r ta 4. Parcel Identification: Map JfC, Parcel /, � i=- , � ✓ok, Zoning District (s) (include o erlays)_ 2, Street Address 5. Narrative Description of Proposed Home Office: (Use additional sheets if necessary) D Sc e 0., c,l, :> epef- Ps) 6. Is this a legal residential building? ,DES NO 7. Will there be an employee /owner who doesn't live in the home YES 0 8. Will you ever see clients or customers at your site? YES 0 How often For what purposes 9. Will there be any signs for the Home Office? YES NO 10. Will there be any goods sold from the premises or any sale of goods stored on premises, either retail or wholesale, or any display of goods on premises? YES Oi 11. Will there be any outdoor storage of materials? YES ,0 12. Will your use be totally within a building and not cause any outward manifestation (including traffic generation, parking _ congestion, noise, air pollution, and materials storage)? YES 'NO\ If NO explain: 13. Attach Plans (if applicable) 14. Certification: I hereby certify that the information contained herein is true and accurate. I understand that if any information is incorrect, my peintit is null and void and I may be liable for non- criminal fines and criminal and civil actions. Date: S1 Applicant's Signature L1s;.�} L\) 1 0 . � THIS SECTION FOR OFFICIAL USE ONLY: Approved as presented /based on information presented APPROVAL EXPIRES ON D CEMBER 31 OF THIS YEAR AND MUST THEN BE RENEWED Denied as presented -- ea on: S" 20/ Signature of Building Inspector_ Da e NOTE:.ssuanoe of a ' does not rollovo an applicant's burdon to comply with all zoning roqulromonta and obtain all roquirod port from tho Board of Hoaith, Conaorvatlon Commission, Dopartmont of Public Works and othor applicablo pormit granting authorltlos. File # MP- 2003 -0164 APPLICANT /CONTACT PERSON NENNO SARAH ADDRESS/PHONE 71 GLEASON RD (413) 584 -5205 0 PROPERTY LOCATION 71 GLEASON RD MAP 18C PARCEL 108 001 ZONE URB THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out � � `n` Fee Paid /l/ Typeof Construction: HOME OFF /OCC REG 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 INFO ATION PRESENTED: ( j roved 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 Co : on • I - _%/� 2 0 20© Signature of wilding Off ial 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. 4, , s 10 MP- 2003 -0164 COMMONWEALTH OF MASSACHUSETTS CITY OF NORTHAMPTON GIS #: Map: Block: HOME Lot: 101 Permit: HOME OFFICE /OCC RE OFFICE /OCC REG Category: Home Office /Occ Registrat _ Permit # MP- 2003 -0164 PERMISSION IS HEREBY GRANTED TO: Project # JS -2003 -1572 Est. Cost: $0.00 -- Contractor: License: Fee: $10.00 Homeowner as Contractor # of Fixtures: Owner: WARD MARY MCSHERRY Applicant: NENNO SARAH AT: 71 GLEASON RD ISSUED ON: 20- May -2003 AMENDED ON: EXPIRES ON: 01 -Jan -2004 TO PERFORM THE FOLLOWING WORK: HOME OFF /OCC REG THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Signature: Fee Type: Receipt No: Date Paid: Check No: Amount: Home Office /Occ Registration REC 2003 - 003349 07 May - 03 97 $10.00 212 Main Street, Phone:(413) 587 -1240, Fax:(413) 587 -1272 GeoTMS® 2003 Des Lauriers Municipal Solutions, Inc.