29-030 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 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
Frontage
Setbacks Front
Side L: R: L: R: L: R:
Rear
Building Height
Building Square Footage
% Open Space: (lot area
minus building Et paved
parking
# of Parking Spaces
# of Loading Docks
Fill:
(volume Et location)
13. Certification: I hereby certify that the information contained herein is true and accurate to the best of
my k nowledge.
Date: 6/224 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 \original\ Building- Inspector\Zoning- Permit - Application - passive.doc 8/4/2004
A
• � Z ` �- y ,'f� \ \
2.-2„ X9. 1 0 File No _ _
a
y or • tint all information and return this form to the B»ildi
rfspector's ce with the $15 filing fee (check or money order) payable to the
City of Northampton
1. Name of Applicant: % �/(� � � Li..-
Address: 841 eya h Telephone4 /0 g-/ 69-6.
2. Owner of Property: tD&°UY7 J -
Address: .S l?2 �5 `-/� aJ� Telephone:
3. Status of Applicant: Owner Contract Purchaser Lessee Other (explain)
4. Job Location:
Parcel Ida Zo ii t app �� t arcel � a �� Distrrct
s
En:EtmfSt eet Di tr m Ins Centrta1Busin s isfirfc
O FILLEI 11* BY T fE 1 l l U l L D I NG $� 1 �4 )
5. Existing Use of Structure /Property: 7 7Y72 P_ )411/
6. Description of Proposed Use /Work /Project /Occupation: (Use additional sheets if necessary):
yYtwai,tLe /lie -A9 Rs, 'u r � r?me.. &s 1 014 ce-
defi ye, t",/Y
7. Attached Plans: Sketch Plan Site Plan Engineered /Surveyed Plans
8. Has a Special Permit /Variance /Finding ever been issued for /on the site?
NO 4- DONT KNOW IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds? e /l�/1 L r1� j4—
YES A t
NO DONT KNOW
IF YES: enter Book Page and /or Document #
9.Does the site contain a brook, body of water or wetlands? NO : DONT 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)
8/4/2004
W:\ Documents\ FORMS \original\Building - Inspector\ Zoning - Permit- Application- passive.doc
4 �.
File # MP- 2010 -0098
APPLICANT /CONTACT PERSON BUCHANAN MIRIAM CIO ROEUN CHEA
ADDRESS/PHONE 284 RYAN RD (413) 835 -1676 0
PROPERTY LOCATION 284 RYAN RD $;
MAP 29 PARCEL 030''001 ZONE URA(100) //WSP
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONIN FORM LLED OUT
F ee Paid /6`_
Building Permit Filled out
Fee Paid
Tvpeof Construction: ZPA - MAKE SPRING ROLLS
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 0f{f Ce 111CaPA 10
INFORMATION PRESENTED: ReQ(,L.( r� RCAC.' G
VApproved Additional permits required (see below) / �
RPPRv ✓e-.
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
16 `' °
6`Z:(
Signature of Building4fficial Date ilo
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.