29-291 i
' C nOr Zr°N1)(L
2r0
- � .m7k( 11 , Le
10. Do any signs exist on the property? YES NO X.
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 a paved
parking
# of Parking Spaces
# of Loading Docks
Fill:
(volume Et location)
13. Certification: I hereby certify that the information contained herein 's true and accurate to the best of
my knowledge.
Date: Applicant's Signature
NOTE: Issuance of a zoning permit does not relieve an applicant's burd n 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
File No.
ZONING PERMIT APPLICATION 01o.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: 6 R.t owl A O I L0051
� l U1)tL '-•, I ??
Address: �� �-t�1�� � r � Telephone: y 3 �f�o'� u
2. Owner of Property: C (LQett -I "1 IAA t 5t t .
Address: ( 3 4 1 \Crta tL- u ( . Telephone: L I l 3 576 3467")
3. Status of Applicant: Owner V Contract Purchaser Lessee Other (explain)
4. Job Location: - Si,S2Roc.
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: lb )0 w
6. Description of Proposed Use /Work /Project /Occupation: (Use additional sheets if necessary):
fu 4 � Is
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 X.. 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 1:' 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
4-
9. ALL INFORMATION MUST BE COMPLETED; PERMIT CAN BE DENIED DUE TO LACK OF INFORMATION.
This column to be filled in by
the Building Department.
Existing Proposed Required by
Zoning
Lot Size
Frontage N/A N/A N/A
Front:
Setbacks:
Side: L: R: L: R:
Rear:
Height
% Open Space:
(Lot area minus bldg and
Paved parking)
10. Certification: I hereby certify that the information contained herein is true and accurate to the best
of my knowledge.
DATE: / U l� APPLICANT'S SIGNATURE • ,��
(__.
I I r
NOTE: Issuance of a permit does not relieve an applicant's burden to comply with all zoning requirements
and obtain all required permits from the Conservation Commission, Department of Public Works and other
applicable permit granting authorities.
i of Northampton
�H4 RE EIVE�
!*� Massachusetts
1 niL I. NT OF BUILDING INSPECTIONS
212 -i Street • Municipal Building Oy:`
sp�IONS • rthampton, MA 01060
m pEpfOF
INSPECTOR
ACCESSORY STRUCTURE PERMIT APPLICATION
(For freestanding structures Tess than 200 sq. ft., at least 5 feet from any other structure)
Permit Fee: $25.00 Check # 07/17 0//O //
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of I Applicant: (9�Q10./L1 ,k U� " A-) 1 ► 0 � -�,
Address: a"l A (Z Telephone: yi.--5 38 7
2. Owner of Property:
c5k 4
Address: Telephone:
3. Status of Applicant: Owner Contractor
4. Structure Location:
Parcel ID: Zoning Map # Parcel # District(s)
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Use of Property: Single or Two Family: t/ Multifamily: Commercial:
6. Description of Proposed Structure:
Shed under 200 sq. ft. Freestanding Deck under 200 sq. ft. Other (describe)
/O / t S ,S2
7. Attached Plans: Sketch Plan Site Plan Plot Plan
8. 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
CONTINUED ON NEXT PAGE
File # MP- 2011 -0089
APPLICANT /CONTACT PERSON MALYNOSKI GREGORY A & KATHLEEN
ADDRESS/PHONE 297 ACREBROOK DR (413) 586 -3877 Q
PROPERTY LOCATION 297 ACREBROOK DR
MAP 29 PARCEL 291 001 ZONE URA(100) //WSP
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out 4 / (7
Fee Paid
Typeof Construction: ZPA - 10 X 14 SHED
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:
VApproved 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
Signs of Building Official Date 5
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 o nl y to th applicants w ho meet the strict standards of MGL • 40A. Contact the Office of
Planning & Development for more information.