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PermitApplication_Patrcik J. Melnik and Alice E. Melnik, trusteesPermit Application Todav's Date- 06/11/2013 Owner Applicant Patrcik J. Melnik and Alice E. Melnik, trustees Patrcik J. Melnik and Alice E. Melnik, trustees 311 Chesterfield Road 311 Chesterfield Road Leeds, Massachusetts 01053 Leeds, Massachusetts 01053 413 -584 -6750 patmelnik@gmail.com City of Northampton department: No Work Location Information How many lots involved in the project: 1 Map / Block / Lots of all lots in project: 15B / 032 / 001 Deed Book of all lots in project: Book 8085 Page 266 Project work address: 259 CHESTERFIELD RD City / State / Zip: Leeds 01053 Zoning District: RR Application for following Permit Types ❑ Planning Bd. Special Permit w/ Site Plan ❑ Planning Bd. Special Permit w/ MAJOR Site Plan NO Special Permit ❑ Administrative Site Plan Review ❑ Planning Bd. Major Site Plan Approval (No Special Permit), including 40R projects ❑ Subdivision Preliminary ❑ Planning Bd. Special Permit w/ Site Plan for flag lots ❑ Planning Bd. Site Plan (NO Special Permit) ❑X Approval Not Required Plans ❑ Subdivision Definitive with Preliminary Approved ❑ Subdivision Definitive with no Preliminary Approved ❑ Zoning Board Special Permit ❑ Appeal of Building Commissioner - Zoning ❑ Variance ❑ Historic District Determination of Non - Applicability ❑ Historic District (Elm St) Determination of Appropriateness ❑ Subdivision Definitive Amendment ❑ Zoning Board Finding ❑ Comprehensive Permit (40B) ❑ Demolition (Demolition Delav) ❑ Central Business Architecture ❑ West Street Architecture ❑ Wetlands Notice of Intent IF ONLY local ❑ Wetlands Notice of Intent IF state wetlands wetlands 210 Main St., Rm. 11, City Hall, Northampton, MA 01060 (413) 587 -1262 Total Fee Amount: $250.00 Existing Use Vacant land - Pasture Planned Use House lot for my son -I have discussed with nieghbor Detailed Project Information Number of Plan Pages:1 Special Permit Description: Neither Special permit nor site plan is not being applied for. Approval Not Required Description: Plan is for single lot -size increased to 80,000 sf Files Uploaded: Supporting Information: Plan is for a single lot.docx Plan Sheets: Melnik ANR 5- 24- 13.dwfx Approval Not Required: Autocad: Melnik ANR 5- 24- 13.dwfx Tiff or PDF: Plan of land- 80,000sf.pdf By typing my name in the signature box, I certify that all the information above is accurate to the best of my knowledge, I am the property owner or have permission from the property owner to apply for this permit. I also grant permission to the City of Northampton to inspect the proposed work Signature: Patrick J. Melnik Date Signed: 06/11/2013 210 Main St., Rm. 11, City Hall, Northampton, MA 01060 (413) 587 -1262 Fee Information Approval Not Required Plans - $250 /plan page $250