38B-222 (4) •
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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 X
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 6C1 X 92, Col X 922
Frontage
$01 6 O I
Setbacks Front Zi (tor tKC.t.gOi f ,c Z,q
Side L: 12. R: $,5 L: (2 R: $45. L: R:
Rear 42. it 42-
Building Height grr,tox , Ar+PacK. Zz►
Building Square Footage 62.0 L, G'2.0 l
Open Space: (lot area 1.9./VA A Z9.S 7.
minus building Et paved
parking 01 642. S X4.7 (I, 43 3 jq. F}.�
# of Parking Spaces
#of Loading Docks
0 0
L
Fill:
(volume Et location)
13. Certification: I hereby certify that the information contained herein is true and accurate to the best of
my knowledge.
Date: 9` 1?)1 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 ADocuments1 FORMS\original\Building-Lnspector\Zoning-Permit-Application-passive.doc 8/4/2004
Li i
SEP I i 2013 v.;`� File No. /V �9"a
F
p -,,--ZONING PERMIT APPLICATION (§10.2)
''"Tease= ; 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
A. City of Northampton
1. Name of Applicant: A.oet-.iN " 14009E4
Address: 24i FA t R V t ft W ,qv e a Ue, Telephone: 5g(e-.2t 74
2. Owner of Property: IA100.1-4 N a 14 ocPF2.
Address: 21 FA i Rat I T W vAv a N U er Telephone: 5'8'6 '2171
3. Status of Applicant: Owner K Contract Purchaser Lessee Other (explain)
4. Job Location: 2.1 Alleiti Mb.) 4v a"•tue.
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: "tea 'F .111- ( 14t di fie.
6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary): To Blew 4 x-P°or
LEN6 + OF Woeo FFutee. $- Fem. Hto-H Or-r13E.e .J 11 .store. Yawn T 29 E4itRv1Et4 AMID
1161 b •wat44Y /r1 '!.7 f '*Vt @W O JMC BY CMv01q agec + . me F6Nee WaULO Asa
paf6AS E PACtftNG- erti4 fAcf Q� fat'041=R Eieu3e AND St Sa Belo( 37.'f IFeer F9owt
.1'4*. STQE4T• 13WTN HovsJS Agit UP FU(r4 of STe.esi 3 FL'C'[ ASove (r Ape.,
.SO Onto.; A TALLER. FENvca. HeKft CA 4 lit Da MA Yiaw cF 1-1EA. 112AsH CANS CA"Rs,
1' 4 - M C 4A+JtCS of 1-kfiA. GtN t�-C444 tt M. ELAVATOAt AN 8RtcrkT PORc
1Ct4A1 lS ON 4° '45 A 'DA`{. Ks. O'%5*% st Wii- fiENEfit As Weti.. .6,e a4tAlikk, maize
PfaV4L`4 0,4 t.}reR. posrM(4s4■C 4 SKI.USES frog .34c141.4-2.0 4c.--), T seoKo W1Ti4 um ggdot T'4A
7. Attached Plans: Sketch Plan X Site Plan Engineered/Surveyed Plans OCP4C a A'`P Su
NAP No Caller
cry
8. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO DON'T KNOW X 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 X 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\Buildinb Inspector\Zoning-Permit-Application-passive.doc
8/4/2004
File#MP-2014-0029
APPLICANT/CONTACT PERSON HOOPER ADELINE
ADDRESS/PHONE 29 FAIRVIEW AVE (413) 586-2174()
PROPERTY LOCATION 31 FAIRVIEW AVE
MAP 38B PARCEL 222 001 ZONE URB(100)/
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid `u Q mot'
Building Permit Filled out
Fee Paid
Typeof Construction: ZPA- 8'FENCE
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 ACTIO BEEN TAKEN ON THIS APPLICATION BASED ON
INFORMATION PRES ED:
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: § 2,56./0 L
Findin g 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
40111007-z
Signature of :uil:''t 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.