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PermitApplication_Marie Emerson / Emerson family trustPermit Application Today's Date: 10/24/2013 Owner Applicant Marie Emerson / Emerson family trust Tom Emerson 61 Fairfield Terr. 664 Park Hill Road Florence, Massachusetts 01062 Longmeadow, Massachusetts 01106 413 - 230 -8602 1ogcabin48 @yahoo.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: 16D / 004 / 001 Deed Book of all lots in project: BOOK 9757 PAGE 59 Project work address: 202 NORTH MAIN ST City / State / Zip: Florence 01062 Zoning District: URA SC 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) ❑ 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 Wetlands Certificate of Compliance reauest 210 Main St., Rm. 11, City Hall, Northampton, MA 01060 (413) 587 -1262 Wetlands Request for Determination OR ❑ Wetlands Amendment or Resource Delineation extension Fee Information Wetlands Request for Determination OR Resource Delineation $125 (WPA form 1 or 4a) - $125 Total Fee Amount: $125.00 Existing Use 2 FAMILY HOME AND BARN DEMOLISHED AFTER FIRE ONLY DETATCHED GARAGE REMAINS WITH DRIVEWAY TO STREET ESSENTIALLY VACANT LOT Planned Use SELLING LAND AS BUILDABLE LOT FOR 1 TO 2 FAMILY (AS BEFORE) HOME Detailed Project Information Wetlands Description: THIS HAD BEEN A FARM HOUSE FOR > 100 YRS UNTIL BURNED DOWN RECENTLY, ONE OF THE OLDEST LOTS IN AREA, TWICE THE OPEN SPACE OF MOST IN AREA, EXACT DATE IS UNKNOWN. Files Uploaded: 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: THOMAS A. EMERSON 10 -23 -13 Date Signed: 10/24/2013 210 Main St., Rm. 11, City Hall, Northampton, MA 01060 (413) 587 -1262