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10. Do any signs exist on the property? YES NO a;,
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
�-(
3 I l AGUE �J for use by the Building
Department
EXISTING PROPOSED REQUIRED BY
ZONING
Lot Size
Frontage
Setbacks Front
r
Side L: R: L: R: ;/ L: R:
Rear /
0
f
Building Height r
Building Square Footage
O
%Open Space: (lot area
minus building & paved
parking
#of Parking Spaces
#of Loading Docks
Fill:
(volume & location)
13. Certification: I hereby certify that the information contained herein is true and accurate to the best of
my knowledge.
Date: L 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\originaliBuilding-Inspector\Zoning-Permit-Application-passive.doc 8/4/2004
MR 16 2oia
EWcuic,Plum
&aas In s File No.
Northa on,
....NG:PERMIT APPLICATION 010.2)
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 ofNorthamp ton
/ 1. Name of Applicant: %
Address: "l. L-7 C40 t)&1 Tom( [ S v06,10;Q( Telephone: 7 c�'`tY " 7&4,
,
2. Owner of Property: Gk V-(S O a�yl 4M ( Ali Wte J
Address: 1 / &osoe,:;f Sf . Telephone:
3. Status of Applicant: Owner f/ Contract Purchaser Lessee Other (explain)
4. Job Location:_ f'► rL [ �Lc� �1"DS,Ae ' ` co-rrle-y- to+
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: IV Q.4,i �-V-f
1
6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary):
7. Attached Plans: Sketch Plan Site Plan Engineered/Surveyed Plans
8. Has a Special P mit/Variance/Finding ever been issued for/on the site?
NO i7 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 _ .� DON'T KNOW _X 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\origina]\Building-Inspector\Zoning-Permit-Application-passive.doc 8/4/2004
File#MP-2014-0086
APPLICANT/CONTACT PERSON MERIDIAN CONTRACTING LTD
ADDRESS/PHONE 9 OLD COUNTY RD#2 (978)440-7616
PROPERTY LOCATION ADARE PL
MAP 24C PARCEL 197 001 ZONE URB(NULL)
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT_ o i0s40 do
Fee Paid
Building Permit Filled out
Fee Paid
Typeof Construction: ZPA-SFH W/ATT GARAGE
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
IN=pproved ATION PRESENTED:
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
Signature o Building fficial 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.
ADARE PL MP-2014-0086
COMMONWEALTH OF MASSACHUSETTS
CITY OF NORTHAMPTON
GIS#: 12076
Map: 24C sl
B1°ck: ' 7 ZONING PERMIT
Lot: 001
Permit: ZONING PERMIT APPLI APPLICATION PERMIT
Category: Zoning Permit
Permit# MP-2014-0086 a PERMISSION IS HEREBY GRANTED TO:
Project# JS-2014-001$3
Est.Cost: �Contractor: License: Expires:
$15.00 Homeowner as Contractor
Fee Charged:
Balance Due:$.00� -Owner: GOLDEN CHRISTOPHER D
#of Fixtures _Applicant: MERIDIAN CONTRACTING LTD
DigSafe# dAT. ADARE PL
UseGroup
ConstClass
ISSUED ON: 24-Apr-2014 AMENDED ON: EXPIRES ON.
TO PERFORM THE FOLLOWING WORK:
ZPA-SFH W/ATT GARAGE
THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF
ANY OF ITS RULES AND REGULATIONS.
Signature:
Fee Type: Receipt No: Date Paid: Check No: Amount:
Zoning Permit Application REC-2014-006020 16-Apr-14 6949 $15.00
212 Main Street,Phone:(413)587-1240,Fax:(413)587-1272,Email:lhasbrouck @northamptonma.gov
GeoTMS®2014 Des Lauriers Municipal Solutions,Inc.