23A-115 (7) 1& Do any signs exist on the property?
IF YES, describe size,type and
YES- I NO
Are there any proposed changes to or additions of signs intended for the property?YES
IF YES,describe size,type and location:
NO L/
11. ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE DENIED DUE TO
LACK OF INFORMATION.
This cols to be filled in
by the Building Department
i.� pct L1-L —L-Luji i nereoy certixy that the information contained herein
is true and accurate to the best of my knowledge.
DATE: ._� G� E� ` APPLICANT'S SIGNATURE
NOTE: Issuanoe of a zoning permit does not relieve an applicants burden to oom PIY With
all
zoning requirements and obtain all required permits from the Board of Health. Conservotion
Commission, Department of Publio Works and other applioable permit granting authorities.
FILE #
Existing
Proposed
Kequlrea
By Zoning
Lot size
Frontage
Setbacks
- side
L: R:
L: R:
- rear
Building height
Bldg Square footage
%Open Space:
(Lot area minus bldg
&paged Fay kLn j J
# of Parking Spaces
# of Loading Docks
Fill:
-(Volume -& location)
i.� pct L1-L —L-Luji i nereoy certixy that the information contained herein
is true and accurate to the best of my knowledge.
DATE: ._� G� E� ` APPLICANT'S SIGNATURE
NOTE: Issuanoe of a zoning permit does not relieve an applicants burden to oom PIY With
all
zoning requirements and obtain all required permits from the Board of Health. Conservotion
Commission, Department of Publio Works and other applioable permit granting authorities.
FILE #
S
L MAR 1 4 �0 0 File No.
� T nC _;; QNING PERMIT APPLICATION (§10 . 2)
...,PLEASE TYPE OR PRINT ALL INFORMATION
?
1. Name of Applicant:
Address: 4 ---Telephone:
2. Owner of Property:
Telephone:
Address: lG3 4 eL
L � �fy - phone: _
3. Status of Applicant: Owner Contract Purchaser Lessee
Other(explain):
4. Job Location: G2 f_
Parcel Id: Zoning Map#� Parcel# /'0 District(s):
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/Property
6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary):
7. Attached Plans: Sketch Plan Site Plan Engineered/Surveyed Plans
Answers to the following 2 questions may be obtained by checking with the Building Dept or Planning Department Files.
8. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO DON'T KNOW— t �/ 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 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)
File#MP-2000-0144
APPLICANT/CONTACT PERSON DA Williams
ADDRESS/PHONE 81 Water St. (413)586-3139
PROPERTY LOCATION 10 MAIN ST
MAP 23A PARCEL 115 ZONE GB
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ONING FO ILLED OUT
Building,Permit Filled out
Fee Paid
Typeof Construction: MEDICAL OFFICE BLDG BASEMENT RENOVATION FOR KITCHEN BATHROOM
&STORAGE FOR EMPLOYEE USE
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included•
Owner/Statement or License
3 sets of Plans/Plot Plan
THELOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION:
I Approved as presented/based on information presented.
Denied as presented:
Special Permit and/or Site Plan Required under: §
PLANNING BOARD ZONING BOARD
Received&Recorded at Registry of Deeds Proof Enclosed
Finding Required under: § w/ZONING BOARD OF APPEALS
Received&Recorded at Registry of Deeds Proof Enclosed
Variance Required under: § w/ZONING BOARD OF APPEALS
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 Commissio" Permit from CB Architecture Committee
i
Signature of Building O cial 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.
10 MAIN ST MP-2000-0144
COMMONWEALTH OF MASSACHUSETTS
CITY OF NORTHAMPTON
GIS 9022
Map: 23A
Block; 115
Lot: 001 ZONING PERMIT
Permit: ZONING PERMT APP
Category: Zoning Permit APPLICATION PERMIT
Permit# MP-1000-0144
Project# JS-20004476 PERMISSION IS HEREBY GRANTED TO:
Est.Cost: Contractor: License:
Fee: $10.W DA Williams
#of Fixtures: owner: TEN MAIN STREET FLORENCE LLC
Applicant: DA Williams
AT. 10 MAIN ST
ISSUED ON. 16-Mar-2000 EXPIRES ON.
TO PERFORM THE FOLLOWING WORK
MEDICAL OFFICE BLDG BASEMENT RENOVATION FOR KITCHEN,BATHROOM& STORAGE FOR EMPLOYEE USE
00*1.1
HIS 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-2000-002657 15-Mar-00 4897 $10.00
212 Main Street,Phone:(413)587-1240,Fax:(413)587-1272
GeoTMS(R 1998 Des Lauriers&Associates,Inc.