32A-158 (8) File k MP•2019-0011
APPLICANT/CONTACT PERSON SIDORf MICALA
ADDRESS/PHONE 47 MUNROE ST (413)604-0097 Q
PROPERTY LOCATION 15 HAWLEY,y�T
MAP 3'A PARCEL t58 000 ZONE NVtl '01 01
IM S SECT- KON FOROFF.CIAL t{:,'.ONLY:
PERMITAPPLCATIO <C-AEC.AJ.IST
E;;i�L03F'ti REQUIRED DATE
Z,ONIN FORM FtLLF.D Oi1T __, _ ___- _
Fee Paid _
BBuildin Permit Filled out _
Fee Paid
TypeofConurrcti ZPA-RESIDENTIAL SPACE
New Construction
Non Stmctura!interior renovations
_
Addition to Existing
ASSgssory StrupAlre
Building Plans lnciudcd'
—Owner/SCatement or License
3 sets of Pians/Piot Pian
TH FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INYORMATION PRESENTED:
_Approved _Additional permits required(see below)
PLANNING BOARD PERMIT REQUIRED UNDER: §
Intermediate Project:`Site Plan AND/OR,^Special Permit with Site Plan
Major Protect: Site Plan!AND/OR„__Special Permit with Site Pian
ZONING BOARD PERMIT REQUIRED UNDER:il,;w1i,,,,_,,,,,
FindingSpecial Permit Variance*
Received&Recorded at Registry of'Deeds Pioof Enclosed
_Other Permits Required:
iCurb Cut from DPW Water Availability Sewer Availability
Septic Approval Board of Health Well Water Potability Board of Health
Permit from Comervation Commission Permit from CB Architecture Committee
_Permit from film Street Commission _,____Permit DPW Storm Water Management
Signature of Building Official Da[ l
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.
9 �t7
y rpt
z° m Fite No. e-
It
ONING PERMITAPPLICATION(§iv.a)
g m Plea a or print all information and return this form to the Building
Instect ce with the$30tin ee check or
g f ( money order)payable to the
City of Northampton
Ni. Name of Ap tican1t:�I 116A 1"a ,.i61,DOR(-
Address: 7 !_�- iy t-�� ��f z Tetephone: ._.
2. Owner of Property:
Address: t�,7lU L`E Tetephone:` 13 f 459 7 U q
3.
Status of Applicant: Owner Contract Purchaser Lessee_Other (explain)__
4. Job Location: O
Parcel Id. Zoning Map# c3=1"+- Parcel# District(sj:
In Elm Street District In Central Business District
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/Property: 42 JL6 _
6. Description dz4Aof_Pr�o�possed Use/Work/Project/Occupation: (Use additional sheets if necessary):
Ye.-S'I 'Iyt A-�. S GC.Cc'. .—_.
T. Attached Plans: Sketch Plan Site Plan Engtneered/Surveyed Plans
&. Has a Speciall"it/VariancefFinding ever been issued for/on the site?
NO _ PONT YES _ IF YES, d sued:
IF YES: Was the permit recorded at t e istry of Deeds?
NO DONT KNOW
IF YES: enter Book Page_., and/or Document# _.._
9.Dm the site contain a brook, of water or wetlands? NO DONT KNO _ YES
IF YES, has a p t been or need to be obtained from the Conservation Commission?
Need be obtained Obtained , date issued:
(Form Continues On Other Side)
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10. Do any signs exist on the property? YES NO
IF 5,describe size, type and location:
7
Are there any oposed changes to or additions of signs intended for the property? YES / NQ
IF YES, describe s , type and tocation:i
11. Will the construction a ivity disturb{clearing,grading,excavation, or filling)over acre or is it part of a common
plan of development tha will disturb over 1 acre? YESNONO
IF YES, then a Northamp n Storm Water Management Permit fr the DPW is required.
12. ALL INFORMATION MUST BE COMP ED, or PERMIT CAN BE DENIED UE TO LACK OF INFORMATION
This column reserved
for use by the Building
,...... Department
E 'TING PROPOSED REQUIRED BY
_ ZONING
Lot Size
Frontage
Setbacks Front
Side L: R: t: R:
Rear
Building Height
Building Square Footage
%Open Space: (lot are
minus building B pav
parking d
#of Parking S75
#of Loadin its
Fill:
(voW R location)
13. Cefication: I hereby certify that the information contained herein is true and accurate to the best of
/ my knowledge. 1 1� '/,f'yII rq � �p
Date: 3 Applicant's Signature_�/� \ ��.✓`.V l^"' �
NOTE:I. nco zomng permit does not relieve 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.
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