46-027 p-3~•..
NO ____10. Do any signs exist on the property? YES "'----=-__
IF YES, describe size, type and location: __________________________
YES ___NO___Are there any proposed changes to or additions of signs intended \or the propertY? .. '
IF YES, describe size, type and location:_____
. . ,'--. , . ,_.. , i .. ", . "",... , .; .•. ~ ,
11. 'Will-the construction activity disturb (clearing, grading, ~xc~vation, cidilUng) 0r?re or is it part of a common
plan of deveLopment that will disturb over 1 acre? ' YES _' _' __ . 'NO ' : .. ... ~ .. : {, i -, ~ (.' ' ~
IF YES, then a Northampton Storm Water Manag~m~nt Permit fr9m the DPW is required.
~ " .f ,. - " ~
12. ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE DENIED DUE TO LACK OF INFORMATION
This column reserved
~. ,'. ~ >. for use by the Building
De]!artment
Lot Size
! EXISTING PROPOSED REQUlREDBY
ZONING
Frontage
Setbacks Front
"
" "
Side L: R: L: R: L: R:
Rear
BuiJding Ii~ight " . , . .'
.' , , 1 •
>(. . ,
" .-,. .~ l '
, ..
-'" l.~
Building Square Footage
%Open Space: (lot area
minus building 8: paved
parking
# of Parking Spaces
"
# of Loading Docks
Fill:
(volume 8: location)
13. Certification: I hereby certify that the information contained rein is true and accurate to the best of
my knowledge.
Date: __-"",gy\\:-1q+-\+-\-=-,~,--_ Applicant's Signature ----..:;-tt:;..;..;:---------
NOTE: Issuance ofa zoning permit does not relieve an appli urden to comply with all zoning
requirements and obtain all required permits from the .'ard ofHealth, Conservation Commission,
mstoric and Architectural Boards, Department ofPublicWorks and other applicable permit granting
authorities.
W:\Documents\FORMS\original\Building-Inspector\Zoning-Permit-Application-passive.doc 81412004