32A-201 (15)LM
10. Do any signs exist on the property? YES NO
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) ver I 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
for use by the Building
Department
13. Certification: I hereby certify that the information co ained herein is true and accurate to the best of
my knowledge.
Date: 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\original\Building-Inspector\Zoning-Permit-Application-passive.doc 8/4/2004
EXISTING
PROPOSED
REQUIRED BY
ZONING
Lot Size
, -7
Frontage
I
f23
�23�
Setbacks Front
Side
L: t R: �Q
L:R:
L: R:
Rear
Building Height
Building Square Footage
% Open Space: (tot area
minus building Et paved
parking
# of Parking Spaces
# of Loading Docks
Fill:
(volume Er location)
13. Certification: I hereby certify that the information co ained herein is true and accurate to the best of
my knowledge.
Date: 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\original\Building-Inspector\Zoning-Permit-Application-passive.doc 8/4/2004
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ZONING PERMIT APPLICATION (§10.2)
Please type or print all information and return this torm to the tsunaing
Inspector's Office with the $15 filing fee (check or money order) payable to the
City of Northampton
1. Name of Applicant: Lj �,1 0�pLG--
Address:,• T3
2. Owner of Property: PAl iu 25 2LA�, LI -6-
Address: �Z— p ri Telephone(4a� e�—�O
3. Status of Applicant: Owner_ Contract Purchaser Lessee Other (explain)
4. Job Location: ' �- PS �,f - U� (m h (D I O& 4
Parcel Id: Zoning Map# Parcel# District(s):
In Elm Street District In Central Business District
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
Existing Use of Structure/ Property: r p's I dJF-r�pq, 3 TWO FAW:L�
6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary):
d o &if�=W 80(.gyptNZ (,x : —M R1�5f b;F: MA -L
7. Attached Plans: Sketch Plan_ Site Plan_ Engineered/Surveyed Plans
8. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO DON'T KNOW X-, YES IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO DONT 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)
W:\Documents\FORMS\original\Building-Inspector\Zoning-Permit-Application-passive.doc 8/4/2004
File # MP -2015-0010
C ("'L"ice
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APPLICANT/CONTACT PERSON MUERLE LINDA ,S—r
ADDRESS/PHONE P O BOX 2943 (413) 253-0080 Q
PROPERTY LOCATION 51 PHILLIPS PL
MAP 32A PARCEL 201 001 ZONE URC(100)/
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid r
Typeof Construction: ZPA - ADD BLDG W/2 RESIDENTIAL UNITS & GARAGES
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
INFORMATION PRESENTED:
Approved Additional permits required (see below)
PLANNING BOARD PERMIT REQUIRED UNDER: §
Intermediate Project rite 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
Septic Approval Board of Health
Water Availability Sewer Availability
Permit from Conservation Commission
Permit from Elm Street Commission
Signature of Building Oficial
Well Water Potability Board of Health
Permit from CB Architecture Committee
Permit DPW Storm Water Management
Bit
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.