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23A-070 70 Main St ZPA 2013-03-01--- File # MP-2013-0083 APPLICANT/CONTACT PERSON MIDDLE HAMPSHIRE DEV GROUP LLC ADDRESSIPHONE 270 EXCHANGE ST (413) 537-9109 () PROPERTY LOCATION 70 MAIN ST MAP 23A PARCEL 070 001 ZONE GB(97)1URB(3)/ THIS SECTION FOR OFFICIAL USE ONLY; PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT 1119Fee Paid Building Permit Filled out Fee Paid Typeof Construction: ZP A -4800 SQ IT ADDITION New Construction Non StructuraJ interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/ Statement or License 3 sets ofP1ans / Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON TmS APPLICATION BASED ON INFORMATION PRESJNTED: __Approved _V_AAddcditional permits required (see below) PLANNING BOARD PERMIT REQUIRED UNDER: § 350 -1/, J Intermediate Project: ,Site Plan AND/OR'--__,Special Permit with Site Plan Major Project: t7Site Plan AND/OR Special Permit with Site Plan ZONING BOARD PERMIT REQUIRED UNDER: ~__________ Findin=g____ Special Permit _____ Variance* ___,Received & Recorded at Registry ofDeeds Proof Enclosed _____ __Other Permits Required: ___Curb Cut from DPW ___Water Availability ___Sewer Availability ___Septic Approval Board ofHealth ____Well Water Potability Board of Health Permit from Conservation Cormnission Permit from CB Architecture Committee ----' ___,Permit from Elm Street Commission ____ Permit DPW Storm Water Management o Signature ofBuilding Official Darel I 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 ofMGL 40A. Contact the Office of Planning & Development for more information. ___ _ Fil26213 Please type or print all information and return this form to the Building Inspector's Office with the $1sJilingfee (check or money order) payable to the City ofNorthampton 1. Name of Applicant: In/Jilt.. /&wvJlru 'Pev~~7 ~f /,. ~c.. Address: de ,0 £XC/.J/rijf J/. d ,4'fU-( Jnt Telephone: '7"1] J}?-'i1C?'f 2. Owner of Property: f/fJrti-/If /tfIt4ttit Address: / Telephone: 3. Status of Applicant: Owner I Contract Purchaser Lessee Other (explain) 4. Job Location: 74J MIIII/ J'l e/?'UN02­ 5. Existing Use of Structure/propertY:_-I-In......,.,,-{;_?_}_/._~-,-1.L.!__~...!.-.--,-,-/._a---=·'-:1'-.______________ 6. Description of Proposed Use/Work/ProjectiOccupation: (Use additional sheets if necessary): 7. Attached Plans: Sketch Plan Site Plan 7 Engineered/Surveyed Plans __V'__ 8. Has a Special PermitlVariance/Finding ever been issued for/on the site? NO .DONT KNOW /' YES IF YES, date issued: ________ IF YES: Was the permit recorded at the Registry of Deeds? NO ____ DONT KNOW YES ____ Book _____IF YES: enter Page --7"---and/or Document # ______/'9.Does the site contain a brook, body of water or wetlands? NO DONT 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-Pennit-Application-passive.doc 8/4/2004 YES ~___ NO _____10. Do any signs exist on the property? '/ IF YES, describe size, type and location:_k'-"--'-I..::.t?~'/J"---'-'/"'-:lJe'I4---J;oIJ'-I-i_---,/h.E.L.<.J,'I',qIL........:J:;...V'---._cL_~_1vt:-_V.-:;,1:f-'if___-,­-r- (j YES _____NO______Are there any proposed changes to or additions of signs intended for the property? IF YES, describe size, type and location: ________________________ 11. Will the construction actMty disturb (clearing, grading, excavation, or filting) ovej:.1 acre or is it part of a common plan of development that will disturb over 1 acre? YES__ NO _Y_ . 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 colwrmreserved for use by the Building EXISTING PROPOSED Lot ~Jl, '1 Side L: R: L: R: Rear /1,11­ 13. Certification: I hereby certify that the information contai ed herein is true and accurate to the best of my knowledge. Date: Applicant's Signature --"'-'-_-hl'-__-=r+___-/J1--~-~-~----d-/xj;J . NOTE: Issuance ofa zoning permit does not relieve an applicant's burden to complywith all zoning requirements and obtain all required permits from the Board ofHealth, Conservation Commission, Historic and Architectural Boards, Department ofPublic Works and other applicable permit granting authorities. 8/4/2004W:\Documents\FORMS\originai\Building-Inspector\Zoning-Permit-Application-passive.doc