74 Bridge St Rear Bldg App 2007-02-01Lot: -001
Permit: Building
BP-2007-0753
COMMONWEALTH OF MASSACHUSETTS
CITY OF NORTHAMPTON
PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category: NEW COMMERCIAL BUILDING BUILDING PERMIT
Permit# BP-2007-0753
Project# JS-2007-00087 4
Est. Cost: $250000.00
Fee: $1420.44 PERMISSION IS HEREBY GRANTED TO:
Const. Class: 5B Contractor: License:
Use Group: Mixed,R3
Lot Size(sq. ft.): 22999.68
Zoning: URC
JOHN MARCHEFKA 090278 ---~~~
Owner: MARCHEFKA TODD A
Applicant: JOHN MARCHEFKA
AT: 74 BRIDGE ST
Applicant Address: Phone:
141 2ND ST (413) 824-8789
TURNERS FALLSMA01376 ISSUED ON:2/1/2007 0:00:00
Insurance:
WC
TO PERFORM THE FOLLOWING WORK:CONSTRUCT MIXED USE BUILDING
(BUSINESS/RESIDENTIAL/STORAGE
POST THIS CARD SO IT IS VISIBLE FROM THE STREET
Inspector of Plumbing Inspector of Wiring D.P.W. Building Inspector
Underground: Service: Meter:
Footings:
Rough: Rough: House# Foundation:
Driveway Final:
Final: Final:
Rough Frame:
Gas: Fire Department Fireplace/Chimney:
Rough: Insulation:
Final: Smoke: Final:
THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF
ANY OF ITS RULES AND REGULATIONS.
Certificate of Occupancy Signature:
FeeType: Date Paid: Amount:
Building 2/1/2007 0:00:00 $1420.441098
212 Main Street, Phone (413) 587-1240, Fax: (413) 587-1272
Building Commissioner -Anthony Patillo
File# BP-2007-0753
APPLICANT/CONTACT PERSON JOHN MARCHEFKA
ADDRESS/PHONE 141 2ND ST TURNERS FALLS (413),824-8789
PROPERTY LOCATION 74 BRIDGE ST
MAP 32A PARCEL 177 001 ZONE URC
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Typeof Construction: CONSTRUCT MIXED USE BUILDING
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Buildin Plans Included:
Owner/ Statement or License 090278
3 sets of Plans / Plot Plan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
l~F~ATION PRESENTED:
-L,.L'Approved __ Additional permits required (see below)
PLANNING BOARD PERMIT REQUIRED UNDER:§ _________ _
Intermediate Project: ___ Site 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 ___ Water Availability ___ Sewer Availability
___ Septic Approval Board of Health ____ Well Water Potability Board of Health
Permit from Conservation Connnission Permit from CB Architecture Connnittee --------'
Permit from Elm Street Connnission ---
Signature of Building Official Date 1 /
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 Office of
Planning & Development for more information.
Versionl.7 Commercial Buildin
City of Northampton
Building Department
212 Main Street
Room 100
Northampton, MA 01060
phone 413-587-1240 Fax 413-587-1272
APPLICATION TO CONSTRUCT, REPAIR, RENOVATE, CHANGE THE USE OR OCCUPANCY OF, OR DEMOLISH ANY BUILDING
OTHER 1HAN A ONE OR TWO FAMILY DWELLING
SECTION 1 • SITE INFORMATION
1.1 Property Address: 1----,. -··--_____ .. -.......... _____ , .............. _,., __________ "'"'"'-"l
!7 4 Bridge St. · 1 Map ' ;Lot
!Northampton, MA. 01060 · ) zone Overlay District
L_ .. , -----.... ·--·-··--· .. ·-·-····--·-·-·-------··----........ _ ....... -.......... -.. : ... ____ ] Elm St.District . CB District
. SECTION 2 • PROPERTY OWNERSHIP/AUTHORIZED AGENT
Name (Print)
Signature
2.2 Authorized A ent.
[ _____ -_Jo H N _ .[AA (Z..c_BE_ftlA ·------· .... _J Lr YI i~ ... 5-'( ___ 1uruv.f flS FA 1., Ls __ 013 l~J
Name (Print) Current Mailing Address: l .. ~------~2'i-_67f.9 ____________ ,, _____________ , ............ 1
Signature Telephone
SECTION 3 • ESTIMATED CONSTRUCTION COSTS
Item
1. Building
2. Electrical
3. Plumbing
4. Mechanical (HVAC)
5. Fire Protection
6. Total = (1 + 2 + 3 + 4 + 5)
Building-Permit Nurn.ber
Signature:
Estimated Cost (Dollars) to be
com leted b ermit a licant
., .. -•-~•~»•~~-m~-~
'}..() .Q -
r _____ .................................... ,. ....... ., ........ · -··· :--·-1
1 lo {) oO .· 1 ... . ...................................................... .,, ___________ , ....... !
Official Use10nly
(a} Building Permit Fee
(b) Estimated Total Costof
Construction from 6 ·
Building. Permit. Fee·
Che.ck Number . i:e I D 9 8
This Section For Official Use Onl
Date
Issued
Building Commissioner/Inspector of Buildings Date
Version 1. 7 Commercial Building Permit May 15, 2000
SECTION 4~ CONSTRUCTION SERVICES FOR PROJECTS LESS THAN 35,000 I CUBIC FEET OF ENCLOSED SPACE
Interior Alterations D Existing Wall Signs . D Demolition D RepairsO Additions 0 Accessory Building D
Exterior Alteration D Existing Ground Sign 0 NewSignsD RoofingO Change of Use D OtherD ,·-,··---··-··-·-···~·--·····-···""""'""'-'"""~-·-------·-·""'""""'"""-·""·"-""""-·-···---.... -----·~-----·--·-""-"""-''"-'"··-·-··--""····-·--·----"·-···"-··--·,
Brief Description Enter a brief description here. . . , · I
OfProposedWork:L CoN5TfLlA.,,C[ M1xO) lASt \j!All--DiN_~_ . i
-·-----··"·---------...... ----···---.. ·---··-----···"··-·····--···-·" ----------------"""-"·-··--·""""'"·''-"""'"'"""""""""'"--·-·--·---·-----,_J -SECTION 5 , USE GROUP ANO CONSTRUCTION TYPE
USE GROUP (Check as applicable) CONSTRUCTION TYPE
A Assembly 0 A-1 D A-2 D A-3 D 1A D
A-4 D A-5 D 1'8 D
B Business D 2A D
E Educational D 28 I D
F Factory D F-1 D F-2 D 2C D
H Hiah Hazard D 3A D
I Institutional D 1-1 D 1-2 D 1-3 D 38 n
M · Mercantile D 4 D v R Residential D R-1 0 R-2 D R-3 mt' 5A ~ s Storage D S-1 D S-2 D 58
u Utility D Specify:/
.. _ _.
!
M Mixed Use ~ Specify: L'BuStEfSS_/&_t_<; l_i)t N tA ~/~To(l..A_§"_ f_ .. __ ... _ .. , ________ ... ____ ·' J
s Special Use D Specify:! I
' COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATIONS, ADDITIONS AND/OR CHANGE IN USE
Existing Use Group: l l Proposed Use Group: I
Existing Hazard Index 780 CMR 34): I l Proposed Hazard Index 780 CMR 34): I I
SECTION 6 BUILDING HEIGHT AND AREA I '
OFFICEUSE OtllL 'f · ... .··.
BUILDING AREA EXISTING PROPOSED NEW CONSTRUCTION .
Floor Area per Floor (sf)
\ .·
1·1 r-·· I 1•t L ______ -_-··------.. ---·· ___________ 1.,:1s2!
2nd'------------·---------.. ----~ .. --.. i,6121
',
2nd I._ l .
3rd I ! 3rd I I
4th I I 4th l I
Total Area (sf) I l Total Proposed Nr Construction (sT094]
'"°'""'""""''"""""---·--.···---·-----·-1----·
Total Height (ft) l .J I._ .. _ ·--------------3Qj Total Height ft i
-
7. Water Supply (M.G.L. c. 40, § 54) 7.1 Flood Zone Information: 7 .3 Sewage Disposal System:
Public 0 Private D Zone L _____ j Outside Flood Zone@ Municipal IZI On site disposal system D
,...,..,-_,...-----------,Versionl.7 Commercial Building Permit May 15, 2000
,<s .. NORTHAMPTON ZONING
Lot Size
Fronta e
Setbacks
Building Height
Bldg. Square Footage
Open Space Footage
(Lot area minus bldg & paved
arkin )
# of Parkin S aces
Fill:
volume & Location
Existing
L .\ ·1 R·I 11 ---·~·--
Proposed
rvn ~.-~,.,~~,~.,-.
LtS:J
Required by Zoning
This column to be filled in by
Building Department
A. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO O DONT KNOW O YES @
IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO O DON'T KNOW O YES @
IF YES: enter Book r. ·-··"'··~ ...... 1 Page[~.=-·~=] and/or Document u[e~~~-i?q--~~~Qlt
B. Does the site contain a brook, body of water or wetlands? NO @ DONT KNOW O YES Q
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained 0 Obtained
C. Do any signs exist on the property? YES
IF YES, describe size, type and location:
0
0 , Date Issued: , ................ ,_, .. _ ................. --'
NO. @
D. Are there any proposed changes to or additions of signs intended for the property ? YES Q NO@
··-·-·""""'""-·-···
IF YES, describe size, type and location:
E. Will the construction activity disturb ( clearing, grading, excavation, or filling) over 1 acre or is it part of a common plan
that will disturb over 1 acre? YES Q NO @
IF YES, then a Northampton Storm Water Management Permit from the DPW is required.
Versionl.7 Commercial Building Permit May 15, 2000
SECTION 9-PROFESSIONAL DESIGN AND CONSTRUCTION SERVICES -FOR BUILDINGS AND STRUCTURES SUBJECT TO
CONSTRUCTION CONTROL PURSUANT TO 780 CMR 116 (CONTAINING MORE THAN 35,000 C.F. OF ENCLOSED SPACE)
9.'.I Registered Architect:
L _____ .. ------------------.. ----. __ -·--·--------.. ----------------· ____ ............ _________ ·-·------........ _I
Name (Registrant):
!_ ..... -. _., --··------·-··------------·-----·--··"'""'"·"'-....................... , .. ,. ..... _ .... --"·-·············· ..... ,.... . -----·····--· ____ __J
Address
L ...... : .. : .. ~---=~~-·-:=J
Signature Telephone
9.2 Registered Professional Engineer(s):
L---------------. ..--------------------------------··· ·-----------· ______ .. : ____________ J
Name
L·--·-----·---·--·------... ____ · . ·------··------·----------........... ---·.·-·--·-·--··· ....... -........... ____ '" _______ .... l
Address
Not Applicable 0
l ___ .......... ..... ___ .. . ___ . ......... . .... . ·-·--_ I
Registration Number r--·------------·---·-··-.. ·-------------···--"·
L-~-·-" ~·-"=«-.,,.,~~-~
Expiration Date
··-·1
I ~,--1
l.-·· ----.... _ .. __ '"C··--................ · -___ J
Area of Responsibility
L ____ . -. ... .... --·-·· .. ... ---· .................. J
Registration Number
'1: __ -__ -__ .. __ ···_-~-----_:~.---_-_-__ ··_-., .... --~=-·1 ' . . . . . . . l ---.... --... -.. ---L. ----·-------------.... -----.... ··-· ..... .. ..1 -----------------------Signature Telephone Expiration Date
Area of Responsibility r·~··--~•AW ~"'"""wc·~,~-.. ~MC neN~--~~~,.,~,,.._«~~-.----··-·-, •~'""••--•"~,,~----~--,q -'<~A••--~~H'>-~~--,~,-~~" ,.--~T ..... , .... ~~•UA, ... ~¥>.•<'<'• .,,.~o-u•o>,,h~<~•••~-~·,
Ls .. ;, ............... -·····-··-·-···-----------····--···------·····--................ --.............................. ,,-...... , ····------·-···-.. -----------··-0---J l -. ,.... .... .. --.. ----. -·-. ,._.......... _J
Address Registration Number
r ....... -·-----.. -·--------... _.1 1._· ----·-··--,.·-----·--·-·--·-.. ---__________ __1
Signature Telephone Expiration Date
• • • • • • • • •• • • • .,,,~,><••-••=•-,·.~-=-,-=-•s•o•_•-,.,•_.,.•,~-,-,•
f . - ' --" ---·-··"·" . . -. --~ . ., . ., _., "' -· --·--···-.. ~-----·---~·-~·--,,.-".. --·.,••o,.·~·-·--· --·---··-· ... ·~~ , ____ J
. i -.... _ ..................................... .,. _______ ,~--·-·--__ ··_-___ ··_·-.-~ ...• -!
L............... .......... -·-... .
Name Area of Responsibility
r· ----·-----... ~:.... -~ __ , __ ,__ . ....... --.. --------. ----·-----------·---.... ,.. _____ , .... _ .. _ ......... _ --.. J .. -.. .------.... -............. _______ . .,_ ....... ___ .. _ .... _ ..... _.,
I I L~-~•-c •••-•·~~--, ,~,,~ ~,-.~,._.-..,~._.,~,~~-·•~•aa~·~•w>,../ •, • •-.,>
Address Registration Number ,------··-· ·----·-........... -.. -1
I 1
-----------------------1~-,L~,~. -''"~-~~••o -" p,,,_J [ ··-··----·-..... _.... .... .. -........... . .. . ............ . __ J
Signature Telephone Expiration Date r ______ ., ............... ------------,-···--------· ........ _______________ .. ____ ... , .. .,--··---·--··· .. --·---··------··-------"--.. -·-,
, I
I~~,., --· -~~,-, ••----~~""".,.,.._""~'-'•-·•~-~-~------~w-·. •••-,< -· ~m,,o• --••A••,• -•·•-~,.,~,.r-••---·--•·•---•-·•---•~s-r•• .. ,.,,._,c•-,o~~'r-•-~-·-•'-"-••••I
!'""" -------·-------·--··------.. ,,_ ..... -·-""" ........ 1
L,. ----..... ........ . . .. ........ _ ..... ..................... ..................J
Name Area of Responsibility .·----·~~·~·-··--·~·----~·~~---~--·--···"·--~~-,=-·--~~~-~---~~~-~-... ~~-··-~~~·~~··-"·--··~ ·-·~---~-~~=--~"~' ,-.. u. ·-~·~· ..,.,..~.,-... ~--,
!.............. ······· ..... ,. ---..................... , ............... ., ............. .,................ ......... ........................ . .......... J L .. · ........ ····-------.......... ,.. .. ..... "'.. ......... .. ...... --..... J
Address Registration Number !_, .............. --·--·-·-------·--1
L-,.,v·-··---.----·-~••••·-·-··-·--1
\~ll-"'~ . -~--·~~ .. ~---~-----~-,·-~-·---· '"~~-..,~~~~~
1 L---~ ......... ---~·
·····------1 ... ____ J -----------------------Signature Telephone Expiration Date
9.3 General Contractor
11Y!ir~h~fl£~ R~ilders, LLC .... · ............ ·-----------.. ---·------.. --........... ···-~·--·--·---------,.--J Not Applicable D
Company Name: . .
tJohn J ~archefka .... ·.. ................. . .............. __ ------------....... , · ..... ____ .................. -...... · ___ ]
Responsible In Charge of Construction . ----··---·····---·--~·----~--·····--_._ .. _,.,,.... ............... " ......... -.... -................ ____ ............. ..................-...................................... "I I.!.~ l __ ~_nd_ .. ~tre~t _Turners Falls,_ MA. 013 7 6 _, ___ ....................... ___ ................. .................... ___ Q
n:1'lJ/l j Sigr1',iture ' ' Telephone
\J
Versionl.7 Commercial Bl.lilding Permit May 15, 2000
SECTION to~ STRUCTURAL PEER REVIEW (780 CMR 110.11) ...
Independent Structural Engineering Structural Peer Review Required
SECTION 11 • OWNER AUTHORIZATION • TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUil.DiNG PERMIT
I
Yes Q No 0
r;:;-----··------------····--··-------·--, '··-·"'··--·-·---·-·----------,···----·--·---·-' ------------·-·----, ! Todd A Marchefka . j . I, ---·-· --· ·-·--· .. ·-·· ____ .__., ___ -------··--···-·-······ . ··--··-·-----....... , as Owner of the subJect property
act on my behalf, in all matters relative to work authorized by this building permit application. ' ,---···-··· ---------·"'---------···-·-·" .. ··---··-·1
~!/}~~20~7 -·-···-·--------.... _ .,. ..... _ I
Signature of Owner Date
I, ""[ _____________ ·-----------------------....... --'-··--------=--=---·----------====---------· ·----~--------·------·----------------· ·---·-----·---·--· ----· =· ___ .. ___ ... ___ ·· · ____ -___ • ___ · ------· ----------... -... ! ___ , as Owner/Authorized
Agent hereby declare that the statements and information on the foregoing application are true and accurate, to the best of my knowledge
and belief.
Print Name
Signature of Owner/Agent Date
SECTION 12 • CONSTRUCTION SERVICES
10.1 Licensed Construction Supervisor:
l"""' ... -··· -----·· -'"'"" -------·--··-·----------·-·--·-....................... -................ -.,
Name of License Holder: j}o~}.:. lV!.ai:.<?.~~~a _______ ,________ --···--------·----·--·------------!
License Number
L . J21lJ_ ~ ZS.. .. ____ .... ·._ ----.J
Telephone
e~"''" °'; / 1/o 8 1(413) 863-0011 I L .... ,------------·-----·--···--··--···----'
ION 13 -WORKERS' C.OMPENSATION INSURANCE AFFIDAVIT (M.G.L, c. 152, § 25C(6))
Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result
in the denial of the issuance of the building permit.
Signed Affidavit Attached Yes @ No Q
i
J !
I . i
j
! ;
.•
DEPl'..R.TMENT OF BUIL.DI~C IN.SPc:CflON.S
212 J\-f:iin Street • Municipal Du;Jding
J\'orlhomplo!i, M ii.ss. 01 OGO
aasemen.::@ . $.15
, ls.: Flo:,c-@ $-.~
2nd Flooc-@ $,..30 ·:
1/2 rloocs. · At:.tic. Gar-age ··$-15
Deck·, Pocches .$.15
Sguate fooc.age_
.-o -----
l b l -z...
/612--
T.OT-J,.l.
. ' ': /i/L'{{ J;;~(-.; . . -~------~~------------
.:.
i
Amount:
f 7 Lf IC oo
1f q86.orJ.
t 193, 4!lf_
•:--:-·-....
Thomas Douglas Architects Inc
CODE REVIEW I November 27, 2006
New Building at 74 Bridge Street
Northampton, MA ' 3'LA --11;
PROJECT DESCRIPTION:
Construction of a new residential building in the rear of the existing lot containing the
"College Inn" at 74 Bridge Street.
.GENERAL INFORMATION
Applicable Building Code : 6th Addition, Massachusetts
SITE INFORMATION: I
Project Address 74 Bridge Street, Northampton, MA
Parcel Number I
Net Site Area '
Total Building Area
Zoning District
Parking Analysis
I BUILDING INFORMATION:
Number of Floors: 2 I
Occupancy Use Groups:/ R3 residential with accessory office, garage, and storage
Fire protection: Smoke ~d Carbon Monoxide detectors
Construction Type: 5B dombustible, unprotected
Exterior bearing wall rat;ng: 0 hour
Exterior non-bearing wall rating: 0 hour
Fire separation assembli~s for Use Groups: 2 hours
I
!
BUILDING AREA CALCULATIONS
Occupancy Use GroupsJ R3 residential
Base allowable area: 4,8;00 square feet per floor
I Frontage increase: 0 !
Sprinkler increase: 0 :
Area Increase factors; 0 I
Total Allowable Area: ~,800 square feet per floor
Actual Area: 1655 Sq. ~t.
I
1 of3
Thomas Douglas Architects Inc
Fire Protection Notes:
Fire separation as~emblies between R3 use groups are requ~red to be 2-hour rated.
(Table 313 .1.2) 4-hour rated walls spanning from the concrete slab to the
underside of the rpof deck will be maintained between these use groups.
FIRE RESISTANCE RAlTINGS OF STRUCTURAL ELEMENTS
Structure element i Fire resistance Ratings of
I Structural Elements
(Type SB construction)
. (hours)
Exterior wall Loadbearing 0
I Non loadbearing 0
Fire walls and party wall~ 2
Fire separation assembli~ Fire enclosure of exits 2
Shafts I Shafts and hoistways 1
Mixed use & fire area 2
seoaration
Other separation I
assemblies
Fire partitions Exit access corridors · 1 (without sprinkler system)
Tenant space 0
separation
Other non load bearing partitions 0
Interior load bearing wa~s, Supporting more than 0
partitions, columns girders, one floor
trusses ( other than roof 1 russes)
and framing
Structural members sup1orting 0
wall
Floor construction including 0
beams I
Roof construction inclutg 0
beams, trusses and fr, g,
arches and roof deck
2 of3
Thomas Douglas Architects Inc
FIRE SUPRESSION AND PROTECTION SYSTEMS:
• Fire suppression systems (sprinklers) will not be installed in the building. They are
not required in R3 uses since there are 2 independent means of egress for each
unit. They are no~ required in B uses since the use areas are less than 12,000
square feet.
• A new fire protetve signaling system ( alarm control panel) is not required in use
groups R3 orits I .. cessoiy uses. (917.4)
• A new fire prote9tive signaling system ( alarm control panel) is not required in use
groups B or its accessory uses if the B use is not 2 or more stories above the exit
discharge level. (917.4.2)
• For Use Group i areas:
• Combinaj' on Smoke and Carbon Monoxide detectors will be installed:
• In each story
• In all bedrooms
• wiithin 10 feet of each bedroom .
MEANS OF EGRESS:
• Hrbitable spaces adjacent to the garage
2 Exits are required for each space or tenant. The multistory R3 use may have an
exit on one leveltonly. (1010.2 exception)
Panic hardware i not required
Exit signs and elergency lighting will be installed in the accessory office use.
HANDICAPPED ACCtSIBILITY and TOILETS:
All entries are at grade and handicapped accessible.
A new unisex h dicapped-accessible bathroom will be installed in the accessory
office.
In the accessory storage use area, the second floor spaces are not areas open to the
public and will ot be accessible by an elevator.
3 of3
, Conditions of Special Permit, 7 4 Bridge Street, (32A-1 Y.7) 10/19/2005
1. Prior to issuance of a building !permit, the applicant must submit revised plans showing
a) accurate location of relocated retached garage at a 15' side setback and 20' rear setback;
b) interior floor plans with bath a~d kitchen space eliminated from the "office and storage" units;
I c) plans labeled that show ~ lodging units in the main building and 1 aparlment unit in
the garage. I
d) Water and sewer plans need to be approved by Department of Public Works.
2. "Office and storage" may only be associated with existing uses on premises.
(
\
1.
2.
3.
4.
DEC -5 2007
l--P-le~se fyj:)e:~or-' :{)':~· information and return this form to the Buildino-
Inspector's Office ivith the $15 filing fee (check or money order) payable t~ the
City of1VorLhampton
Name of Applicant: -r;JJ f1 a rc.&1..e f kt:f.
Address: 7J../ B~e.. ~+reef-/ KC)t.l-e Cf Telephone: 4/3, ..2 3 7.-5§55-
0wner of Property: ~d) )1 a r::.he -P/c.t:<
Address: 7£..{ &,/tfje S.free:f,/~uk. Cf Telephone: ct/J .. ';257e S-S-S.S-
Status of Applicant: Owner V Contract Purchaser ___ Lessee. ___ Other (explain) -----
Job Location: . 7 q Br1d.,e S+re..e_,,f-,ll~oule r l<eav' bv/ldt':J
5 .. Existing Use of Structure/Property:. ______ -'------'---------------
lv EW Aa~ssoYLJ-t c:;-r µ_c.,TuVL-E
6. Description of Proposed Use/Work/Prqject/Occupation: (Use additional sheets if necessary): .
, -, JJ N · J"Vvtfe
} Jv fv offl C6
7. Attached Plans: Sketch Plan ./ Site Plan ___ _ Engineered/Surveyed Plans __ _
a. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO ___ _ DON'T KNQW ___ _ fF YES, date issued:._--=-(p--~·· _.2_1-_o_<.,,._
IF YES: Was the permit recorded at the Registry of Deeds?
NO --~-· DON'T KNOW . YES /
lFYES: enter Boole c)B 7&/ · Page :2 8 3 and/or Document# _____ _
9.Does the site contain a brook, body of water orwetlands? NO .... · VD~N'T KNOW __ _ YES __ _
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs tb5e.bbtaineo. ···---···--. ---··-· ... ·-··--· ·--obta med _____ , date issued: ______ _
(Form Continues_On Other Side)
8/4/2004
..... _ ....
'10. Do any signs exist on t'1e property? YES ___ _
IF YES, ·describe size, type and location: _________________ ---'--------...:..
Are there any proposed changes to or additions of sigi,s intended for the property? YES ____ ;NO
IF YES, describe size, type and location: ______________ ..:.-_ __, _________ _
11. Will the construction activity disturb (clearing, grading, excavation, or :fi!ling) over 1 acre or is it part of a common
plan of development that will disturb over 1 acre? YES___ NO _l:C_
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 JfllFORMATION • . •; t
fLoC fl6f
. T'nis column reserved
for use by th.e Bu:ilding
DeDar!Ioea.t
I
Lot Size
Frontage
Setbacks
. Building Height
Front
Side
Rear
Building Square. Footage
I
% Open Space: (lot:area
minus building & paved
· arkinq
# of Parking Spaces
# of Loading Docks
L:
. J
Fill: J .
... .... --,--.... .{l!olume_&Jo.catL011)_____ ··-.
EXISTING PROPOSED
J.
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.. -13 ... Cec:tlfi.cati.on,;,J..!:!gr:eby certify that the information corrtained herein is true and accurate to the best of my knowledge. ·· · ·-·-···--.... ·· · · .... ·· ---------------------.......... .
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::: 2°:~ zoning;::;:s:::.~G~:! :_!f!Cfuall zoning
requirements and obtain all required permits from the Board ofHealth, Conservation Commission,
F..istoric and A:rchited:u_-r-al Boards, Department of Public 'Works and ofaer applicable permit granting
authorities.
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814/2004
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