31A-192 (4) File 4 MP-2019-0048
APPLICANT/CONTACT PERSON KEiTER BUILDERS
ADDRESS/PHONE 35 MAIN ST (413)586-8600()
PROPERTY LOCATION 75 WASHINGTON AVE
MAP 3IA PARCEL 192 001 ZONE URB(I001/
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out
Fee Paid
TvmeofConstmctiom ZPA-DEMO EXISITNG GARAGE AND CONTSTRUCT NEW
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:
Ll 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:
Cub Cut from DPW Water Availability Sewer Availability
Septic Approval Board of Health Well Water Potability Board of Health
Permit from Conservation Commission Permit from CB Architecture Committee
Permit from Elm Street Commission Permit DPW Storm Water Management
Z /�_ �� X 3(, 1( 7
Signature of Building ial 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.
ly
File No. h7�/q' `/O # � �Kq 6�
ZONING PERMITAPPLICATION (§io.2)
Please type or print all information and return this form to the Building
Inspector's Office with the $30111ingfee (check or money order)payable to the
City of Northampton
1. Name of Applicant: O ul\ QeL , VC
Address: 3S 0,CkkJ\ lIi �7(Pf Telephone: 79
6 E6C)U
2. Owner of Property:—gLo_
Address:7i5 Wasl�.If� J'1�.)J�w\.__Telephone:�L�. '
3. Status of Applicant: Owner ___ _Contract Purchaser, . --Lessee-- Other (explain) ra^,TILAoT.tY�,
4. Job Location: 3-s
Parcel Id: Zoning Map# 3 Parcel# . //�7--�L District(s):
In Elm Street District In Central Business District
_ (TO BE FILLED IN BY THE BUILDING DEPARTMENT) _
5. Existing Use of Structure/Property: 022> q>tir- QFS�nCw�1tka.-•
b. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary):
_—
GEVk J,.`E oF._�xlSi Nfki�.fi_�iE, ION StTLO�. NEW b•4ft.r4f„G _
S SEJg`�QI-. L% FFTFiCF+ei)._
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_ DONT KNOW..__ yYES 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# _
o.Does the site contain a brook, body of water or wettands? NO _. Jl_ 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)
WO i Q OHMSVonginelARuild,,r In..mad/nnluclbrmu APFL ,u,,, -......due Nil,'00;
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 filing) over cre 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
/)w&, ,31y -/,9L—cc Deportment
EXISTING PROPOSED REQUIRED BY
ZONING
Lot Size
Q . Z¢ AlitS L1r26 AcnC
Frontage
Setbacks Front
Side L: R: L: R: L: R:
Rear
Building Height
Building Square Footage ,L
2-
%
%Open Space: (lot area
minus building Et payed
parking
#of Parking Spaces 2—
#
#of Loading Docks
O U
Fill:
(volume B location)
13. Certification: I hereby certify that the information cont erein is true and accurate to the best of
my knowledge. 7CL
Date: _ .Applicant's Signature
NOTE:Issuance of a zoning permit does not r leve an applicant's burden to comply with all zoning
requirements and obtain all required pe its fr m the Board of health,Conservation Commission,
historic and Architectural Boards,Department of Public Works and other applicable permit granting
authorities.
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