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23A-059 (10) File #20 — `'• V- APPLICANT/CONTACT PERSON:SARAH T BURNHAM 55 MAPLE ST FLORENCE, MA 01062 PROPERTY LOCATION 55 MAPLE ST MAP:LOT 23A-059-001 ZONE • THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST • ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Building Permit Filled out Fee Paid $30.00 Type of Construction: ZPA -CONVERT HOUSE FROM 2 FAMILY TO 3 FAMILY New Construction Non Structural Renovations 3-0 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 INFOR_VATION PRESENTED: pproved 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 SpecialPernit With Site Plan ZONING BOARD PERMIT REQUIRED UNDER: § Findin: Special Permit Variance* Received&Recorded at Registry of Deeds Proof Enclosed OtherPerm its Required: Curb Cut from DPW Water Availability SewerAvailability 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 Managemenit Demolition Delay 3-1-7-2DZ7 Signature of Building Official 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 Office of Planning&Development for more information. 1-itUbk L. C.40 (/00 4430 MAR 1 5 2022 File No. di,u ZONING PERMIT APPLICATION t§lo.2)=. Please type or print all information and return this form to the Building Inspector's Office with the $30 filing fee (check or money order)payable to the City of Northampton 1. Name of Applicant: z 5cu yl�- Lk V��Qyle) Address: 55 Mcc pia t InrelicQ /`fit I Q% Telephone: 41 3 522 5 66 2. Owner of Property: rnLo Q-A ca_bc V—C Address: Telephone: 3. Status of Applicant: Owner � Contract Purchaser Lessee Other (explain)__ 4. Job Location: 55 M L3 S , UYC►1 co I A 0 (06 - Parcel Id: Zoning Map# Parcel# District(s): In Elm Street District In Central Business District (TO BE FILLED IN BY THE BUILDING DEPARTMENT) II 5. Existing Use of Structure/Property: 2, `mu 1 — (c ru ' 1\O.JJA +1C AbC , OW2.. l A Gee-FCcc NZ.C\ `� i n- 6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary): C1'vc z v c -PC.,m 2 - -Yu.Ul #c {3 So U.c e cci.,Lla \ d. 6...2a L vl4 Z U (a Lk cia rhoo4 10 O .o) 7. Attached Plans: Sketch Plan V Site Plan Engineered/Surveyed Plans 8. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO DON'T KNOW YES IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO DON'T KNOW V 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 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) ovQr 1 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 EXISTING PROPOSED REQUIRED BY ZONING Lot Size O 1 g 3 ID, 9 3 3 Frontage Setbacks Front Side L: R: L: R: L: R: Rear Building Height 2'/z s Z'/2 s Building Square Footage Otiv t �� 2 , 560(aPp 1 %Open Space: (lot area Cc"'fb)() ►—' 3 r7 3 2 minus building B paved parking \0 33-356G= #of Parking Spaces u - 5 4-5 #of Loading Docks 0 Fill: (volume It location) U CS Cl 13. Certification: I hereby certify that the information contained herein is true and accurate to the best of my knowledge. Date: �/ 4/2-2— Applicant's Signature efai, 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-lnspector\Zoning-Permit-Application-passive.doc 8/4/2004 Iv/r bpi Kr_13/Ni. 23A-59 FOUND MOLLY BURNHAM & IRON PIN SARAH BURNHAM TO BE SET S89'39'42"E BOOK 6612 N PAGE 73 1)/M lit /4tl 3.8 ' 1__I09 r I'01114i c t �_ 10,933 SQ. FT.± 50.6' oP i%� Fjf 29 / --Zof --n 78 »� I;MIL I(U = / 2 1/ �_ ' I I �� �` ',ll!/' at w / W/F HOUSE // ' �i- i `9` u . ;� y i1()c?I< r iD; I 'F pt N 1, V) Irs � I 1 15 / ca to Q 1" IPF Q; rn ° DOWN 0.2' I �i P- I % IPF ' J SHOT © BASE 167.45' L' S89'51'30"W 1 I " k o. 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