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18C-032 (2) File#MP-2007-0046 APPLICANT/CONTACT PERSON ST. MARY CEMETARY ADDRESS/PHONE 235 NORTH ELM ST (413)584-3257() PROPERTY LOCATION BRIDGE RD MAP 18C PARCEL 032 001 ZONE RR THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ACTING FORM LED OUT idFCCl Building Permit Filled out Fee Paid Typeof Construction:_ZPA-BERMED FILL 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 PRUENTED: Approved V Additional permits required(see below) yy�� PLANNING BOARD PERMIT REQUIRED UNDER: § � ^/V -4 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 Commission Permit from CB Architecture Committee Permit from Elm Street Commi de7" /C),/;7' .46o6 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 the Office of Planning&Development for more information. • L .0! i' File No. 1P0 9"?' GCT 1 3 2006 ZONING PERMIT APPLICATION 010.2) . , Please type or print all information and return this form to the Building Inspector's Office with the $15 filing fee (check or money order)payable to the - City of Northampton 1. Name of Applica t: / et /V.// Address 4'/6'e . t d( r 14 0/0 TeIephone:f 2. Owner of Property: r/&,sigy coltehr,y, Address cZ r WA/4' /OWno d//J Telephone: 3. Status of Applicant: Owner Contract Purchaser Lessee Oth (explai et-1r ©A CC/rs4✓'s 4. Job Location: Parcel Id: Zoning Maps Parcel# U 3 Z District(s): In Elm Street District in Central Business District (TO BE::FILLED-AI_EY T BUILDING DEPARTMENT) 5. Existing Use of Structure/Property: Ce itAe TE 2Y 6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary): -562.rne b FIIC.c, 1200 yards 7. Attached Plans: Sketch Plan ✓ Site Plan Engineered/Surveyed Plans 8. Has a Spec' 1 Permit/Variance/Finding ever been issued for/on the site? NO i DONT KNOW 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 V 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:1Documenm\FOPMS\origin2r\Buiiding-Lnspecto?Zoning-Pe?mit-Application-passive.doc 8/4,2004 10. Do any signs exist on the property? YES II NO K typeC)' X `� Cr i IF YES, describe size, and location: /� �-�. �S'/� 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) Qver 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 ZONING Lot Size /0 Aft, � Frontage Setbacks Front • Side L: R: L: R: t: R: Rear Building Height /P/1 Building Square Footage /tiM • %Open Space: (lot area •minus building& paved �4 :. parking #of Parking Spaces IU4 of Loading Docks Fill: (volume & location) s22 (Jr 13. Certification: I hereby certify that the information cont.' ed h_ ein is true and accurate to the best of my knowledge. ' Date: Applicant's Signature . �P 4S)1 NO : 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. 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