06-055 349 HAYDENVILLE RD BP- 2012 -0064
GIS #: COMMONWEALTH OF MASSACHUSETTS
MV-,Bloc 06 - 055 CITY OF NORTHAMPTON
Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category: Tents BUILDING PERMIT
Permit # BP- 2012 -0064
_Project # JS -2010- 000164
Est. Cost:
Fee: $25.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: Homeowner as Contractor
Lot Size(sq. ft.): 617245.20 Owner: LINDA MANOR LLC
Zoning: SR(100) Applicant. LINDA MANOR LL_ C_
AT. 349 HAYDENVILLE RD
Applicant Address: Phone: Insurance:
349 HAYDENVILLE RD (413)586 -7700 O
LEEDSMA01053 ISSUED ON. 7118120110:00:00
TO PERFORM THE FOLLOWING WORK.- TENTS
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: Oil: 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 7/18/20110:00:00 $25.00
212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272
Louis Hasbrouck — Building Commissioner
L
f I
.
fJUL 18 2011 ; ` File No.
-
P 'formation and return this form to the Building
Inspector's Office with the $i5, filing fee (check or money order) payable to the
City o l fNorthampton
1. Name of Applicant: I ` 1
. I �J Address. 3 - \ Telephone:
2. Owner of Property: !
Address: , <(— L 1 (� Telepho
3. Status of Applicant: Owner Contract Purchaser Lessee Other (explain ))
4. Job Location: �� t K c j l' - 1'� l E'� .�
Parcel Id: Zoning Map# Parcel# District(s):
In Elm Street District In Central Business District
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/ Property: C q
G �.1
o
6. Description of Proposed Use /Work /Project /Occupation: (Use additional sheets if necessary):
RJ
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 DON'T KNOW I/ 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 --\Z 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- Permit- Application - passive.doc o l 8/4/2004
�3�,�l1
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. Wilt the construction activity disturb (clearing, grading, excavation, or filling) over 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
Frontage
Setbacks Front
Side L: R: L: R: L: R:
Rear
Building Height
Building Square Footage
% Open Space: (lot area
minus building Et paved
parkin
# of Parking Spaces
# of Loading Docks
Fill:
(volume Et location)
13. Certification: I hereby certify that the information co tained herein is true and accurate to the best of
my knowledge. 1
Date: { ii L i r r Applicant's Signature Cul"IL� 4U�Llcl
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- Inspector\Zoning- Permit- Application- passive.doc 8/4/2004