11-002 (17) File # MP- 2012 -0006
APPLICANT /CONTACT PERSON Global Tower Assets LLC
ADDRESS/PHONE c/o Seth Thompson, Esq.; Duval, Klasnick & Pastel (781) 569 -6555
PROPERTY LOCATION HAYDENVILLE RD
MAP 11 PARCEL 002 001 ZONE RR/SR(100)/URA//RI/WP/WSP
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
__ // ENCLOSED REQUIRED DATE
i,ZONING FORM FILLED OUT
F
6o 4 JO
aid
V
Building Permit Filled out
Fee Paid
Typeof Construction: Zoning Permit Communications Tower
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 cop cs�
INFORMATION PRES TED:
Approved Additional permits required (see below)
Y(T6 P"" R P P ZOVA p
PLANNING BOARD PERMIT REQUIRED UNDER: § TA ISLE Q S6 S Sv f 1 l l 1 –�� ! 350' j0� /
Intermediate Project:-1ZSite 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
,, ySetic 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
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.
File No.
'tall information and return this form to the Building
ns ector w h the $i5 filing fee (check or money order) payable to the
JUL 2 201 ty of Northampton
f A licant: G obal Tower Assets, LLC
��� tMS et Thompson, Esq.; Duval, Klasnick & Pastel
` r t, suite 17, Woburn, r>A oieoi Telephone: (781) 569 -6555
2. Owner of Property: City of Northampton
Address: 210 Main Street, Northampton, MA 01060 Telephone: (413) 587 -1249
3. Status of Applicant: Owner Contract Purchaser Lessee X Other (explain)
4. Job Location: Map 11, Block 2, Lot 1, Haydenvi l l e Road ( Route 9 )
a
4\`
5. Existing Use of Structure/ Property: Mostly open space
6. Description of Proposed Use /Work /Project /Occupation: (Use additional sheets if necessary):
The Applicant is proposing to construct a 190 foot monopole style
telecommunications tower on the property.
7. Attached Plans: Sketch Plan Site Plan X Engineered /Surveyed Plans X
8. Has a Special Permit /Variance /Finding ever been issued for /on the site?
NO X DON'T KNOW YES IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO DON'T KNOW 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 X
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained X Obtained , date issued:
(Form Continues On Other Side)
W:\Documents\ FORMS \original\Building - Inspector\ Zoning- Pennit- Application- passive.doc 8/4/2004
10. Do any signs exist on the property? YES NO x
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) over 1 acre or is it part of a common
plan of development that will disturb over 1 acre? YES NO x
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 PROPOSEDQ »Y
Lot Size t :'
182 acres 182 acres n
Frontage
2025 2 0 2 5'
�•5
Setbacks Front n/a 1116
a
Side L: n/a R: n/a L: 343' R: 1643 , z h r *�} ,
tf:
Rear n/a 1421'
Building Height n/a Tower = 190'
S
S t 4
Shelter = 11 '�:�°
Building Square Footage
n/a Approximately
40 w5' ft.
-
x
% Open Space: (lot area
minus building Et paved n/a 99.1%
parking
# of Parking Spaces n/a n/a r "
# of Loading ocks / / 4'' i
g n a n a 3
Fill: n/a n/a
T .
(volume Et location)
13. Certification: 1 hereby certify that the information contain er�in is ue and rate to the best of
my knowledge.
Date: j � l Applicant's Signat e
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