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07-027 File # MP- 2010 -0080 APPLICANT /CONTACT PERSON City of Northampton - Office of Planning & Development ADDRESS/PHONE 210 Main Street ()587-1265() irly THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FO ILLED OUT Fee Pai Building Permit Filled out Fee Paid Tyneof Construction: ZPA - LEGAL SFH New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building _Plans Included: Owner/ Statement or License 3 sets of Plans /Plot Plan jH6 61f- fAr� Gy HvusE A T 5'q No 21 FAk/"�S THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFORMATION PRESENTED: __ '' 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: 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 Commission Permit DPW Storm Water Management 6 � 1 3 (4 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. ZONING PERMIT APPLICATION § 10.2 Complete this form using your computer and the free Adobe PDF Reader ( http: / /www. adobe. com / products /acrobat/readstep2.htm1 Print the completed form, sign it, and return it to the Building Inspector's Office together with the $15 filing fee (check or money order) payable to the City of Northampton. 1. Name of Applicant: Northampton Office of Planning and Development, c/o Wayne Feiden Address: 210 Main Street, Room 11 City: Northampton State: MA Zip: 01060 Telephone: 413- 587 -1265 2. Owner of Property: Robert and Athleen Zimmermann Address: 549 North Farms Road City: Florence State: MA Zip: 01062 Telephone: 3. Status of Applicant: Owner O Contract Purchaser O Lessee Q Other (explain) ©e partner in preservation project 4. Job Location: 549 North Farms Road, Map ID 7- 027 -001 (RR, WSP) Town: Florence Parcel Id: Zoning Map# 7 Parcel# 027 District(s): RR ' WSP In Elm Street District In Central Business District (TO BE FILLED IN BY THE BUILDING DEPARTMENT) 5. Existing Use of Structure/ Property: Single Family Home with backland. 6. Description of Proposed Use /Work /Project /Occupation: (Use additional sheets if necessary): No change to single family home. We are asking for an agreement from the Building Commissioner/ Zoning Enforcement Officer that the house and lot will continue to be a legal house and lot even with the placing of a conservation restriction on the rear of the property (see attached plan) 7. Attached Plans: Sketch Plan Q Site Plan O Engineered /Surveyed Plans Q 8. Has a Special Permit /Variance /Finding ever been issued for /on the site? NO Q DON'T KNOW 0 YES © IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO 0 DON'T KNOW @ YES Q IF YES: Book Page and/ Document # or 9. Does the site contain a brook, body of water or wetlands? NO Q DON'T KNOW O YES O IF YES, does a permit need to be obtained or has a permit been obtained from the Conservation Commission? A permit needs to be obtained 0 A permit has been obtained Q and was issued: NO WETLANDS PERM - I - required in order to.puta- £onservation Restrictio�-on the property. No physical OOO.pdf work or property line changes are proposed. 10. Do any gDON'T ns exist on the property? NO KNOW() YES IF YES, describe: Size: x x length width depth Type: Location: Are there any proposed changes to or additions of signs intended for the property? NO Q DON "T KNOW Q YES O IF YES, describe: Size: x x length width depth Type: Location: 11. 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 NO CHANGE ZONING Lot Size (ft) NO 0 Frontage Front Setbacks Rear L: R: L: Side Building Height (ft) Building Area ft Building Volume (ft Total Area of Paved Parking, Decks, and Other Impermeable Surfaces (ft Area ft) % Area (ft) % Area (ft) % lot 0 lot 0 lot Open Space: - building 0 - building 0 - buildin impermeable 0 - impermeable 0 - im ermeable Total 0 100.00% Total 0.00 0.00% Total # of Parking Spaces # of Loading Docks 0 Fill: volume (ft) volume (ft) 0 volume (W) location location location 12. Certification: I hereby certify that the information contained herein is true and accurate to the best of my knowledge. Date: 5/ 11 / 2010 Applicant's Signature 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. OOO.pdf Parcel 7 -27 with Zimmermann house Hat{leld Boundary r CO Additional parcels owned by Zimmermann that will be subject to Conservation Restriction