10B-061 File # MP- 2011 -0017
APPLICANT /CONTACT PERSON Pape Pouye
ADDRESS /PHONE
PROPERTY LOC ffiJ -I2 WATER -ST
M#P JOB PARCEL 061 001 ZONE GI VURB(4) //WP
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ILLED T
Paid
Building Permit Filled out
Fee Paid
I y Construction: ZPA• Taxi company
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
INFO VMATION 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 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
� f,�. 61 1 -2,)1 0
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.
1 7 File No.
E7 ZONING PERMITAPPLICATION (§10.2)
Please type or print all information and return this form to the Building
inspector's Office with the $15filingfee (check or — -- — —j e to the
City of Northampton
2. Owner of Property: l
Address: Z!4 66ff'O&Dd H. jUagg tmatuqTelephone: .508
3, Status of : Owner ______ Contract Purchaser Other (explain)
4' Job Location:
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 /Prnperty:
6. Description of Proposed Use /YVork/Pnject/Occupation: (Use additional sheets ifnecessary):
10CA W1 tAS& Mt 4"99 11 4"M
��.
.. Attached Plans: Sketch Plan Site '- ____---_- Engineered /Surveyed Plans
8' Has a Special Pernii/Variance/Finchng ever been issued for/on the site?
NO DONT KNOW X YES |F 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 Dmcument#
v. Does the site contain a brook, body nf water orwetlands? NO DON7'KNOVV --'% YES
IF YES, has permit been orneed bobe obtained from the Conservation Commission?
Needs tobe obtained Obtained date issued:
(Form Continues On Other Side)
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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 N0
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 4_
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
Dep artment
EXISTING PROPOSED REQUIRED BY
�. ZONING
Lot Size
Frontage
Setbacks Front
r
Side L: R: fit: I L: R:
,r
Rear r
Building Height
Building Square Footage
% Open Space: (lot area
rniruc building rt Hayed
p arkin g
# of Parking Spaces
# of Loading Docks
i (volume Et location)
13. Certification: I hereby certify that the information contained herein is true and accurate to the best of
my knowledge.
Date: �' S 7— 24/0 Applicant's Signature
NOTE: Issuance of a zoning permit does not relieve an a pl)Board is den to comply with all zoning
requirements and obtain all required permits fro of Health, Conservation Commission,
Historic and Architectural Boards, Department of Public Works and other applicable permit granting
authorities.
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