48-006 File # MP- 2010 -0008
APPLICANT /CONTACT PERSON KOCH DEBORAH S
ADDRESS/PHONE 140 LOUDVILLE RD (413) 586 -2092 Q
PROPERTY
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING RM FILLED OUT ' 0 � dU
ee Paid W/
Building Permit Filled out
Fee Paid
Typeof Construction: ZPA - ADDITION
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 PRESfED:
Approved Additional permits required (see below) r
PLANNING BOARD PERMIT REQUIRED UNDER: § �� , � 7'
Intermediate Project : Site Plan AND/OR . Special Permit with Site Plan
Major Project: Site Plan AND /OR Special Permit with Site Plan
ZONING BOARD ERMIT REQUIRED UNDER: §
Finding Special Permit !/ Variance* (�,Aj� ✓��
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 om Elm Street ssion Permit DPW Storm Water Management
7 12-
,
Signature of Building Officiaf Date
Note: Issuance of a Zoning per mit 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.
I
� C
File fro. V
ZOMNG PERMIT APPLI TI&V W0 �.�
Please ti?I)e or print all information and retnru,,tlii lei ' f e Building
Inspector's Office with the $1 filing fee (check or mot, z order) payable to the
(� City ofl�orthampton
1�
1. Name of Applicant: F-40 S - V'Oaf
Address: 140 L.OU6 y i i -LE R? b Telephone: 41 J - 9_O 6 - Z0 c t 7_
2. Owner of Property: Dr f � i<QU4
Address: 1+0 �-i- IG-� Telephone
3. Status of Applicant: Owner ✓ Contract Purchaser Lessee Other (explain)
4. Job Location: 14Q L V l I- L F_ F, t� -
Parcel Id: Zoning Map# Parcel# District(s): _
In Elm Street District In Central Business District
(TO BE FILLED IN B B � Y THE BUILDING DEPARTMENT)
5. Existing Use of Structure/ Property:- FL�'{ �C -n A L---
5. Description of Proposed Use/ Work/ Project/ Occup tion: (Use additional sheets if necessary)*
e rJ'V '
_ a--p kfr"h . Lo- 2. s - 1 itm O
ca,"fi l ever re &vvi aACL- 0-K &Vey Si 0- . IA1/V-116t e_cfE -- -
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 DONT 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 c ntain a brook, body of water or ettands? NO DONT KNOW YES ✓
ifi� a .a� .a�. � °Ve ts^^ &4 . 1) rook
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained _ i� _ Obtained date issued:
(form Continues On Other Side)
W- Docuuetin FORMS orz mal Building- Inspe.tor.Zonn;2- Permit _Application- passi 8:4 2004
10. Do any signs exist on the property:' YES _ NO
IF YES, describe si =e, type and location:
Are there any proposed changes to or additions of signs intended for the property? YES NO_
IF YES, describe si =e, 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 _ Z
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
77tis eoIutnn reserved
for use by the Building
Dc artinent
EXISTII\G PROPOSED REQI - IRED BY
ZONING
Lot Size o -�� , •f -�
Frontage
Setbacks Front
Side L: R: L: R: L: R: L®
Rear
N
Building Height
I3 f i� S
Building Square Footage
q36 9,4f-
% Open Space: (lot area c�q�
minus building & paved (2 � )o Fo
parking O
# of Parking Spaces I
# of Loading Docks G
Fill:
(volume & location)
13. Certification: I hereby certify that the information contained herein is true and accurate to the best of
my knowledge.
IV Date: Lo_ Applicant's Signature
NOTE: Issuaiice of a zoning permit does not relieve an applicant's burden to comply witli all zoning
regiuremeiits and obtain all required permits from the Board of Health. Conservation Commission.
Historic anti Architeettirai Boards. Departinent of Public Xi-orks and otiier applicable permit granting
authorities.
N Documents OR��IS'ortainalBuil3ino- Inspect r.Zoniag- Penrut- Application- passcte.doc 941004
AcH 14,x �,�� C 4 �%,{'",
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OK
THIS PLAT IS COIMPILED FROM DEEDS. PLANS ANLb OTHER SOURCES AND IS NW
TO BE CONSTRUED AS AN ACCURATE SURVEY AND IS NOT TO BE RECORDED.
BUILDING LOCATION ACCURACY IS NOT GUARANTEED
NOTE: A PORTION OF THE'PREMISES IS LOCATED WITHIN
A 100 YEAR FLOOD ZONE (ZONE A), THE STRUCTURE
IS NOT LOCATED WITHIN THIS FLOOD ?pN;
�'� lei•- t`��' -
��►�. �`�� ` 32.0 ,,r
O: PEOPLESBANR &
CONNECTICUT ATTORNEYS TITLE INSURANCE COMPANY
O THE BEST OF MY INFORMATION. KNOWLED E AND BIEUEF -
HIMMY REPORT THAT I HAVE EXAMMED THE PREMISES AND BASED ON EXISTING
100SAME lTATION ALL VISIBLE EASEMENTS. AND BUILDIMS ARE LOCATED ON
HE GROUMD AS SHOWN AND THAT 7K WLUNGS ARE Dnit&Y WffM THE lOT LMIES,
XCEPT - AS -- NOIED� t FURTHER REPORT TEIAT PROPE W 1S
►� PRONE AREA AS SHOWN ON FEDERAL FLOW INSURANCE MAPS FOR
25(}167
WRVMR -E' AND O R
PLAT NOT MORT'GAG'E LOAN PURPOSES ONLY PROPERTy SURVEY
OF %). YORRT'tC:AC.E LAN CTI[1�! PL AT-
IDRTUPJWlM
PREPARED FOR
m JANE CAREY
soft SCALE: 1" =40 JANUARY 6, 2004
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