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7870 COUNTY /
• '� LAYOUT LINE
10. Do any signs exist on the property? YES NO 1 > <
•,„
IF YES, describe size, type and Location 1 "
Are there any proposed changes to or additions of signs intended for the property? YES NO Y
IF YES, describe size, type and location:
11. Witt the construction activity disturb (clearing, grading, excavation, or filling) over 1 acre or is it part of a common
plan of development that wilt 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
11111111S1 .5,4"1.k
Frontage
Setbacks Front
Side L: R: 3o L: L: R:
Rear
Building Height
02 - f
Cf Building Square Footage
% Open Space: (lot area
minus building Et paved i -
parking /0
# of Parking Spaces
# of Loading Docks
0
Fill:
(volume Et location)
13. Cet 1ification: certify that the information contained herein is trua accurate to the best of
my -
Date: /172,57( Applicant's Signature
NOTE: Issuance of a zoning permit does not relieve an applicant's burden to comply with all zoning
req and obtain all required pci sniti from the Board of Health, Conservation Commission,
Historic and Architectural Boards, Department of Public Works and other applicable permit granting
W:Tocuments WORMS \originalTuilding-Inspector1Zoning-Permit-Application-passive.doc
8/4/2004
•
RECEIVED
Nov 2 9 2011
File No. 17) 6
r _ �. . »s.sa :� _... , , r.. u...
Please type or print all information an re turn this form to the Building
Inspector's Office with the $15 filing fee (check or money order) payable to the
City of Northampton
1. Name of Applicant: ///14 , S i✓ ,CV
Address: CYi d
_ �/� ��,✓� Y �� /'rii,✓r/ Telephone: / 3 - /7
2. Owner of Property: Ji4P
Address: ,�P/41" Telephone: / /$ 6)6 - /T71
3. Status of Applicant: Owner iX Contract Purchaser Lessee Other (explain)
4 Jo o atiQnr 5 0 i» �c> >• YJ 1,Tt_iL DS— _
s''+ L,� "tl: "' '.%,"= '"'? '- i," s3 au°3az, - :k�}a si �3y 3, y „y,,; u :a�n *z § its _,P
�' � x l a . ..� ® n M +:� � � l , ,�� rk(s:4„. ) — � 3 ' `3 ' a. �, "a
s ti r s, 1 " l'i' e' nY c nub % 3 g - 'N' 3 S }�
� ' �� � � � e '� I� Elrt') Street Qastrict3 . � �� In C�n�raBussi�ss'1�riot ��
=� : s ,,, I' W , t rsa i gym, u - f 2 a i
� `�i ro , ..: ( ' � 3 CLLEI B `THEc BUILt INC i #?�T NT)
5. Existing Use of Structure /Property: 6 2 /4"f /LSD f/cri�
6. Description of Proposed Use /Work /Project /Occupation: (Use additional sheets if necessary):
_ v t • . )e--/ i4 2A(r/� 7
/99P / �f elgiC A, 3,Z TM/ /, J /-)".)5 pi /D __5",-'A" CS PICi-117ii✓G—
FEASAYiC/ ZY
7. Attached Plans: Sketch Plan Site Plan V Engineered /Surveyed Plans
8. Has a Special Permit /Variance /Finding ever been issued for /on the site
NO K DONT KNOW YES IF YES, date issued:
IFYES: Was the permit _ recorded at the Registry of
NO DONT KNOW YES -
IF - enter Book Page a #
9.Does the site contain a brook, body of water or wetlands? NO X 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:1 Documents \FORMS\original\Buiiding - Inspector\Zoning - Permit - Application - passive.doc d 8/4/2004
3'%
Lor A2A 12
File # MP- 2012 -0054
APPLICANT /CONTACT PERSON SENEY TIMOTHY J Q A
ADDRESS/PHONE 43 COUNTY RD (413) 626 -1797 0 3 � �y I
PROPERTY LOCATION 8 AUDUBON RD
MAP 10B PARCEL 013 001 ZONE URB(100)/
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid 1/
Building Permit Filled out
Fee Paid
Typeof Construction: ZPA - 2ND FLR GARAGE ADDITION FOR 3 FAMILY
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 PRESENTED:
Approved Additional permits required (see below)
PLANNING BOARD PERMIT REQUIRED UNDER : 5
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: § 36"0 - -4o 30 , TR g Lk 17toe) r fCM
Finding Special Permit Variance* 17
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
.(� ?� `- /
� /
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.