38C-057 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 NO X
EF YES, describe size, type and location:
11. Wilt 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
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 '[0 LACK OF INFORMATION
This column reserved
jiir use by the Building
Deportment
EXISTING PROPOSED REQUIRED BY
ZONING
Lot Size 6000 sq ft No Change 8000sq ft
60ft frontage x 100ft min 75ft frontage
Frontage 60 ft no change 75ft
Setbacks Front not applicable / 20ft 20ft
Side L: R: L: 15ft R: 15 ft L.; 15ft R; 15ft
Rear 20ft 20ft
Building Height Zero ( No building exists 2 Story
Building Square Footage Zero Approx 600sq ft
% Open Space: (tot area
Zero (paved over 4000 sq ft
minus building Et paved completely)
parking
# of Parking Spaces 15 2
# of Loading Docks 0 0
Fill: unknown depends on what is required after
(volume Et location) pavement is removed
13. Certification: I hereby certify that the information contai d herein is true and accurate to the best of
my knowledge.
Date: 12 Applicant's Signature 41.111
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.
,DoaimmtsTORIVLS ,ort gala! ilu Id! ng ZontIllf-E'crtrat-Application-pasial doc t04201.4
DE c 2 2 2011
File No. fl'/ /
ease type or punt all information and return this form to the Building
Inspector's Office with the $15 filing fee (check or money order) payable to the
City of North amp to n
Pete Olsen
1. Name of Applicant
Address: Gregory Ln Florence MA 01062 Telephone: 97 8
2. Owner of Property: Double Duck LLC
Address: 384 South Street, Northampton, Massachusetts 01060 Telephone:
3. Status of Applicant. Owner Contract Purchaser X Lessee Other (explain)_
4. Job Location: 36C
'2;5 District(s» y_
In Elm Street Distrkt In Central Business DiStritt
(TO BE FILLED IN BY DEPARTMENT)
S. Existing Use of Structure/ Property: Parking Lot
6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary):
A two story single family home approximately 600 - 2000 sqft
7. Attached Plans: Sketch Plan Site Plan X Engineered/Surveyed Plans
8. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO DONT KNOW X YES IF 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 Document #
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:' PORMS"vorigina klini IS -Invect orVion ing-Permit-Applicat ion-raivr .doc ,4,-1004
File # MP- 2012 -0061
APPLICANT /CONTACT PERSON OLSEN PETER
ADDRESS/PHONE 6 GREGORY LANE (978) 761 -3474 ()
PROPERTY LOCATION SOUTH ST
MAP 38C PARCEL 057 001 ZONE URB(100)/
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT ?/!/_ 7
Fee Paid
V 7 Y" `��
Building Permit Filled out
Fee Paid
Typeof Construction: ZPA - 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
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INFORMATION PRESENTED:
Approved y permits required (see below)
PLANNING BOARD PERMIT REQUIRED UNDER : §
t...Cr T I S fj G i
Intermediate Project : Site Plan AND /OR Special Permit with Site Plan 'JRC tl AT P 1't SE,J 1
Major Project: Site Plan AND /OR Special Permit with Site Plan
ZONING BOARD PERMIT REQUIRED UNDER: § ago - 9,3 ( �� RAC I N f� A I �` Cc� a RuTE�
ST
` VI S E
Finding V 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
Signa a 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.