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24C-182 {o na �Q 5\7/1(_ 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 IF YES, describe size, type and location: 11. Will the construction activity disturb (clearing, grading, excavation, or filling) ove/ 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 TO LACK OF INFORMATION This column reserved for use by the Building Department EXISTING PROPOSED REQUIRED BY ZONING Lot Size 1 3, 4 SG? PT 13,490 Frontage q4.1 ef 4•l� Setbacks Front Z.I 2-7 Side L: 4. R: Z&' L: 4.5` R: ZGo • ' L: R: Rear 649 6 Building Height Building Square Footage 2,19 4- Z 2.4 52 i % Open Space: (lot area minus building a paved 1 I v/, 1 ( '7 0 parking # of Parking Spaces 4 + 4 + # of Loading Docks NIA NIA Fill: N Nl 1� (volume a location) 13. Certification: I hereby certify that the information contained herein is true and accurate to the best of my knowledge. Date: 121 2.1 1 1 Applicant's Signature ChM 1421 41 0I1ri)D2 S 1>l1 C_ 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. W: WocumentsTORMSi original \Building- Inspector\Zoning- Permit- Application - passive.doc 8/4/2004 JPA -32 2 M n File No. /`" 1 d &5 NINE PERMIT APPLICATION (§10.2) Please type or print 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 ofNorthampton 1. Name of Applicant: 2t G to T (j 1 L- i) CY2S 1 t) C- Address: 4 GA-- M5 T, N.) 1 ro Telephone: (4)?) 5 F3 io - S z-S 2. Owner of Property: Ni Ati C , e tJ. Lo 'J2-? a- cvotAa>LG T2UST Address: 2 -1 2- C. ►- 5 (c NI 5 T ► NI ' roN- Telephone: (4 t 3) 6 Q 4- (p l to 8 3. Status of Applicant: Owner Contract Purchaser Lessee Other (explain) 6 4. Job Location: 2 ( C (LE5 ( Eta i sT , 1J ` - ONA Parcel Id: Zoning Map# Parcel# D In Elm Street District In Central Business District (TO BE FILLED IN BY THE BUILDING DEPARTMENT) 5. Existing Use of Structure /Property: 51 61 -e' r A f" I r... -? i2 t S i 7 i'\3 C C 6. Description of Proposed Use /Work /Project /Occupation: (Use additional sheets if necessary): co 5 o;- A I 5TO2.-; lo X 5 (c P Tl -1 (2-oQM A DD1T1 o►\.\. 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: W 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 ✓ 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:\Documents\FORMS\original\ Building- Inspector\Zoning- Permit- Application- passive.doc 8/4/2004 File # MP- 2012 -0065 APPLICANT /CONTACT PERSON WRIGHT BUILDERS ADDRESS/PHONE 48 Bates St (413) 586 -8287 (116) PROPERTY LOCATION 212 CRESCENT ST MAP 24C PARCEL 182 001 ZONE URA/URB(100)/ THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT cy/,� 91r Fee Paid f l Building Permit Filled out Fee Paid Tvpeof Construction: ZPA - BATHROOM 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 PRESENTED: l,/ 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 2_ 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.