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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 NO
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 ,�
• 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 •
EXaSTING ----- PROPOSED R E U.1RED BY
Lot Size O
_. . -. 3
Frontage __.__ -- -_. _. - .
• _.. _._. -- Setbacks . Front 3o art'
Side L: R: L: R: /c9 Fee L R
•
�ttc+rl+
Rear �� CY _ N
Building Height !T
cfP)
Building Square Footage 1
�i 322 C5 C � r u �
% Open Space: (lot area 3 yao 7° ( ����
minus building 8 paved
parking fS J /p
# of- Parking Spaces CQ'Y
3 _
# of Loading Docks
. Fill:
(volume It location)
13-Cer lificatiorr: I hereby information contained herein is true and accurate to the best of
my w ge.__..___ •
Date: 1 / 3J Applicant's Signature
NOTE: Issuance of a zoning permit does not relieve . licant's burden to comply with all zoning
reginieinents and obtain all required permits • in of Health, Conservation Commission,
- Historic and Architectural Boards, Department of Public Works and other applicable permit granting
authorities
W:\Docuuiients\ FORMS \original\Building - Inspector\Zoning - Permit- Application- passive.doc 8/4/2004
•
•
RECEIVED
JAN 1 7 2012 � � �
File No. / d
.�,...y -�Mr , � � E au w.�*s A n e - a AT., �4{ �- t e � �
Ia, € ' 1 22 . ....``, , r5t': 4. . ,. aw. t ,s24 .,w n„.,,��.. ..:., ;;; ,, n ` �, " ,‘,:-1.,-,,.: 1 , �, la lt , 4s.. 4 .
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 of Northampton
1. Name of Applicant: i c it y ii Co✓'e/n'o 0111 �` 0
Address: , 5 ---z-/- g 4 Y S on r 57- 'i- °' ' c9 .- >'8 > S'
2. Owner of Property: / t ta,nc>/apiY'a cP5 c-3 J /3) //
/- / C� : . ,.a YrtiG w,p rG H € /e' ( c,
Address: (2 sc./pi fir
r/ c 7c, - R ,N -,' Telephone: 1 "//3 ._.s .e" >p
3. Status of Applicant: Owner Contract Purchaser // Lessee Other (explain)
__ �X A
4. Job Location, Cl�6 6 c!1-? C./ 6 - T- 21 rntsi
r.TR,I.kgis,,,,,,,,,,ov,,,a,*,-4,144izt, T V.
r !' d 9 � . 1 , i., i� - : ' -::-A-61,6 s p + , ' - h , 4 .� .
it � ri
5. Existing Use of Structure /Property:
5rn 441'l7 H 0rhE
6. Description of Proposed Use /Work /Project /Occupation: (Use additional sheets if necessary):
! .1 v ) 16, G .0 9., l'crJ! Ca (0/ 77 eb •P C
7. Attached Plans: Sketch Plan Site Plan Engineered /Surveyed Plans X
8. Has a Special Permit /Variance /Finding ever been issued for /on the site?
NO DONT KNOW X YES IF YES, date issued:
IFYES - - mss the permit recorded at the Registry of Deed T
NO DONT KNOW YES
IF Book Page dTor "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\FORivMS\ original \Building- Inspector\Zoning- Permit- Application- passive.doc F 8/4/2004
I.
•
File # MP- 2012 -0069
APPLICANT /CONTACT PERSON GRANDONICO KATHRYN
ADDRESS/PHONE 25 N PLEASANT ST (413) 253 -7879 ()
PROPERTY LOCATION 66 BANCROFT RD
MAP 31B PARCEL 003 001 ZONE URA(100)/
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid ✓
Building Permit Filled out
Fee Paid
Typeof Construction: ZPA - 2 CAR ATT GARAGE
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 CI DE SC BACK
INFORMATION PF NTED:
Approved Additional permits required (see below) kEt (kc t° t3 Ar1. ED
PLANNING BOARD PERMIT REQUIRED UNDER : § 11'3 tTH S u 1)69 -.A, i
Intermediate Project : Site Plan AND /OR Special Permit with Site Plan I 'O S61
Major Project: Site Plan AND /OR Special Permit with Site Plan GA
•
ZONING BOARD PERMIT REQUIRED UNDER: § Is O — TA 61-1 (fV t ENS OA /pfh) i ( J
Finding Special Permit 1 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
/ // z
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.