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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 e 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
I EXISTING I PROPOSED __3 -
Lot Size
I I 4,
Frontage / -7 JT r b J _ , !
Setbacks Front Z O i
30 .
Side L: R: L R: O (. - /S R_ / s -
Rear
.30
Building Height I
f Building Square Footage
' ° 4" o -
"J,;2:.:..:57::........;,...._,,_ .. i_____ a__ .
.
% Open Space: (lot area
minus building & paved I :::36,
parking
i-
# of Parking Spaces 1 t
of Loading Docks
Fill: i Vr_s� ,/ 2 - 4 , er—
(volume &location).
7'<'7'C eg
13. - Dertrica ion_ -I hereby certify that the information contained herein is true and accurate to the best OT
my knowledge. _.
Date: �� Applicant's Signature �� �`�
NOTE: Issuance of a zoning permit does not re'tieve an ap 'cant's burden to comply with all zoning
requirements and obtain all required permits from the Board of Health, Conservation Commission.
Historic and Architectural Boards. Depm Linent of Public Works and other applicable permit granting
authorities.
W: DoL-.:rn s . = 0r " v S \or .. raiLl7 _ _ _ --- -. -=: ii=rion- pzsive. n4,200z.
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— Z ZOOS /We) �02
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� Tease type or print all information and return this form to the Buildin
Inspector's Office with the $15 filing fee (check or money order) payable to the
City ofNorthampton
1. Name of Applicant:
Address: - ,75 �� � --7/...„‘.., Telephone: 'i r J 5 / ,-,1
".
2. Owner of Property: `r'E`'� '
Address: Telephone:
3. Status of Applicant: Owner ✓' Contract Purchaser Lessee Other (explain)
4. Job Location: iV , " ----A.4 - "ro , °�. '
_
. °�-�— r � 6 E F�66fs s�y� - � • �C ' _ �C
- :._ •__ - 1_, ..- - ` -' � ., . : . ----- .... . - - .7, 7 -
5. Existing Use of Structure/Property: • ,
6. Description of Proposed Use/Work/Project /Occupation: (Use additional sheets if necessary):
Z. C a ✓'r . 7 - d- e' a.r
7. Attached Plans: Sketch Plan Site Plan Engineered /Surveyed Plans
8. Has a Special Pe, alit ✓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 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?
Neecs to be obtained Obtained , date issued:
(Form Continues Or. ,Other Side)
W: ..==. ORM5.., v ._l' _ - _.___' Zoning.- ?e =zt- 4 _v^7i i1 =t'ion- ass'" t.doc F 20D4
Anthony Patillo
From Bruce Young _, }
Sent: Monday, September 15, 2008 10:08 AM
To: Anthony Patillo
Subject: 164 North Farms Road '„ SEP 1 5 2008
Hi Tony,
According the Northampton GIS, the property located at 164 North Farms Road contains no resource
areas. The property may have wetlands (or other resource areas), but we have no information that
would require the applicant to file with the Conservation Commission.
Best,
Bruce
Bruce W. Young
Land Use and Conservation Planner /Senior Community Preservation Planner
City of Northampton, Office of Planning and Development
210 Main Street, City Hall, Room 11
Northampton, MA 01060
(413) 587 -1263 / fax (413) 587 -1264
www.NorthamptonMA.aov
1
File # MP- 2009 -0023
APPLICANT /CONTACT PERSON BEHRENS MICHAEL
ADDRESS /PHONE 699 PARK HILL RD (413) 586 -0138 0
PROPERTY LOCATION 164 NORTH FARMS RD - LOT 7 RUSTLEWOOD RIDGE
MAP 12 PARCEL 036 001 ZONE RR
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 - 2400 SO FT HOUSE
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 ACT N HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INFORMATION PRES TED:
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
ptic Approval Board of Health
Well Water Potability Board of Health
Permit from Conservation Commission Permit from CB Architecture Committee
Permi from Elm StreeV ommission Permit DPW Storm Wate M. agement
•
7 X00
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.