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15B-032R 7P AMPTON 4 - ��,, 35 00 C1 r/ 8¢ r✓a A-t�.�.�.,,proa TO BE CoNYEYED BY iti6 �ps8 3p, CITY OF NOR7HAMP70AI moo, ro P47RICK J. MEL.NIK N AL.ICSE. MELNIK moo- . Q` w �zu /0.3467 ACRES ".k LAND OF PATRICK T MELNIK , T v'p "it BOOK : /979 PAGE : !z4 V) 0 ap �P 4'Cp D 23 • �, , C��ST 3 to .ypviIL �a 48(0.03' r— N Be* -36'-37-W S8$*- /d'- 3$"W A 66.00' WIDE COUNry HIGHWAY LAYOUT pzp "d ues� z0 =So'W 10. Do any signs exist on the property? YES NO ✓X IF YES, describe size, type and location: Are there any proposed changes to or additions of signs intended for the property? IF YES, describe size, type and location: YES NO '-"\ 11. Will the construction activity disturb (clearing, grading, excavation, or filling) oyer 1 acre or is it part of a common plan of development that wall disturb over 1 acre? YES NO J� 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 13. Certification: 1 hereby certify that the information contained herein is true and accurate to the best of my knowledge. Date: Applicant's Signature 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:\Documents\FORMS\original\Building-Inspector\Zoning-Permit-Application-passive.doc 8/4/2004 EXISTING PROPOSED REQUIRED BY " ZONING Lot Size / 0, �(7 4C/.,* -r /D.21 -).4e Ay -t Frontage I V 6 9 q 6 Setbacks Front 57V 5-0 Side L: ibd R: L: S-" R: �f� L: R: Rear D 0 Building Height Building Square Footage ! y UD y 6 o % Open Space: (lot area minus building Et paved parkin # of Parking Spaces # of Loading Docks V 0 Fill: 0 U (volume ft location) 13. Certification: 1 hereby certify that the information contained herein is true and accurate to the best of my knowledge. Date: Applicant's Signature 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:\Documents\FORMS\original\Building-Inspector\Zoning-Permit-Application-passive.doc 8/4/2004 "Ir go.31* File No. /'yyr � P -J d _73 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: PTRr K f ,,rt A4'j+I{ Address: 2 N C ��rt"�- eL� ��� Telephone: S`P d 7 S-0 2. Owner of Property: 44-rx iu Address: 1) C fie rTt ti 4.0 D j0 Telephone: 3. Status of Applicant: 4. Job Location: Parcel Owner Contract Purchaser 1) (Nt trgti "GW /�-p AJ �L/essee Other (explain) Id: ,', Zoning Map# Parcel# District(s)': In Elm Street District, In Central' Business District (TO BE FILLED IN BY THE BUILDING DEPARTMENT) 5. Existing Use of Structure/ Property: C, r�pL 7 /a^+ N Na -v4 -e b. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary): 7. 8 Z�J 1-4 Or, data, c f0 Z.on AlaLl U.o' �A4aw '. 3 l,✓ r trete, (✓ A- lke,.T ✓,f4 �^7' ND., It e4llt4 Attached Plans: Sketch Plan _ Site Plan Engineered /Surveyed Plans Has a Special Permit/Variance/Finding ever been issued for/on the situ NO X 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 towetlands? NO �_ DON'T 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 -2012-0073 APPLICANT/CONTACT PERSON MELNIK PATRICK J & ALICE E TRUSTEES ADDRESS/PHONE 311 CHESTERFIELD RD (413) 584-6750 Q PROPERTY LOCATION 311 CHESTERFIELD RD MAP 15B PARCEL 032 001 ZONE THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Buildiniz Permit Filled out Fee Paid TWeof Construction: ZPA - GROUND PHOTOVOLTAIC PANELS 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 P N fED: Approved " Additional permits required (see below) "IDD PLANNING BOARD PERMIT REQUIRED UNDER: § S TR 6 LE U S E SC G 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 Elm Street Commission Signature of Building Official Permit from CB Architecture Committee Permit DPW Storm Water Management 2 9ri 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.