32C-027 ZPA
File # MP~20l2-0075 ,APPLICANT/CONTACT PERSON RYAN JOSEPH C ADDRESSIPHONE 3 BREWSTER COURT (413) 584-7381 0 PROPERTY LOCATION 3 BREWSTER CT MAP 32C PARCEL 027 001 ZONE CB(lOO)J THIS
SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid I 0 'is '0 Building Permit Filled out Fee Paid TypeofConstruction:
ZPA -2 USED CARS' New Construction Non Structural interior renovations Addition to Existing AccessoIYStructure Building Plans Included: Owner/Statement or License 3 sets of Plans /Plot
Plan THE FOLLOWING~CT. N HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFORMATION PRE TED: ___ Approved _' _Additional permits required (see below) PLANNING BOARD PERMIT REQUIRED UNDER:
§ ___ _ Intermediate Project: __ Site Plan AND/OR'---__ Special Pe'nnit with Site Plan Major Project: Site Plan AND/OR Special Permit with Site Plan ZONING BOARD PERMIT REQUIRED UNDER:
§_~__.'_ 0_-_9_, ""-3_ ___ Finding V' Special Permit ____ _ Variance* _____ _ ___ Received & Recorded at Registry of Deeds Proof Enclosed ___ Other Pennits 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 Stonn Water Management _-=~==_ =---/~LA--f2_'...._ -_ Signature of Building Official 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 ofMGL 40A. Contact the Office of . Planning
& Development for more infonnation.
......... "u::o ..... type or print all information and return this form to the Building Inspector's Office with the $lsfilingfee (check or money order) payable to the City of Northampton
.,:"~ 1. Name of APplicant:------pI(!\-y,.....Il.s-pJ-I~Zm~..pfb.'-4£~..7....G.~ " '-"il.--~~:,£.;~r..r~\___P_Ii..1...t.. ;. T:e.:Ht9+1IIl-~~----'X;~A.u./C_./~._ ~ Address: .JlJAew,97ell
CtrJ~r Telephone: tfl3 ~ 73?j z. Owner of Property:_---"-'06~· .v-S."",e.:..L.f?~·'),"----"C""""-~1?'-++y...L.,'4,.....tV~----__ -_~---_ flt7!l!A~dress: I p 4Mt1;/1J1e'--3. Status of
Applicant: _ Owner -*--Contract Purchaser ___ Lessee ___ Other (explain) ___ _ 4. Job Location:, _______________________________ ~ 5 . Existing Use of Structure /property:_-"I-,f/f---1-'tJLL72>I.L-_~
£l~e..c:..Lf..J... I tt4-/..../~~I__-_____________ . 6. Description of Proposed Use/Work/ProjectiOccupation: (Use additional sheets if necessary): SAte t 7. Attached Plans: Sketch Plan
Site Plan Engineered/Surveyed Plans __ _ 8. Has a Special PermitlVariance/Finding ever been issued for/on the site? NO ___ _ DON'T KNOW --X~,---YES ___ _ IF YES, date issued:_--.,-_____
_ IF YES: Was the permit recorded at the Registry of Deeds?_ NO ___ _ DON'T KNOW ___ _ YES ___ _ IF YES: enter Book. ____ _ Page _____ andl:or ·Document # ______ _ 9.Does the site contain
a brook, body of water or wetlands? NO --.X.-. 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;\DocUIl)entsIFOR.lI.1S\originallBuilding-Il15pector\Zoning-Perrnit-Application-passive.doc 8/412004
Are there any proposed changes to or additions of signs intended for the property? YES ___ NO ~ 7 IF YES, describe size, type and lOCat1'on: __________ , _____ ~ ___,_-----------11.
Will the construction acttvity disturb (dearing, grading, excavation, or filling) pver 1 acre or is it part af a common plan of development that wtll disturb over 1 acre? 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 rese1'Ved
for use by the Building D epa1 'tme nt I EXfSTING PROPOSED ' " ·'~)N_D.~Bl\':' L ~~~:, jLotSize , S'lJ >< 100 1-::--. J .. ,':.: , ~ -Frontage !%"'tJ I~ I ", ',"" , ,;,/.: ':,~~ -Setbacks
Front 4 ••• I("" '; I I 3/:;' , Side L: ~ R: I L, R: II~' R: ~, :: i , Rear Building Height r P-d I I r: ! :' Building Square Footage I f).tJCJO "',',: % Open Space: (lot area ~ l' ',k:'":
minus building B: paved ~(JS-() ",: Ip arking # of Parking Spaces 10 ' ",' '?i.'i .~ ,,': # af Loading Docks .... "" "<':; <;-i I~~~~me B: location) 13. Certification: I hereby certify
that the Information contained herein is true and accurate to the best of my knowledge. D.t., ---J.f I :3 jJ.'" (Mpp'oant" Slgnatu!,!;!rik::~fL4iJ.~~~~~c;;;:..~1!--A~~-NOTE: Issuance
of a zoning permit does no reli requirements and obtain all required 'tg from the Boar ealth, Conservation CoIlllIl:ission, Historic and Architectural Boards, Department of Public Works
and other applicable permit granting authorities. W:\Documents\FORMS\original\Building~In.spec1Dr\ZoDiDg·Permit-AppIication-passive.doc 8/4/2004 -.~.+
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