36-346 Sep. 10 2009 01: 39PM P1
FAX NO. :4135865959
FROti rriA 411.141471Z72 Z001
C ty o Northampton
Mlussaehusetts
• car 7Witrallei MNIPZCXWORS -_, 4
212 Wu ailvonam., maradaes.1 linading
iiroxlilloopteas, to, 4,4
INS Par.TOR
ANTlio ref PATILLO
BLHLDING COMMISSIONER
, ,
THIS FORM MAY SE FAXED TO: #13467
REQUEST FOR PERMISSION TO VIEW RECORDS
OR HAVE COPIES OF DOCUMENTS MADE
*PLEASE KEEP THESE DOCUMENTS IN CHRONOLOGICAL ORDER*
DATE: q Jio mAilt 3Co BLOM 34(0
FILE ADDRESS: utp
bJpti al 3o r) reL -12em-tiGi-es
NAME: i2.124V2A-A- • L itkiLet
ADDiegSs: 5_5 I P 15
1111—
PHONE C
• 44( 57
MASSACHUSETTS GENERAL I.AWS GRANT US TEN (10) WORKING DAYS
OF THE ABOVE LISTED DATE TO MET THIS IT*QUEST.
a /
10. Do an signs exist on the property? YES NO
Y g
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 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
Frontage
Setbacks Front
Side L: R: L: R: L: rs R:
Rear
Building Height
Building Square Footage
% Open Space: (lot area
minus building It paved
parking
# of Parking Spaces
# of Loading Docks
Fill:
(volume Et location)
13. Certification: I hereby certify that the information contained her • is true and accurate to the best of
my knowledge.
Date: s / / 6 Applicant's Signature
NOTE: Issuance of a zoning permit does not relieve applicant' urden to comply with all zoning
requirements and obtain all required permit from the oard of Health, Conservation Commission,
Historic and Architectural Boards, Departm nt of is Works and other applicable permit granting
authorities.
W ADocuments\ FORMS \original \Building- Inspector\Zoning- Permit- Application- passive.doc 8/4/2004
ore dl (kJ 11
File No. /9(6 / /' � 1� 1 6 {
A2O G FRIYIIT APPLICATION ( §Y 0.2)
Please ..type or pr; ' all information and return this form to the Building
Inspector's Office uvt1i filing fee (check or money order) payable to the
City of Northampton
1. Name of Applicant:hG-\Ant'ln (3C.Luk
Address: S ( k,-; ` F� k (t Telephone: 4 (> - ?''3 i 1
t� �
2. Owner of Property: +a ( 1 rL I L
Address: C t� 1 ],.� Telephone: 4(3- C d ( 3 F C
3. Status of Applicant: Owner Contract Purchaser � htt
pp Lessee Other(explain) � M ]
4. Job Location: (b ca.-A l Lt\ l� � P i -,c but-yn/
Parcel Id Zoning N1ap# P arcel# - District(s),
h . : I '- 4 V AI 49 ;.: , � 4 axe <. • ,�
in Elm Street District In Central Business District -.
(TO BE FILLED IN THE I3UILDING DEPARTMENT).
11
5. Existing Use of Structure /Property: '�� l v^
6. Description of Proposed Use /Work /Project /Occupation: (Use additional sheets if necessary):
t-511^5It' - (-011 , ■_(() Lgvi tr-s
(4 fl Vl vie t,-
£ v l ► -h Y /Ix f
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 DON'T 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?
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
tmoot
. Y
File # MP- 2009 -0096
APPLICANT /CONTACT PERSON BAYUK JONATHAN
ADDRESS /PHONE 125 CARDINAL WAY (413) 230 -7899 ()
PROPERTY LOt le` 14,. 9.3, ;INiL. WAY
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
"`ZONING FO:- FILLED OUT ,
ee ' ai• - 1'
Building Permit Filled out
Fee Paid
Tvpeof Construction: ZPA - SFH
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
INF ATION PRESENTED:
, 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 C 'ssion Permit DPW Storm Water Management
9 I, .9/4 ?
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.