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38B-311 File t MP -2010 -0027 APPLICANT /CONTACT PERSON FIEMAN BENJAMIN ADDRESS /PHONE 54 FORT STREET 0 586 -9610 0 PROPERTY LOCATION FORT ST MAP 38B PARCEL 311 001 ZONE SC(35) /URB(65)/ THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE \ ZONING FORM F LED OUT /6 �t /S Fee Paid )[/ Building Permit Filled out Fee Paid Typeof Construction: ZPA - 2 FAMILY 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 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: § 3- •- A -TrAC. 6 ,? , secet1 i /S 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 Commission Permit DPW Storm Water Management / Signature Building 0 ficial 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. 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 COMPIXTED, otFEIAff'i N E 011ifE0 OUE TO i ACik OF INFORMATION Tide column reserved r used " ding EXISTING PRO • Pt + Lot Size 1 Frontage i - Setbacks Front .241 Side L: R: L 15 1 R; /‘2 {.. Rear ° !? Building Height Building Square Footage X i 2 4- D0 � ?'!Iry II Open Space_ (lot an;a f ,� minus buildrrg & paved ! parkin # of pa ridn® SAS 4, —' .# Loatfing Dodts • Fill: jvolizne & locatinnt 13, Cert.ificatlornabereby certify that the information contained herein is tnie and accurath to the best of my knowledge. Date: Applicant's Signature .._ NOTE: : Issuance of a zoning permit dog not remove an applicant's bur en to comply with all teriftig _ requirements -and obtain all required posits from the Board of Heealtl Conservation Commission, Hfstr nic and Architectural Boards, Department of Public Works and other applicable permit granting authorities. WATho - - Ef42004 File # MP -2010 -0027 APPLICANT /CONTACT PERSON FIEMAN BENJAMIN ADDRESS/PHONE 54 FORT STREET 0 586 -9610 0 - - - - -- - PROPER Y - L ATFfi olms — __ - - -- -- -- . - - - - -- --- ... - - - - -- -- - - -... . MAP 3813 PARCEL 311 001 ZONE SC(35)/URB(65)/ THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FI1.1.FD OUT Fee Paid 1// �i BuiIdingt Frjled out Fee Paid Tvpeof Construction: ZPA - 2 FAMILY New Construction Non Structural interior renovations Addition to Ex`stin_ Accessoy Sttucture Building Plans Included: Owner/ Statement or License 3 sets of Plans / P1ot Plan THE FOLLOWING ACTT HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFORMATION PRES D: 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 A•TD /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. Str ,. ` • nrn fission Permit DPW Storm Water Management ..."7",,,,...:7Z _ a 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 MOL 40A. Contact the Office of Planning fir Development for more information.