25A-093 10. Do any signs exist on the property? YES NO V
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 t,/
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
N e I1 asj s 7,, be PvtR.de exii-n'e r P v- , a e r l-- y , for use by the Building
J Department
EXISTING PROPOSED REQUIRED BY
ZONING
Lot Size
Frontage
Tt' a c11BBI11111lt snfl
llnlUnnl IUuhIlIlIl111ID11Il1111111Il
Tnt r1111I11Il1Il11Il rl r1IlIllllillll]1 rl r111111IDllllllll r
11IhUIlIl]IlIlIl1IlIll1Il11Il1
llM11111111111111111111 ta s
GRin di id '
GRinfolfli Rmt1Lnn'adt
1 htflTha t rl(lot area
minus building Er paved
parking
# of Parking Spaces
Bln lnaoddlIn
c
!'r
(volume a location)
13. Certification: I hereby certify that the information contained her • ' e and accurate to the best of
my knowledge.
Date: 7 /2sl20 /l Applicant's Signature 1 1
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\Z oning- PermitApplication- passive.doc 8/4/2004
RECEIVED
2 5 2011
File No.
AP
D Pl {Jf1 i w+aau ,va uE x » �
t p ING PERMITAPPLICATION (§ o 2 f f -t- t .
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: RtAS S'e l 1 1
Address: 81 Williams S4-: tJ rec3to4,e: 9' (3 - 3 8 1- $129
2. Owner of Property: ?mss sell 3reo l s (Se k, -F
Address: Z I S Noy lit Si:, NOr't' L.VWj'/ V Telephone: 13 -3? 7 - R' 1 2-1
3. Status of Applicant: Owner 1/ Purchaser Lessee Other (explain)
4. Job Location: 2(S !`J o r Sf JJoY'f'KR. 4Oxl ) / IAA
,
Parcel Id Zoning Map# Parcel# Distnct(s) '
d 1 J1 �1 p y 1 's Ina' 'sayl cft_o:1Ini�rii � "
5. Existing Use of Structure /Property: KES ( De
6. Description of Proposed Use /Work /Project /Occupation: (Use additional sheets if necessary):
Sv1.4.11 3 by a ik,-E-Mevl,+ on ly dog r'amivj services
KIO c e v t c - 0.r wit( be i v r r 0-41 . 0 s' - 4 - ' e_ .
V lit le -I FPk . /Jo -fekof -frafGc..
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 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 ft
/
9.Does the site contain a brook, body of water or wetlands? NO V 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
File # MP- 2012 -0011 ( (
p
APPLICANT /CONTACT PERSON BROOKS RUSSELL
ADDRESS/PHONE 81 WILLIAMS ST (413) 387 -8129 ()
PROPERTY LOCATION 215 NORTH ST
MAP 25C PARCEL 093 001 ZONE URB(100)/
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 - DOG GROOMING SERVICE
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 S ED:
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 UND R: § /01 /
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 Elm Street Commissio, Permit DPW Storm Water Management
Signature of uilding fficial 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.