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� - Y.iMi.O 20 0 19 19 roues
. \ \ n i 4400 h71 _ ..
..—== The 4 /an MOM *�' •+L Plan of Land in Preliminary
as • FMNMMOD Northampton, Massachusetts
T 01.Yr.NM91NNMI iv P Cluster Subdivision ,,, ,q ,, ,,m„ bailie.
Group, Inc. r r INIhrylwlM++rMn Hampshire County 614 r• a
Group, w.......... CAN41•. • 11....t • ws.. prepared for Dmitri Robbins Flag Lot Plan s na
IDANpr W.A✓.Na m Ort/ } •
•
. 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? 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 COMPLETED, or PERMIT CAN BE DENIED DUE TO LACK OF INFORMATION
This column reserved
for use by the Building
Department
EXISTING PROPOSED REQUIRED BY
ZONIN
Lot Size
14 Acres 22, 783/13 Acres�� ��;
Frontage 172 '
i
121'/50'
Setbacks Front 9 0 9 0 2 5 0
•
Side L: 75 R: 25 L 22/25 R: 40 +/40+ L R
300+ 75 +- 300+
• Rear
•
Building Height
2 Story 2 Story
Building Square Footage
is
% Open Space: (lot area
i't a
9 5% 75% 85%
minus building p ved
parking
# of Parking Spaces
2
# of Loading Docks
Fill:
(volume Et location)
13. Certification: I hereby certify that the information contained herein is true and accurate to the best of
my knowledge.
Date: l ) 1 D Applicant's Signature CAk.1yeAlft /'L4&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.
WADocuments)FORMSIongmal \Building- Inspectoaoning Permit - Application- passive.doc 8/4/2004
•
i
SEP — 8 201'
/
- File No.
5 �T,APP CATIOg(. ro.2l�l v 4
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
I. Name of Applicant: Office of Planning & Development for Dmitri Robbins
Address: 210 Main St , Rm 11 Telephone: 587-1287
2. Owner of Property: Donald Jr. & Elizabeth Willard
Address: 400 Burt s Pit Road Telephone:
3. Status of Applicant: Owner Contract Purchaser Lessee Other (explain) :41 n I - App with
4. Job Location: 400 Burt Pi t Road
Contract Purchaser
Y I s• -. E M1 W ' kQ a, ,I Isl IJ4 -d 5 �R -� '' +. $ III h 3 a � 51w .IrI I - 'f ve { I - r R
� S im! 3k �5 I �" E f - {
' Parcel'Id Zonin 30C r iI 'Parcel #� mo F4"4 v Distriet:( 4 s)� S RI I e R q
r '�' ���l � r� � tii � � h .. 1 5 a �F �� PoM1' C � f I E F .r+� � � h ' {
° 3EL 5 1�W ! !' �. - i} r 4 ,, h . " £ S fre - 4 p M1 5 4 k I { } R -
6 I .
-_ a�m h f' ', Ir m In Elmy treet District ' ' s��11nfiCentra b l Business.pistrict '�' ' "' E ''
� ` �'r' 'ifµ "'X ngal r li(TO.BE FILLED..I.N.BYIHE BUILDING f EPART`MENT. . 5T; 4 5 ..`,. ,.! ',, N` 4. , . 4 °
5. Existing Use of Structure /Property: Two Family House
6. Description of Proposed Use /Work /Project /Occupation: (Use additional sheets if necessary):
Convert property to two family cluster lot and 1 flag lot with
Common drivoway. ••
7. Attached Plans: Sketch Plan Site Plan X Engineered /Surveyed Plans
8. Has a Special Permit /Variance /Finding ever been issued for /on the site?
NO DONT KNOW X 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 X
IF YES, has a permit been or need to be obtained from the Conservation Commission ?NO, work is outside buffer
Needs to be obtained Obtained , date issued:
(Form Continues On Other Side)
W;\Documents\ FORMS \onginalBuilding - Inspector\ Zoning - Permit- Application- passive.doc 8/4/2004
File # MP -2011 -0032
APPLICANT /CONTACT PERSON CITY OF NORTHAMPTON PLANNING DEPT
ADDRESS/PHONE 210 MAIN ST (413) 587 -1265 0
PROPERTY ,•. • • Q TS PIT RD
MAP 30C PARCEL 001 ZONE SR(IN) //WP
5417) 19 O THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
( i G FO LLED OUT
Fee Paid RM /s
Buildin Permit Filled out Ow `
Fee Paid
Typeof Construction: ZPA - 2 FAMILY CLUSTER & FLAG LOT W /COMMON DRIVEWAY
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 PRESENTED:
Approved Additional permits required (see below) eg SPCC i At PE kA/vt
�g SiTE P 1._
PLANNING BOARD PERMIT REQUIRED UNDER : § TA 6 LE USE C CA(si (
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* Li
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 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.