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. CHRISTOPHER COUCH & !3
QUELYN HAMM SOUTHERN
26, PAGE 248 — TRACT NO 2 10,815± &) . h I . j
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---- - - - - --
72.50' i I 73.34' t 75.c
" S / 13' 00'08 ---- -- -
OAK STREET --- A 40' WIDE PUBLIC WAY
,
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9. ALL INFORMATION MUST BE COMPLETED; PERMIT CAN BE DENIED DUE TO LACK OF INFORMATION.
This column to be filled in by
the Building Department.
Existing Proposed Required by
Zoning
Lot Size 10 p •
Frontage N/A N/A N/A
Front: f
--- -- Sat — beK
Side. L: R: L: S R: 6 0
Rear: J
Height
1 % Open Space: I
(Lot area minus bldg and
Paved parking)
10. Certification: I hereby certify that the information contained herein is true and accurate to the best
of my knowledge.
DATE: G� l 7 / a APPLICANT'S SIGNAT ' = / ��
%�
NOTE Issuance of a permit does not relieve an applicant's burden to comply with all zoning requirements
and obtain all required permits from the Conservation Commission, Department of Public Works and other
applicable permit granting authorities:
City of Northampton
44,k Massachusetts `
a I RECEIVED Vi
DEPARTMENT OF BUILDING INSPECTIONS pr
sl2 Agin Street • Municipal Building
SEP Northampton, MA 01060 - --
INSPECT .•
EEPI OF BUILDING INSPECTION$
NORTHAMPTON, MA 01060
ACCESSORY STRUCTURE PERMIT APPLICATION
(For freestanding structures less than 200 sq. ft., at least 5 feet from any other structure)
Permit Fee: $25.00 Check # \ c
PLEASE TYPE OR PRINT ALL INFORMATION
1. — F Name of Applicant: e55C / `Or'ft c rn c' j
Address: 1'(,O_.- - CK S�,(� a rtvi C -Z, -. Telephone: t 1 / 3 - CP'1 (PP
2. Owner of Property :... - -. 7 54 c
Address: - 1,d Oct. k 5\- 'f— c yL € / Telephone: I I( 3 - SP- -5 - (r.:
3. Status of Applicant: y Owner contractor
4. Structure Location: -Llc) 'O S- l ttlicC. f14
Parcel ID: Zoning Map # Parcel # District(s)
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Use of Property: Single or Two Family: V Multifamily: Commercial:
6. Description of Proposed Str
Shed under 200 sq. ft. `' Freestanding Deck under 200 sq. ft. Other (describe)
a Co.
7. Attached Plans: Sketch Plan Site Plan Plot Plan
8. Does the site contain a brook, body of water or wetlands? NO ✓ 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
CONTINUED ON NEXT PAGE
File # MP -2013 -0040
APPLICANT /CONTACT PERSON MONTGOMERY JESSE C & HEATHER A
ADDRESS/PHONE 40 OAK ST (413) 584 -4941 0
PROPERTY LOCATION 40 OAK ST
MAP 17C PARCEL 323 001 ZONE URB(100)/
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid JOilif 495
Building Permit Filled out
Fee Paid
Typeof Construction: ZPA - 12 X 16 SHED
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)
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 Commission Permit DPW Storm Water Management
(;Z //`/(/'—je) YP/21/
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.
40 OAK ST MP- 2013 -0040
COMMONWEALTH OF MASSACHUSETTS
CITY OF NORTHAMPTON
GIS #: 11299
Map: 17C
Block: 323 \ _- � `` A ZONING PERMIT
Lot: 001
Permit: ZONING PERMIT APPLI £®'. �95 ^ �
APPLICATION PERMIT
Category: shed
Permit # MP -2013 -0040 PERMISSION IS HEREBY GRANTED TO:
Project # JS -2013- 000501
Est. Cost. Contractor: License: Expires:
Fee Charged: $25.00 Homeowner as Contractor
Balance Due: $.00 Owner: MONTGOMERY JESSE C & HEATHER A
# of Fixtures: Applicant: MONTGOMERY JESSE C & HEATHER A
DigSafe # AT: 40 OAK ST
lUseGroup
ConstClass
ISSUED ON: 21- Sep -2012 AMENDED ON: EXPIRES ON:
TO PERFORM THE FOLLOWING WORK:
ZPA- 12X16SHED
THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF
ANY OF ITS RULES AND REGULATIONS.
Signature:
Fixtures:
Floor: Type: # of Fixtures Floor: Type: # of Fixtures
Fee Type: Receipt No: Date Paid: Check No: Amount:
shed REC- 2013 - 001128 17- Sep -12 3094 $25.00
212 Main Street, Phone:(413) 587 -1240, Fax:(413) 587 -1272, Email :lhasbrouck @northamptonma.gov
GeoTMS® 2012 Des Lauriers Municipal Solutions, Inc.