22D-062 r i° ^l ---- 2
N i
\ _1
\ -n 67\ \
o
\ \ \
\ -",-._ .--- \
6
('
,_7:
,--Y
Q
0 <, ( \
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
Frontage N/A N/A N/A
Front
— Setbacks:
Side: L: R: L:
R: /
- - - - = - - -_. Rear:
Height
Open Space: I I
(Lot area minus bldg and
Paved parking)
10. Certification: I hereby certify that the information contain - d herein is tr = ccurate to the best
of my knowledge.
,../ DATE:SEQj APPLICANT'S SIGNATURE
NOTE: Issuance of a permit does not relieve an applicant's burden o 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
RECEIVI7 U Massachusetts
a D ••'TkIENT OF BUILDING INSPECTIONS
7 21' Main Street • Municipal Building {,
SEP I Northampton, MA 01060 -
INSPECTOR DEPT OF BUILDING INSPECTIONS
N 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 # 020
PLEASE TYPE OR PRINT ALL INFORMATION
1. . __�z of Applicant: LAS 11 f t '&l 1 1 4 L L
Ad_cfr_ess: - _ � F .L3 - �V� 1,� Telephone: 4. /. G-1 o
- 11
2. .''Owner •of Property:.. U. ST1►J
Address: S �� >� � _ R 1 Telephone: y1
3. Status of Applicant: y Contractor
4. Structure Location:
Parcel ID: Zoning Map # Parcel # District(s)
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Use of Property: Single or Two Family :x Multifamily: Commercial:
6. Description of Proposed Structure: `` I ,
Shed under 200 sq. fty Freestanding Deck under 200 sq. ft. Other (describe)
if xJ (o
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
• 1
File # MP- 2013 -0042
APPLICANT /CONTACT PERSON KIMBALL JUSTIN & MAURA GLENNON
ADDRESS/PHONE 53 FLORENCE RD (413) 218 -2396 O
PROPERTY LOCATION 53 FLORENCE RD
MAP 22D PARCEL 062 001 ZONE URA(100)/WSP(100)/
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out v Bra d i t
Fee Paid L v V
Typeof Construction: ZPA - 4 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 F LLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
IN 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 Commission Permit DPW Storm Water Management
A L--/4 ` --)' 9 ito ii - 7
i
V
in S gnature o g 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.
53 FLORENCE RD MP- 2013 -0042
COMMONWEALTH OF MASSACHUSETTS
CITY OF NORTHAMPTON
1GIS #: 2701 4o,� Tav
1 Map: 22D
Block: _ 062 = 'Pa; , ZONING PERMIT
Lot: 001 �
Permit: ZONING PERMIT APPLI �s �- �= %Ve -
Category: shed
£R�ENTE- APPLICATION PERMIT
Permit # MP-2013-0042 PERMISSION IS HEREBY GRANTED TO:
Project# JS- 2013 - 000511
Est. Cost: Contractor: License: Expires:
Fee Charged: $25.00 Homeowner as Contractor
Balance Due: $.00 Owner: KIMBALL JUSTIN & MAURA GLENNON
# of Fixtures: Applicant: KIMBALL JUSTIN & MAURA GLENNON
bigSafe # AT: 53 FLORENCE RD
UseGroup
ConstClass
ISSUED ON: 21- Sep -2012 AMENDED ON: EXPIRES ON:
TO PERFORM THE FOLLOWING WORK:
ZPA - 4 X 16 SHED
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 001166 19 Sep - 12 2055 $25.00
212 Main Street, Phone:(413) 587 -1240, Fax:(413) 587 -1272, Email :lhasbrouck@northamptonma.gov
GeoTMS® 2012 Des Lauriers Municipal Solutions, Inc.