The URL can be used to link to this page

41-022 (4) _ _ . �- 7 _ .....„ / . 0 / 4 / ' ©/ ~ f / i d` s �' A�" 7 7 / / / 41 ,,ct,„ AJ ° 1 \ / / / &V iv / / 1 ti 4 a .- \ -fr vti'nzard , ° oN. \ ' NG Ld 0 M 5 60 t . c --4 - 4 z_,L-N,--vo i '_.vzl - a ' -3 tu r c_ . k Q-3-La-1‘14gM 10., Do any signs exist on the property? YES NO X dE t 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) Dyer 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 bS% the Building -- __ — -- - -- - -- • r .s I ent EXISTING PROPOSEDRI?D B3' Lot Size / ,7 7 Aye ►2E5 4-' 2i Frontage 2- ThS 'FT Setbacks Front •Ao.,‘n Side r %.4 L L -° R: 21 - O L: R: I � R:i Rear l e l."4- 1 - b _ Building Height • Building Square Footage % Open Space: (lot area minus building & paved e / tea" • 1 9 P ��P�X ° I © to y�- � 5 wr parking # of Parking Spaces A--- rl C '� 1 _ 5 rA vr^ , l � # of Loading Docks Fill: (volume & location) 13. Certification: I hereby certify that the information contained herein is true and accurate to the best of my knowledge. Date: I 1 3 r 2'-' Applicant's Signature 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\ FORMSIoriginal1Building- Inspector\Zoning- Permit - Application- passive_doc 8/4/2004 R sEP 3 2012 File No. DEPT. P - /3 -3 DE •- ` +'f{ Au 7 M uw,, - � µ r � x y n o-. r. a,.auy ^e #' 4 x t �" 4 ,,, a c. y `,° ' i+ ' A.47 Ise -. D Gfi tp,6 ,5 D /g ih �' < �- _` yK Rik' A h � � h a &e P! ? ' 1 W LL"° � m • . Z },k L' .4u1s F . ;rF.,.. .;-'1,-i, �A n mx.�+h» �„-w � ��n w�;„� 4.;: ��- . � �, � _ :e.az � i u 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 ofNorthampton 1. Name of Applicant: / k , A A, p/l 1L_ Address: 'It I 4, --11 - c WW1 ST, l J AP—ri Pl i wtVt- Telephone: 5« "�AC-- -- IZ - 2. - Owner of Property: 1,1u (L-ti )rte 1,-.} Address: / (Ne - sni A- wiiPru1' '(2-4,, 1+ 41p!vf u4Telephone: 3. Status of Applicant: Owner Contract Purchaser Lessee dar pia in) /)T L- 4 ( IA J 4. Job Location: /Ef wes1't+ iow, wqk ? , 10 0....- wtf tryev v.4 - � ,n - non -a Z�.i..;" I `n'. �' 'S7f�- ^�i.. -^r ^c. r •,* '�' '� ;tea a t ei� �'�is F at � �y "�''"'.,�vr �'�a�-� f .� �s �vnwx `�'; 4�� e .- ' ` ��'� k : ra lra� a > sl n � . � entra ' ®tislness �sta'�i c '� ,- -, , O , �� r,I ,, i S'4>' s ... . , .,,, ' ' - ' `� _ q., .� �tnom. �icm �yti i �t � - �- v f w,_,`" i# : + " ' " ' ? j ;b x �L . 7 .• L 4 . ®.', !'' LL .43I7� Y T It7MW+F?'RT' : 42gZi ,`� S. Existing Use of Structure / . • y: �' ' SEA , ~' 'U . t 145 lfop 6. Description of Proposed Use /Work/Project/Occupation: (Use additional sheets if necessary): ' r' ♦ , tQ • 00 S tom t-_ - E'v% t_STI ,3 - P. r J ' S a A I ' eft 'N.r— L. fVt I ► I, vT @.) TrsJ\C", & ' Ira : a. In e'}"i w i as I,-) — 7 S Lk-TV - „ A LLJO 2GL 0 . At ♦ ' _ S?7ti vi r / •.lL . ♦ 0 7. Attached Plans: Sketch Plan . ?e. Site Plan 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 f the Registry of Deeds? T4. 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 x __ 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 :Documental FORMS\ original \Building- InspectorlZoning- Permit- Application- passive.doc 8/42004 File # MP- 2013 -0035 APPLICANT /CONTACT PERSON PAYNE JOSHUA ADDRESS/PHONE 201 NORTH ELM ST (518) 610 -1207 () PROPERTY LOCATION 1095 WESTHAMPTON RD MAP 41 PARCEL 022 001 ZONE • THIS SECTION FOR OFFICIAL 'USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT 07 - or - Fee Paid Building Permit Filled out Fee Paid Typeof Construction: ZPA - DET ACCESSORY APT IN BARN 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 PREENTED: Approved V 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: § 1 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 9 `e f i r°r Si iature of Building Official Date r 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.