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it 8 2012 I File No. W'1
3 C
o -� OF , L6�r -�J 0 NING PERMIT APPLICATION ( §i0.2)
' ease • 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: i 0 _ _ . 1 111 ,
0
Address: d MAI r—.t S , O IE- Tron� -r P-► » t' Telephone: 58( 70o
2. Owner of Property: 'PA (De;
Address: G2 I`4Ar -1 _Sr t... ,�L�.r --t pw?- 1 Telephone: 5 G 7Oo o
3. Status of Applicant: Owner
Contract,Purchaser Lessee Other (explain)
4. Job Location: 7 9
Parcel Id: Zoning Map# Parcel# District(s):
In Elm Street District In Central Business District
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure /Property: 1 1K
6. Description of Proposed Use /Work /Project /Occupation: (Use additional sheets if necessary):
1] LI_Sf I i fib A. f. L-.. t . Go
b r ll
?~)c )1 1_1 () .4_tF7 • r- t.E.C&J
)1L /1, -4G1 .
7. Attached Plans: Sketch Plan Site Plan Engineered /Surveyed Plans Y-
8 . Has a Special Permit /Variance /Finding ever been issued for /on the site?
NO DON'T 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 #
9.Does the site contain a brook, body of water or wetlands? NO X 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:
(Form Continues On Other Side)
W:\Documents \FORMS \original \Buil ding - Inspector\Zoning - Permit- Application- passive.doc 8/4/2004
File # MP- 2013 -0061
APPLICANT /CONTACT PERSON Berkshire Design Group
ADDRESS/PHONE 4 Allen Place (413) 582 -7000
PROPERTY LOCATION 79 KING ST
MAP 31B PARCEL 216 001 ZONE CB(100)/
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid /Sf
Building Permit Filled out
Fee Paid
Tvpeof Construction:_ZPA -DEMO BANK BLDG & CONSTRUCT NEW BANK BLDG & 4 STORY APT
BLDG
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 PRESOTED:
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 v" Special Permit with Site Plan 35'0 J 3 Si ?e PLA N,"
. siC CIA r, 'ERA IT Foe NEcJ
ZONING BOARD PERMIT REQUIRED UNDER: §
BA to uD f DiaV6ti/P
Finding Special Permit Variance*
35 MY-AWN i 14
Received & Recorded at Registry of Deeds Proof Enclosed C C
(..."' 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 ci Permit from CB Architecture Committee /S6
Permit from Elm Street Commiss' n Permit DPW Storm Water Management
11 13 17
Signature of Building Official Date
g g
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.