32C-296 (3) i.
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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
Frontage ( N/A N/A N/A
Front: `
Setbacks_
Side: L R L: Li R: fi
Rear:
Height
% Open Space: l 4
(Lot area minus bldg and
Paved parking)
10. Certification: 1 hereby certify that the information contained herein is true and accurate to the best
of my knowledge.
DATE: 7 / 3 J lt
APPLICANT'S SIGNATURE ` iC C4eA U4
( I
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 •
R tC ,- -. Massachusetts r�
DEPAR NT OF BUILDING INSPECTIONS a .^
201 1 212 M ' n Street • Municipal Building , �t*
Northampton, MA 01060
INSPECTOR DEPT OF BURN C TN FtcTiOrNs
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 # o(o qo
PLEASE TYPE OR PRINT ALL INFORMATION
1. ._Name of Applicant: :. "'l1 i A t 6 {
Address: – Telephone: -006
2. Owner of Property:
Address: Telephone:
3. Status of Applicant: L— Owner Contractor
4. Structure Location: ":710 V 117
Parcel ID: Zoning Map # Parcel # District(s)
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Use of Property: Single or Two Family: IV Multifamily: Commercial:
6. Description of Proposed Structure:
Shed under200 sq. ft. "� Freestanding Deck under200 sq. ft. Other (describe)
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 -0098
APPLICANT /CONTACT PERSON EVERETT MALCOLM G
ADDRESS/PHONE 40 VALLEY ST (413) 584 -0068 0
PROPERTY LOCATION 40 VALLEY ST
MAP 32C PARCEL 296 001 ZONE URC(93)/
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid /
Building Permit Filled out /Z940 at.L
Fee Paid
Typeof Construction: REPLACE 8 X 10 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
IN�F 2MATION 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
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 VALLEY ST MP- 2013 -0098
COMMONWEALTH OF MASSACHUSETTS
CITY OF NORTHAMPTON
GIS #: 6739 /a� "
Map: 32C
Block: 296 � 1
-Airj ': ZONING PERMIT
Lot: 001 �'►
Permit: ZONING PERMIT APPLI Tf APPLICATION PERMIT
Category: shed
Permit # MP -2013 -0098 - PERMISSION IS HEREBY GRANTED TO:
Project # JS-2013-001559
Est. Cost: Contractor: License: Expires:
Fee Charged: $25.00 Homeowner as Contractor
Balance Due: $.00 Owner: EVERETT MALCOLM G
# of Fixtures: Applicant: EVERETT MALCOLM G
DigSafe # AT: 40 VALLEY ST
UseGroup
ConstClass
ISSUED ON: 11- Apr -2013 AMENDED ON: EXPIRES ON:
TO PERFORM THE FOLLOWING WORK:
REPLACE 8 X 10 SHED
THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF
ANY OF ITS RULES AND REGULATIONS.
Signature:
Fee Type: Receipt No: Date Paid: Check No: Amount:
shed REC 2013 - 005403 08 Apr - 13 2690 $25.00
212 Main Street, Phone:(413) 587 -1240, Fax:(413) 587 -1272, Email :lhasbrouck @northamptonma.gov
GeoTMS® 2013 Des Lauriers Municipal Solutions, Inc.