25C-166 (5) N.
/ -,
G
\. ti L \.
i
2Y 2c-
r 621L4. ii.. -1J
W. Do any signs exist on the property? YES NO h
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) over 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 by the Building
Department
EXISTING PROPOSED tip, ab r P
Lot Size
E;
Frontage
Setbacks Front
Side L: R: L: R: L R:
Rear
Building Height
Building Square Footage
% Open Space: (lot area
minus building & paved z
parking��
# of Parking Spaces
•
# 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: -yrC° /f3 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: ding- Inspector\Zoning- Permit- Application- passive.doc 8/4/4004
APR — 2013 •
File No. _
f , " ; :,:'' :, ; 1 1:) ..,:.1.,.t.....--- 1 � :.r � .., '_ F �. 2 ..€' r�. L ..; ..+ ; rt.. ,i ?, ?, ...m� S.v .n:. W... .r ;d4wti s
eas ;;;:3)-:r7.-2--.1'
ype or print a ll information and return this form to the Build
Inspector's Office with the $15 filing fee (check or money order) payable to the
City ofNorthampton
1. Name of Applicant: % M,4 c4-r � ou"Si. �� - //iL Pt _r /24 c4 41r
Address: / / 3o Z < 'v� �= ,wc � /� �- Telephone: SAS S ��
2. • Owner of Property: c=z � H�
Address: .2 2C L 3 / - 1 Lt) S Telephone: 7 re/ .5
3. Status of Applicant: Owner Contract Purchaser ----- Lessee Other (explain)
4. Job Location: 2 5' - 2 O/� ''' -51
- -47:;-- - 47 - ,.: - .. � k i ':4
.... — .. - 7 - 7 , 777.: 7 - ...-\' Vi' �..v 1 r'a't s y ' q ";- 4 s.,, a �.'S u, ,al - . :740,,
-- t t ! f { - , r ,„ r i ( --+ »` �, - 4.4 ' r� - � L t t H #':�•'esvy r , "
� r 4 � --� t � ( P 1 I t x .,.�.y � s- 3 - � . N '. , + '
r E'--� m " l` r , t. • s y i - � { ' a be.. = 7 t . ', - ` s '• r
- ' - -1, ; - s+. .a ,r a :r d S + ,� .t� ' .0 " ' 'i:. i re . gt e,,,
', �s F�r'`�`a. � i 't T'+� � d �r ��'se'� F`.S k f �+r.e S " ' � e S n 1 � .a .a � p � � g y Y Ev ` �"� � '1 u N i a �;. s. x ... � �r�, � � ,
�
- -+Kf. x... s n d 1',sE f.r e..r 9 x _ - � g r aa .r,
' � :3 ' ^ '4 +f ` ,.' ,�',wiY " r � : '. S"'a. ;,imp � �' t I ® ' : 8 fwr. 6 l'; �Ri ° 6 .'. k ,. `'' �.,r �,.^ = s..
5. Existing Use of Structure /Property:
6. Description of Proposed Use/Work/Project /Occupation: (Use additional sheets if necessary):
,%� _>i.: ma c. �`�yAe /2..7 e L . /VG lam' &1Fti' 42._,i2_,4/4,_ J—/// /' S ioiL� .� cam.
7. Attached Plans: Sketch Plan `'-/- Site Plan Engineered /Surveyed Plans
8. Has a Special Permit/Variance /Finding ever been issued for /on the site?
NO DONT 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 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 C ontinues On Other Side)
W:\Documents\FORMS\ original \Building- Inspector\Zoning- Permit- Application- passive.doc 8/42004
File # MP- 2013 -0099
APPLICANT /CONTACT PERSON PROSPECT BUILDERS INC 0 IL—
ADDRESS/PHONE P 0 BOX 302 (800) 486 -4976
PROPERTY LOCATION 24 ORCHARD ST L', L
MAP 25C PARCEL 166 001 ZONE URB(100)/
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid Permit Filled out 3 �', / I V , -
Building X �
Fee Paid
Typeof Construction:_ZPA - TEMPORARY TRAILER DURING FIRE RESTORATION
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) F° g-- iii RN t 2_ MW part 3
(4L INA sec 3 )
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
l
4 1 1 111)3
. gnature 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.
24 ORCHARD ST MP- 2013 -0099
COMMONWEALTH OF MASSACHUSETTS
CITY OF NORTHAMPTON
i IS #: 4542 9,,W AMP*Ory
M ap: 25C
Block: 166 I '
�: i NING PERMIT
Lot: 001 V\� p !�O
!Permit: ZONING PERMIT APPLI , r R= APPLICATION PERMIT
Category: ELECTRICAL
Permit # MP- 2013 -0099
PERMISSION IS HEREBY GRANTED TO:
Project # IS- 2013- 001545
Est. Cost: Contractor: License: Expires:
[Fee Charged: $15.00 PROSPECT BUILDERS INC
[Balance Due: $.00 Owner: KONHEIM ALEXANDER CARL
# of Fixtures: Applicant: PROSPECT BUILDERS INC
DigSafe # AT: 24 ORCHARD ST
UseGroup
ConstClass
ISSUED ON: 11- Apr -2013 AMENDED ON: EXPIRES ON:
TO PERFORM THE FOLLOWING WORK:
ZPA - TEMPORARY TRAILER DURING FIRE RESTORATION - not more than 12 months GL40A -SEC 3)
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:
TRAILER REC 2013 - 005439 09 Apr - 13 3860 $15.00
212 Main Street, Phone:(413) 587 -1240, Fax:(413) 587 -1272, Email :ihasbrouck @northamptonma.gov
GeoTMS® 2013 Des Lauriers Municipal Solutions, Inc.