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ALL INFORMATION MUST BE CONPLE7ED, or PB'i41T CAN BE DENIED DUE TO LACK OF INFORMA110N This column reserved for use by the Building Department EXISTING PROPOSED REQUIRED BY ZONING Lot size 65; l{ rW X (d.9 PEE 1° 56-140E Frontage NdIJE Setbacks Front 0.1 S fhin E *7 r Sde L: I( r fou R: �, L: (( 6tt R: ( L: R: Rear 1 I Building Heig t Building Square Footage /031,i1 DAIS G�,S 1200 �' sARAGGS`SAMC) � jP�,R.�� +max cb 0�K '1 ao 41 Lpvp/s S PAcE +q-go c z- Q jG SPRcE %Open Space:(lot area minus building&paved �� l 0 parking n .2(0 #of Parking Spaces 4 G tfa-d a-6 4 `t o PEN SPACES 3 o t°t ?u S PAGE S #of Loading Docks 0 0 Fill: (volume& location) Q 13. Certification: I hereby certify that the information contained herein istrue and accurate to the be of my knowledge. Date: e2-5 l3 Applicant's Sgnatt re 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. WAD o cum entstFORMSIoriginalSuildiag-IaspectorlZoning Permit Application-passive.doc 8/4/2004 2 of 2 4/19/2013 3:47 PM 1VllC7 in wuru-c,umng-rermu-Appiicauon-passive.doc-Zoning-... http://www.northamptonma.gov/building/uploads/1i/stWidget/3219/Zo... File No, ZONING PERMIT APPLICATION 010.2) 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 of Northampton 1. Name of Applicant: 60ivsT`i-AJCE L. F=/=x1,Q o1O 3? Address: R' THE L©PF f HAYOEA)ttc- . , fn A4 Telephone: g!3 r'!,-3 -4t6,So 2. Owner of Property: Con/s;�gsU L. FE7V P 6 19 7W3 / 1-F f}r G-L E{. 0/0A? Address: St 171-rr 1.0 PF , l-1A Yl)E'N t/2 L(.&, r)719- Telephone: '/3 — S(o 3^ 16).S.79 3. aatusof Applicant: Owner X Contract Purchaser Lessee other(explain) 4. Job Location: 41 / u/'/I0q,8rAiE AvE, J VTh 7 /A-m F7,)( /Y),9 o to G. 0 Parcel Id: Zoning Matp# 2.51} Parcel# 15 /- District(s): In Elm Street District In Central Business District (TO BE FILLED IN BY THE BUILDING DEPART ENT) 5. Edging Use of aructure/F-operty: RFS.rd7 EN)TJ L RE-K17-19 L (4A,fZ7` 6. Description of Proposed Use/VVork/Project/Occupation: (Use adcitional sheets if necessary): c'lWNE!Z 0rcaP��-tCl AtAD 0,1' 0 &TpRy L.zV2:111G SPffcE OVER !IN P-1cr:C7-,17v I 7. Attached Plans: &etch Ran ✓ Ste Plan / Engineered/airveyed Rans 8. Has a 4:)ecial Farmit/Variance/Rnding ever been issued for/on the ate? NO DONT KNOW 17- YES IF YES, date issued: IF YES Was the permit recorded at the Rejstry of Deeds? NO DONT I(NCW YES IF YES enter Book Page and/or Document# 9.Doesthe site contain a brook, body of water or wetlands? NO ✓r DONT KNOW YES IF YES hasa permit been or need to be obtained from the Conservation Commission? Needs to be obtained Obtained , date issued: (Form Continues Qi Other Sde) W:1 DocumentsWORMSIoriginal Building-Inspector\ZoningPeanit Appli cation-passive.doc 8/4/2004 1 of 2 4/19/2013 3:47 PM File#MP-2013-0107 f'IN®°' APPLICANT/CONTACT PERSON HAIGLER JUDY&CONSTANCE L FENDER ADDRESS/PHONE 8 THE LOPE (413)563-4650 0 PROPERTY LOCATION 39 WOODBINE AVE MAP 25A PARCEL 153 001 ZONE URB(100)/ THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT ��j j Fee Paid 342 Building Permit Filled out Fee Paid Typeof Construction: ZPA-ADD 2ND FLR LIVING SPACE OVER EXISTING GARAGE 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 ACT ON HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFORMATION PREENTED: 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: § 350 ` 9 33 (7) 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 C> —.. 4/--- -,--/e 4 ,_ te .- 2t3 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.