06-064 (14) 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 / 7 OS 5 S.F. 5x144
Frontage //e r J N/A S'e �.-N/A N/A
Front: "
Setbacks:
Side: L: R: L: R:
Rear:
Height
% Open Space:
(Lot area minus bldg and /
Paved parking)
10. Certification: I hereby certify that the information contained herein is true and accurate to the best
of my knowledge.
DATE: APPLICANT'S SIGNATURE � ^
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
REMassachusetts
1, CEIVED
;
DEP•:' T OF BUILDING INSPECTIONS
u 212!Mai Street • Municipal Building
J� 2013 orthampton, MA 01060 Pir 37?..
INSPECTOR
DEPT.OF BULGING INSPECTIONS
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 # 2 7/4
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant: id ose-/A ttf d1-�
Address: 6 /- /''e- f l Telephone: 1/43 " 5 7S- 2.5&
2. Owner of Property: Joseph (�/ti J4 n�
Address:16 3 C�-�►/ Telephone:
3. Status of Applicant: ✓Owner Contractor
4. Structure Location: 6 -'¢""'
Parcel ID: Zoning Map# Parcel# District(s)
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Use of Property: Single or Two Family: ' Multifamily: Commercial:
6. Description of Proposed Structure:
One Story Shed under 200 sq.ft.: ✓ Freestanding Deck under 200 sq.ft., less than 30"above grade:
Other(describe): /0 X l6 SLtos{
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-2013-0126
APPLICANT/CONTACT PERSON WAYNE JOSEPH M&LINDA L
ADDRESS/PHONE 68 CHESTNUT AVE EXT (413) 575-2586 0
PROPERTY LOCATION 68 CHESTNUT AV EXT
MAP 06 PARCEL 064 000 ZONE
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRLD DATE
ZONING FORM FILLED OUT y��� 4�
Fee Paid c(1 9
Building Permit Filled out
Fee Paid
Typeof Construction: ERECT 10 X 16 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 FOL WING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INFO ATION PRESENTED:
pproved Additional permits required(see below)
PLANNING BOARD PERMIT REQUIRED UNDER: §
Intermediate Project: Site Plan AND/OR Special Permit with Sit;Plan
Major Project: Site Plan AND/OR Special Permit with Sire 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 Sewe-Availability
Septic Approval Board of Health Well Water Potability Board of Health
Permit from Conservation Commission Permit from CB Architecture Committee
Pi: om El treet C o mmission Permit DPW Storm Water Management
ir
• L . j --./
Si:41111 ilding 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 4-0A.Contact the Office of
Planning&Development for more information.
68 CHESTNUT AV EXT MP-2013-0126
COMMONWEALTH OF MASSACHUSETTS
CITY OF NORTHAMPTON
GIS#: 12073 �yt H/Mpr
Map 06 1
Block: 064 , g 0. , ZONING PERMIT
Lot 000
T� ' APPLICATION PERMIT
Pernllt: �ZO1V •
11�G i Ei�1v1IT APPLI T�RCENTENP��
Category: shed
Permit# MP-2013-0 126 PERMISSION IS HEREBY GRANTED TO:
Project# JS-2013-001894
Est. Cost: Contractor: License: Expires:
Fee Charged:$25.00 Homeowner as Contractor
Balance Due:$.00 Owner: WAYNE JOSEPH M&LINDA L
#of Fixtures: Applicant: WAYNE JOSEPH M&LINDA L
DigSafe# AT: 68 CHESTNUT AV EXT
UseGroup
1ConstClass
ISSUED ON: 07-Jun-2013 AMENDED ON: EXPIRES ON:
TO PERFORM THE FOLLOWING WORK:
ERECT 10 X 16 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-2013-006521 04-Jun-13 2914 $25.00
212 Main Street,Phone:(413)587-1240,Fax:(413)587-1272,Emailahasbrouck @,northamptonma.gov
GeoTMS®2013 Des Lauriers Municipal Solutions,Inc.