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way
10. Do any signs exist on the property? YES NO
IF YES, describe size, type and location:
afv'E @ ccivre-R ST, - / ofrjfM '7 D 8 'Y S/<il/
a/14- A1/9/Al ST - /LLOW/V 9 T&' 4o)(
Are there any proposed changes to or additions of signs intended for the property? YES f/ NO
IF YES, describe size, type and location:RCLOc4r(IrgNrrR Sr 5"/VV 6' 'p1q i
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 v
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 REQUIRED BY
ZONING
Lot Size /) flg2. 3 /) .
Frontage
Setbacks Front 1. 61 Z G
/9
Side L: R: /9 L: 2, R: L: Rt
Rear
Building Height
q5 t 76-1
Building Square Footage / �l 9a/ / 790/
V
%Open Space: (lot area 49'minus building a paved 3% 2
parking /
#of Parking Spaces
0
#of Loading Docks
Fill:
(volume a location)
13. Certification: I hereby certify that the information contained herein is true and accurate to the best of
my knowledge. n(�
Date: <6 J'i 1 l3 Applicant's Signature 3
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:\Documents\FORMS\original\Building-Inspector\Zoning-Permit-Application-passive.doc 8/4/2004
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s - RECE:V
AUG 12 2013
DEPT.OF 6Ullili,13 INSFECTION6 File N O. M P~I - 7
ZONING P RMIT APPLICATION 010.2)
o.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
D ? City of Northampton
1. Name of Applicant: F(RS/ C/ v/Ct lEJ ,,'
Address: /2 9 /'/�7//y ST N°/S/r1/9 VAlf M/9' Telephone: 434/3-'5'10" 93 94
2. Owner of Property: f/4.3 C i7 Q4 Cf7`f 5 /� Q �1
Address: /1 7 1k14(NS'� NO /1 fMPToN telephone: /3'5 ' '7392
3. Status of Applicant: Owner Contract Purchaser Lessee Other (explain)
4. Job Location: N XZE
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: C/u9?C/7
6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary):
9e4 T/N 9 SYSTEM /MPRObEA4E111 T,s'. /NST/XL /NTilkE I EXI/i 1a$7-
P/PES i9T 7T/70 3.9cE/9EWT W/NOoW aPEN/4/ 5 ENO
R&-OC47'E S/cr/V D,V cENTC/{ STREET
7. Attached Plans: Sketch Plan Site Plan V' 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 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\Building-Inspector\Zoning-Permit-Application-passive.doc 8/4/2004
File#MP-2014-0017
APPLICANT/CONTACT PERSON WHITHAM CHALLENGER J&HELEN P
ADDRESS/PHONE 112 CHESTNUT ST ( )586-2531 0
PROPERTY LOCATION 129 MAIN ST
MAP 31B PARCEL 286 001 ZONE CB(100)/
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT i of 6
Fee Paid
Building Permit Filled out
Fee Paid
Typeof Construction: ZPA-RELOCATE SIGN&INSTALL VENT PIPES
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 PRESNTED:
Approved t Additional permits required(see below)
PLANNING BOARD PERMIT REQUIRED UNDER: § STA F r e- V t E vJ Fa 2 SI N s 5v � CD)C3)
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:
-1 i STag l c
Curb Cut from DPW Water Availability Sewer Availability
CCIANWSR l
Septic Approval Board of Health Well Water Potability Board of Health C-f c f`ipmN�
Permit from Conservation Commission Permit from CB Architecture Committee
415Tov-tcAAt,
[Aermit from Binergireet Commission Permit DPW Storm Water Management
is l3
Si ature of Bdil ing 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.