32C-120 (13) Y
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10. Do any signs exist on the property? YES NO
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:
I i. ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE DENIED
DUE TO LACK OF INFORMATION. This column to be filled in
by the Building Department
EXISTING PROPOSED REQi3IREDX
ZONING
Lot Size
Frontage
Setbacks Front
Side L: R: L: R: L: R:
Rear
Building Height
•
Building Square Footage
% Open Space: pot area
minus building&paved
parking
#of Parking Spaces
#of Loading Docks
Fill:
(volume&location)
12. Certification: I hereby certify that the information contained herein is true and accurate to the best of my knowledge_
(1,
Date: C' ) /t- 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.
C '• t; 1V E
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I i J.-1) � File No.
y t' `'�O ''I G PERMIT APPLICATION 010.2)
Please,type or'print':all info ation and return this form to the Building Inspector's Office with the
-0:-fil'.; (check or money order) payable to the City of Northampton
,q e ZA A/i'\ S -I--t p_i'h E S a
1. Name of Applicant:;-� n I, r �,/� � / /
Address:) ( ( I L 1 b V0,0 t% 1<°(/{ , Telephone: Q 0 t.9 J b/'' Z Z 1
2. Owner of Property:^Abe `-' i4,M — eA 6 V7( Ai 6_1Y-t— t 0,/V1 i�l S/�
Address: 11 a- Cam. d ti 2 ` • Telephone: .i"
3. Status of Applicant: Owner `f Contract Purchaser Lessee Other(explain)
4. Job Location: l 1 Co �-- •
Parcel Id: Zoning Map# (571-79—C— Parcel# v District(s):
In Elm Street District In Central Business District
(TO BE FILLED IN BY THE BUILDINGDEPARTMEN'1) ,
f
5. Existing Use of StnrcturccPmperty �2��-1@ j `7
6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary):
Cp.1ns 4AA L1-- of Pt.J /�i ,.1/I.�i_L): ,tit /,7
Lo/t/t1 -Ct i /- 29---. ,1--i
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 `' DON'T KNOW YES IF YES,date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO DON'T KNOW YES
IF YES: enter Book Page and/or Document it _
9. Does the site contain a brook,body of water or wetlands? NO j/ DON'T KNOW YES
1
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)
i •
a- R
File#MP-2002-0107 ;i1 as
APPLICANT/CONTACT PERSON SHEMESH AVRAHAM&
ADDRESS/PHONE 261 RIDGEWOOD RD (860)561-2271 0
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ONING FO' FILLED OUT
Building Permit Filled out
Fee Paid
Typeof Construction: ZPA-CONSTRUCT 3 STORY MULTI-FAMILY 3-6 UNITS
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)
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
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.