32C-215 (4) «n pa}spool }Qty �! utalc� shy} va uMOy� sa�.j:.t�e.tc ec.
e=Ixe 8U00-A04 AAAA0 's }oDa} wy} 6ul}a0}#a pt'o04.x 10 s;uecua$
sQ, 00.jdt ul aq-4 Aq pagti-nsop sasiujo id PL41 uodrt s}uewyCjDoAo
IDS4; `pag!iimop Sas:ujaid dy) ua paID:aol Go &: uUSL QA0.,tdl.0
try ! ��� l iodaa Agajo!! 4,jaileq Pura '8bpalM►ou
3m QNVI
3HO 3oanos
Ld
:F4zg
3snON ,
r �
10. Do any signs exist on the property? YES NO 4.
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, orfilling) 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
EXISTING PROPOSED
t.
Lot Size b
r ..
Frontage -
Setbacks Front /
Side L: R: L: R:
Rear
Building Height
Building Square Footage
%Open Space: (lot area ,
minus building &paved
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.
1
- it-
Date: 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.
8/412004
�
�.
7fc�T,
JUN — 9 2�Q5 JUL 1 20Q5 ,�' File No/� — A
Z-6, N -,M#T A LI OATION § 10 2
A,C�mp'lee thicv=fiorm -yau� computer� nd the free Adobe PDF Reader
-bh p://www.ido-be.com/products/acrobat/readstep2.htm1). Print the completed form, sign it,
and return it to the Building Inspector's Office together with the $15 filing fee (check or
money order) payable to the City of Northampton.
1. Name of Applicant: a
Address: 37 'V tL-[C-3CKe City: 4 �� State: Zip: 01060
Telephone: q1
2. Owner of Property: -7y�)(n a\
Address: 7 h r\&�rL' 5( Citv: n Stater Zip: 0<!,9
Telephone: 44(3 6-7-6
3. Status of Applicant:
Owner & Contract Purchaser 0 Lessee (D Other (explain) �.
4. Job Location: i/ig-111L /Ve lrku-,R P Town:
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:
.'9 V
6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessa
w
7. Attached Plans: Sketch Plan (1) Site Plan (2) Engineered/Surveyed Plans
8. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO 0 DON"T KNOW (Z) YES (�) IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO 0 DON"T KNOW 0 YES IF YES: Book Page and/ Document#
or
9. Does the site contain a brook, body of water or wetlands? NO ) DON'T KNOW 0 YES
IF YES, does a permit need to be obtained or has a permit been obtained from the Conservation Commission?
A permit needs to be obtained 0 A permit has been obtained and was issued: / /
OOO.pdf
y.
File#MP-2005-0136
APPLICANT/CONTACT PERSON BOUCHER JOHN J SR
ADDRESS/PHONE P O BOX 1672 (413)586-9320 Q
PROPERTY LOCATION 37 HOLYOKE ST
MAP 32C PARCEL 215 001 ZONE URC
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
Z�ai ILLED OUT ��
�'li 7`
Building Permit Filled out
Fee Paid
Typeof Construction: ZPA-CONSTRUCT 2ND FLR DECK
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 PREED:
Approved dditional permits required(see below)
PLANNING BOARD PERMIT REQUIRED UNDER: §
Intermediate Project: Site Plan AND/OR Special Perniit with Site Plan
Major Project: Site Plan AND/OR Special Permit with Site Plan
ZONING BOARD PERMIT REQUIRED UNDER: § 57r
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
1114,1
12�0 oS
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.