32C-286(1) WRDajl , File NoA)1 / 6
DEPT OFBUH.0IN6iNSPECTIOON9RE ISTRATION OF HOME OFFICE/OCCUPATION 810.2 & 11.11)
NORTHAMPTON MA 01060 With the Building Inspector
1. Name of Applica t:
Address: // j%/, /?�15 151-11` Telephone:
2. Owner of Property: ojFm�
Address: _'it„a_ Telephone: Sara_
3 . Status of Applicant:_j_Owner Contract Purchaser Lessee
Other (explain: )
4. Parcel Identification: Map f3;tC'., Parcel f
Zoning District(s) (include overlays)
Street Address
5. Narrative Description. of Pro osed Home Office: (Use additional sheets
if necessary)
6. Is this a legal residential building? YES NO
7 . Will there be an employee/owner who doesn't live in the home YES Zj¢
8. Will you ever see clients or customers at your site? YES O
How often
For what purposes
9 . Will there be any signs for the Home Office? YES NO
10. Will there be any goods sold from the premises or any sale of
goods stored on premises , either retail or wholesale, or any
display of goods on premises? YES O
11. Will there be any outdoor storage of materials? YES
12 . Will your use be totally within a building and not cause any
outward manifestation (including traffic generation, parking
congestion, noise, air pollution, and materials storage) ? YES NO
If NO explain:
13 . Attach Plans (if applicable)
14 . Certification: I hereby certify that the information contained herein
is true and accurate. I understand that if any information is incorrect,
my permit is null and void and I may be liable for non-criminal fines and
criminal and civil actions.
Date: Applicant's Signature:
� -
THIS SECTION FOR OFFICIAL USE ONLY:
roved as presented/based on information presented
APPROVAL EXPIRES ON DECEMBER 31 OF THIS YEAR AND MUST THEN BE RENEWED
Denied as presented---Reason:
Signature d r D t
NOTE: Issuanoo of a permit dons not rolleve an appllcanYa burden to comply with all zoning requlromonts and obtain all roquirod ponntts
from tho Board of Hasfth,consorvatton commission, Departmont of public Works and othor applicable pormit granting authoritlos.
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:
11 . ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE DENIED DUE TO
LACK OF INFORMATION.
21da cols to be filled in
by the Building Department
I Required
Existing Proposed By Zoning
I Lot size
Frontage
Setbacks
- side L: R: L: R:
- rear
Building height
Bldg Square footage
%Open Space:
(Lot area minus bldg
&Paved parking)
# of Parking Spaces
t 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 knowle g .
y ���
DATE: — APPLICANT's SIGNATURE
NOTE: Issuance of a zoning permit does not relieve an a plioant's burd n to oomp it4 all
zoning requirements and obtain all required permits from the Board Health. Conservation
Commission, Department of Publio Works and other applioable permit
granting authorities.
FILE #
! w
l t
File
ZONING PERMIT APPLICATION (§10 . 2)
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant:
Address: //T �//�i � ��- Telephone: Z//--3 62 Z,
2. Owner of Property:
Address: 1.122�5�-S—f Telephone: 4Z/3
3. Status of Applicant: _Owner Contract Purchaser Lessee
Other(explain): ` �p _
4. Job Location: _ ��//�6tri5 /ILd�T
Parcel Id: Zoning Map# 39\(�—_ Parcel# District(s):
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5, Existing Use of Structure/Property
6. Description of Proposed UseMlork/Project/Occupabon: (Use additional sheets if necessary):
",e M le4i I vl/-�I
7. Attached Plans: Sketch Plan Site Plan Engineered/Surveyed Plans
Answers to the following 2 questions may be obtained by checking with the Building Dept or Planning Department Files.
8. Has a Special Permit/Vadance/Finding ever been issued for/on the site?
NO DON'T KNO:AI x 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#
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)
a
File#MP-1999-0092
APPLICANT/CONTACT PERSON STANISEWSKI JOHN J&SANDRA A
ADDRESS/PHONE 114 WILLIAMS ST 584-4268
PROPERTY LOCATION 114 WILLIAMS ST
MAP 32C PARCEL 286 ZONE URC
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid .12gA
Building Permit Filled out
Fee Paid
T_ypeof Construction: HOME OFFICE/OCCUPATION REGISTRATION
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/Statement or License
3 sets of Plans/Plot Plan
THF,?OLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION:
4i/Approved as presented/based on information presented.
Denied as presented:
Special Permit and/or Site Plan Required under: §
PLANNING BOARD ZONING BOARD
Received&Recorded at Registry of Deeds Proof Enclosed
Finding Required under: § —w/ZONING BOARD OF APPEALS
Received&Recorded at Registry of Deeds Proof Enclosed
Variance Required under: § —w/ZONING BOARD OF APPEALS
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
Signature of Building O 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.