34-026 (10) 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:
ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE DENIED
DUE TO LACK OF INFORMATION. This column to be filled in
by the Building Depart.
EXISTING PROPOSED REQUIRED BX
Z V ZONIN0
Lot Size
Frontage
Setbacks Front
Side L: J R: L: 1�-1 ' 2 R:
4v t k 1,2-e
Rear ^�
Building Height
Building Square Footage
Open Space: (lot area ' .7
minus building Et paved parking
# of Parking Spaces
# of Loading Docks
Fill:
(volume Et location)
12. Certification: I hereby certify that the information contained herein is true and accurate to the best of
my knowledge.
Date: Z 02- Applicant's Signatur h
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.
Q �
2 $ 2002 it No. 10-�3 3
QN INII APPI;ICA 'OT.
Please type or Tint 4 ha return this form to the Building Inspector's Office with the
$� . Ing fee (check or money order) payable to the City of Northampton
Name of Applicant: ; ,-y
Address: �`{� (umyA ie:
2. Owner of Property: �c
Address: ne: 5'd (n- S� S
3. Status of Applicant: Owne — Other (explain)
4. Job Location: L c3 d d ro l 5 ✓
Rarceh I'd: Zoning/vlap#. ict(sJ::
In.E[i-n:Street: t,
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/Property:
6. Description of Proposed Use/Work/Project/Occup ion: (UV additional sheets if necessary):
-tO- •t�SIOUS wo�kl, We- Qom. 0.{m\
4 Q.��w�etiF SF,^vci��Z . VS< w.wwu �`^y<vew�� 0.�.C�'� �.���� be
T 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
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? W,k�
Needs to be obtained X Obtained date issued:
(Form Continues On Other Side)
File#MP-2003-0033
APPLICANT/CONTACT PERSON Tristram W Metcalfe
ADDRESS/PHONE 142 Main St (413)586-5775
_> 4: THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM ILLED OUT
Building Permit Filled out
Fee Paid
Typeof Construction: ZPA-CONSTRUCT 4 UNITS
New Construction
Non Structural interior renovations
Addition to Existing
Accessoa 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 PRES TED:
Approved Additional permits required(see below)
PLANNING BOARD PERMIT REQUIRED UNDER: § .2
Intermediate Project : !/ Site Plan AND/OR Special Permit with Site Plan
Major Project: Site Plan AND/OR Special Permit with Site Plan � �
a. b� 7za"
ZONING BOARD PERMIT REQUIRED UNDER: § f,&A'Pqae)43T
Finding Special Permit Variance*
Received&Recorded at Registry of Deeds Proof Enclosed Q°iJ'°7.10A�l
Other Permits Required: I
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 Stre Commission
Lj Zoe
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.
- r
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. This column to be filled in
by the Building Depart.
EXISTING PROPOSED REQVIREA BY
Z & ZONING
Lot Size Sr r
Frontage
Co��a row
367.4
Setbacks Front pj
Side L: J R: L: I0� R: 4S i 1 L: U Rr:
40 # ��
Rear
Building Height
Building Square Footage �2
Open Space: (lot area
minus building Et paved parking O
# of Parking Spaces
# of Loading Docks
Fill:
(volume Et location)
12. Certification: I hereby certify that the information contained herein is true and accurate to the best of
my knowledge.
Date: Z 7 0 Applicant's Signatur - h
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.
2 g 2002 it No. -03—,�3
I-ON 1NII APPLICATION (�10.2
Please type or print rsi A� return this form to the Building Inspector's Office with the
$I ing fee (check or money order) payable to the City of Northampton
i. Name of Applicant:
Address: � �^0.��N— S F ��� '�V� .�C� Telephone: S S
2. Owner of Property:
Address: ���— `���� S{ `y��"`����`�" Telephone: S��S
3. Status of Applicant: Owner Contract Purchaser Lessee Other (explain)
4. Job Location:
Parcel Cd: Zoning IvCap#.' Parcel#, District(5}:
In..Elm:Street District In Central Business District
(TO BE FILLER IN BY THE`BUILDING,DEPA`RTMEIJT),
5. Existing Use of Structure/Property: S C-,kw \a
6. Description of Proposed Use/Work/Project/Occup ion: (U e additional sheets if necessary):
—For �e v�ous v,6 UJe ct�e_ 0. \
q Q.A --e—on
F
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 DON'T KNOW YES 1-J/ _ IF YES, date issued: �t�s <<�
IF YES: Was the permit recorded at the Registry of Deeds?
NO DON'T KNOW YES J
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? l_q,`�
�1
Needs to be obtained X Obtained date issued:
(Form Continues On Other Side)