35-297 (2) ' r
Da
to Filed File No. -
;tt
'REGISTRATION OF HE ME OFFICE/OCCUPATION (510.2 & 11.11)
with the Building Inspector
1. Name of Applicant:
Address:u`� ( 300 j) t,�t Telephone: 15 24
2. Owner of Property: t MC-r- a/ C
Address: i Telep e: —t
3 . Status of Applicant:_ZOwner Contract Purchaser Lessee
Other (explain: )
4 . Parcel Identification: Map _, Parcel 06 ,
Zoning District(s) (inclucle overlays)
Street Address (,� e
5. Narrative Description of Proposed Home Office: (Use additional sheets
if necessary)
6. Is this a legal residential building? ES,' NO
7 . Will there be an employee/owner who doesn't live in the home YES
8_ Will you ever see clients or customers at your site? YES NO
How often
For what purposes
9 . Will there be any signs for the Home Office? YES D1119
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 nT 11. Will there be any outdoor storage of materials? S
12 _ Will your use be totally within a building and not cause any
outward manifestation (including traffic generation, parkin
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: F,Q-b '2,9 "26b q Applicant's Signature.
THIS SECTION FOR OFFICIAL USE ONLY:
y Approved as 'presented/based on information presented
APPROVAL EXPIRES ON DECEMBER 31 OF THIS YEAR AND MUST THEN BE RENE-WED
Denied as presen ---Reason: -
signature of Building Inspector Dat
NOTE: tuuanoo of a permit does not rollove an applicant's burden to oompty with all zoning requiramonts and obtain all roqulrod pormit3
from the Roard of Health.Conservation commission, Department of Public Works and other applicable pormlt granting authorities.
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 reserved
for use by the Building
Department
EXISTING PROPOSED REQUIRED BY
ZONING
Lot Size
Frontage
Setbacks Front
Side L: R: L: R: L: R:
Rear
Building Height
Building Square Footage
Open Space: (lot area
minus building it 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: cm6 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.
OOO.pdf
rile No. IV P
OD I C.PE ITAPPLICATION(§lQ.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
�o City of Northampton
1. Name of Applicant: 1 'i V ASS A jccn rl U M Q0_0
Address: C,0O<�J 6 1)r— Telephone:
2. Owner of Property: &, i C^ n, k (+_ �O n 0,e C C, I�
Address: n L:JOC° C�( rl&. 1. ) Telephone: L4
T
3. Status of Applicant: Owner �_Contract Purchaser Lessee Other (explain)
4. Job Location: (�-�yy CAS ol)6J Q--
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:
6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary):
-H 0 kr`4 Z CCC E 0(4 rz(U ed S "a t)y
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 DONT 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?
Needs to be obtained Obtained , date issued:
(Form Continues On Other Side)
File#MP-2004-0099
APPLICANT/CONTACT PERSON DUGGAN BRIAN&MARYANNE L
ADDRESS/PHONE 63 WOODLAND DR (413)582-9984 Q
PROPERTY LOCATION 63 WOODLAND DR
MAP 35 PARCEL 297 001 ZONE SR
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out
Fee Paid
Tpeof Construction: RENEWAL-HOME OFF/OCC REG-ENGRAVED SIGNS
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 F9AOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INF ATION 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
2- Zo a
Signature of Building fficial 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.
63 WOODLAND DR MP-2004-0099
COMMONWEALTH OF MASSACHUSETTS
_ CITY OF NORTHAMPTON
�GIS#: 10672
Map: 35
Block: 297 HOME
ILot: 001
Pe t: 'HOME OFFICE/OCR-REi OFFICE/OCC REG
Category: Home Office/Occ Registrat _
f�P-ert# jMP-2004-0099 PERMISSION IS HEREBY GRANTED TO:
Project# _JS-2003-0984
Est.Cost: Contractor: License:
Fee: $15.00 Homeowner as Contractor
�#of Fixtures: Owner: DUGGAN BRIAN&MARYANNE L
Applicant: DUGGAN BRIAN&MARYANNE L
AT: 63 WOODLAND DR
ISSUED ON: 04-Mar-2004 AMENDED ON: EXPIRES ON: 01-Jan-2005
TO PERFORM THE FOLLOWING WORK:
RENEWAL-HOME OFF/OCC REG-ENGRAVED SIGNS
THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF
ANY OF ITS RULES AND REGULATIONS.
Signature:
Fee Type: Receipt No: Date Paid: Check No: Amount:
Home Office/Occ Registration REC-2004-002413 20-Feb-04 174 $15.00
212 Main Street,Phone:(413)587-1240,Fax:(413)587-1272
GeoTMS®2004 Des Lauriers Municipal Solutions,Inc.