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36-069 C" OD co to M r, m .Q m ° m m 7.7 N 1 ° to Q) co m m m M M° ci to to r N MO 1 CO co W M h ' M Q N co°m m M to to M C m n) LO m o Id m m m m m m m ° m W M � O m r W W V lh O m W to D'Y T M � °m coo M 1 ^ O �q N t 3 CF to t`" L M tto m M O�;/MN! M to tD to W to CO 1 n O N m 1 M Cl) M M `* M M to m M to N 1 t0 1 O M Rh m o Cl) n M �M m M S M M p ° M W m 'V N N m O W (D 1 m N n 0 0 0 0 0 0 0 r r � m In N W Q m N U) a 0 N m W N M m r r m N N N co r to O O N M r M, 1 1 _ M N to to o_.th N M 0 m O N m N e N r °o m °� Cl) 1 0 to O° ' O O m m Co O- Co m - N W co N m m N N O M O co - ..T•...- _ _ _ O tt) m 1 0 to N - 1 m c N m M O t ro M to m N to r M r � co N C c r to °a 0: C7D M � m to N $ to m m V � N O v� N •".N. f.'.i N to - n to m r M 10. Do any signs exist on the property? YES NO IF YES, describe size, type and location: Aw 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, or filling) over 1 acre or is it part of a common plan of development that will disturb over 1 acre? YES NO I 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 Department EXISTING PROPOSED � BY O z Lot Size -Z Frontage - Setbacks Front -- Side L: R: L• R: 'Rt Rear Building Height Building Square Footage y - %Open Space: (Tot 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. Date: 'r/G Applicant's Signature NOTE:Issuance of a zoning permit does not relieve an ap 'can t'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. W:1Documents\FOPMS\original\Buil ding-InspectorlZoning-Permit-Application-passive.doc 8/412004 L UUQ File No - Please-typgorprrt all information and return this form to the Builing Inspector's Office with the $15 filingfee (check or money order)payable to the City ofNortbampton 1. Name of Applicant: IV54 J. s`°�/�"� rA/ Address: ` /mss © Telephone: �' � G''`ig 2. Owner of Property: `` �' r'�/�✓� Address: N 9' ;V -'-t"-4lephone: 3. Status of Applicant: Owner Contract Purchaser �Lessee Other (explain) 4. Job Location: 4 v i — �/•��,�/ 5. Existing Use of Structure/Property: 6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary): �'` .✓f�T�.� r`"i .�/' - S r /z` 'd' s t /r�,� °jam 7. Attached Plans: Sketch Plan V 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 DONT 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) W:\Documents\FORMS\original\Building-Inspector\Zoning-Permit-Applica ion-passive.doc 8/4,2004 File#MP-2007-0028 APPLICANT/CONTACT PERSON MICHAEL J BEHRENS ADDRESS/PHONE 699 PARK HILL RD (413) 586-0138 PROPERTY LOCAT> i , .0t LAME LOT 14A MAP"36 PARCEL 069 (©lr.BONE SR THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ONING FORM ILLED OUT ee ai Building Permit Filled out Fee Paid Typeof Construction: ZPA-BUILDING LOT 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 Pl%NRTED: 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 s ZONING BOARD PERMIT REQUIRED UNDER: § o CS✓� 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 Co ssion 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.