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35-194 (4) �� c i�.�-�f �` - �S� V ^( � .r �y c �-. �< ', n ; ` �� .M-�...L ; i i c'' ! C. �w'�5�- I` -c.. � r _..,_--- } � / � l 9. ALL INFORMATION MUST BE COMPLETED: PERMIT CAN BE DENIED DUE TO LACK OF INFORMATION This column to be filled in by the Building Department. Existing Proposed Required by Zoning Lot Size . Frontage N/A NIA N/A Front: Setbacks: Side: _R: L: R: Rear: Height _. !o Open Space: (Lot area minus bldg and Paved parking) 10. Certification: I hereby certify that the information contained herein is true and accurate to the best of my knowledge. DATE: ? APPLICANTS SIGNATURE ��Z c 2 ice. L� i —/ NOTE: Issuance of a permit does not relieve an applicant's burden to comply with all zoning requirements and obtain all required permits from the Conservation Commission, Department of Public Works and other applicable permit-granting"authorities: City of Northampton s � -stcl. . }' Massachusetts . „ DEPART�FNT OF BUXLDING INSPECTIONS ry 212 Main Street • Municipal Building ti Northampton, MA 01060 APR - 72014 INSPECTO f>:✓ 1 STRUCTURE PERMIT APPLICATION (For freestanding structures less than 200 sq. ft., at least 5 feet from any other structure) Permit Fee: $25.00 Check # PLEASE TYPE OR PRINT ALL INFORMATION a. Name of Applicant: / 1� LCL� F1L L= Address: /lit % U,",.IJ` %�/1` �t'`� f'.:.fi<'!I(c Telephone: 2. Owner of Property:.-..7T5'g xzw4- Address: //� U' (i�i�`L `o l /�'L>- Telephone: 5 L ©G'� 3. Status of Applicant: y Owner Contractor 4. Structure Location: 4 ',1�, C ,1)4 V,,ri'6 Parcel ID: Zoning Map# Parcel# District(s) (TO BE FILLED IN BY THE BUILDING DEPARTMENT) 5. Use of Property: Single or Two Family: ✓ Multifamily: Commercial: 6. Description of Proposed Structure: Shed under 200 sq.ft.- V' Freestanding Deck under 200 sq.ft. Other(describe) 7. Attached Plans: Sketch Plan Site Plan Plot Plan 8. 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 CONTINUED ON NEXT PAGE File#MP-2014-0079 APPLICANT/CONTACT PERSON FOLEY TERRENCE W&PATRICIA A ADDRESS/PHONE 1190 BURTS PIT RD (413)586-0639 Q PROPERTY LOCATION 1190 BURTS PIT RD MAP 35 PARCEL 194 001 ZONE THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out Fee Paid Typeof Construction: ERECT 8 X 12 SHED 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 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 Permit DPW Storm Water Management 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. 1190 BURTS PIT RD MP-2014-0079 COMMONWEALTH OF MASSACHUSETTS CITY OF NORTHAMPTON GIs#: ,7011 Map: 35 - 1 Block: 194 d ZONING PERMIT 100, ---- --- �,. Permit: ,ZONING PERMIT APPLI APPLICATION PERMIT Category: shed Permit# MP-2014-0079 PERMISSION IS HEREBY GRANTED TO: - Project# JS 2014 001763 Est. Cost: Contractor: License: Expires: Fee Charged $25.00 Homeowner as Contractor Balance Due.$.00 Owner: FOLEY TERRENCE W&PATRICIA A �#of Fixtures Applicant: FOLEY TERRENCE W&PATRICIA A DigSafe# AT: 1190 BURTS PIT RD UseGroup - -- ConstClass ISSUED ON: 10-Apr-2014 AMENDED ON: EXPIRES ON: TO PERFORM THE FOLLOWING WORK: ERECT 8 X 12 SHED 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: shed REC-2014-005774 07-Apr-14 1278 $25.00 212 Main Street,Phone:(413)587-1240,Fax:(413)587-1272,Email:lhasbrouck@northamptonma.gov GeoTMS®2014 Des Lauriers Municipal Solutions,Inc.