25A-113 (4) r
10. Do any signs east 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.
Th a col— to be Pilled in
by the 2MX2dia9r D0epart-eut
Required i
Existing Proposed By Zoning
Lot size '
Frontage
Setbacks - front
- side L: R: L: R:
- rear
Building height
Bldg Square footage
%Open Space:
(Lot area minus bldg
&paved parking)
# of -Parking spaces
f of Loading Docks
Fill:
vol-ume--& location)
fi
13 . Certification: I hereby certify that the information contained herein
is true and accurate to the best of my knowledge. .
DATE: -1-Z$ -o 3 APPLICANT'S SIGNATURE
NOTE: Issusnoe of as zoning permit does not relieve an appiloanrs bu o oomply With '"11
zoning requirements and obtain all required permits from the Board of Health, Conservation
Commission, Department of Publio Works and other applioable permit granting authorities.
FILE #
File No.
ZONING PERMIT APPLICATION (§10 . 2)
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant: `AIA Capacn
Address:a-t 5qk-9,, tAN A-E . NbRrrcAHP►d`', MA_Telephone: 'At3 •531.5119
2. Owner of Property: SAM C4LNh _
Address: 54 sHEQMkN Noe.zKAMPra MATelephone: y13.S31.5-if9
3. Status of Applicant: ?Z Owner Contract Purchaser Lessee
Other(explain):
4. Job Location:
Parcel Id: Zoning Map# Parcel# District(s):
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/Property 4-1oM F
6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary):
HoA.E npP C.,=
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/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__.)< i 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 No.117P—a
'l"
OF HOME OFFICE/OCCUPATION 010 . 2 & 11. 11)
With the building Inspector
J
aoNS Gam,
ant: SAM ---
A� RCN, ttEQMAN ����F I•�oGrrKAFIPtoN�/✓lA_`T'ei_ephoi�e: 4�3-531•S1►q
2 . Owner of Property: &W GRA'hn
Address :_ SK Ai-*P ,�o�tua P��!, A_1'elephone: ut3•S31 •5119
3 . Status of Applicant: )( Owner Co;itract Purchaser Lessee
Other (explain: -- -- —)
4- . Par.cel Identif ication: Map A_�Parcel r�3
Zoning District(s) (include overlays) &4,i�---
Street Address
5 . Narrative Description of Proposed Home Office: (Use additional sheets
if necessary) (i9mpy-r,62 LpHSWiTIN(.
6 . Is this a legal residential building? YES' NO
7 . Will there be an employee/owner who doesn't live in the home
8 . Will you ever see clients or customers at your site? YES 6
How often
For what purposes
9 . Will there be any signs for the Home Office? YES iv0
1.0 . 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
11 . Will there be any outdoor storage of materials? YES N0
12 . will your use be totally within a building and not cause any
outward manifestation (including traffic generation, parking
congestion, noise, air pollution, and r„aterials storage) ? YE NO
If NO explain:
1.3 . 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-c ina -fines and
criminal and civil actions .
Date: Applicant' s Signature :
THIS SECTION FOR OFFICIAL USE ONLY:
Approved as presented/based on information presented
APPROVAL EXPIRES ON DECEMBER 31 OF THIS YEAR AND MUST THEN BE RENEWED
Denied as presented---Reason:
Signature of Building Inspector Date
NOTE: Iauanco of a pormlt doo:not roliovo an applicant's burdon to comply with ali zoning roqulromonts and obtain all roquirod pormlt3
from tfw Board of Hoalth,ConzorvatlOn Commission, Dopartmont of Public Works and othor applicablo pormit granting authorltios.
.► It
File#MP-2004-0008
APPLICANT/CONTACT PERSON CRAIG SAM
ADDRESS/PHONE 54 SHERMAN AVE (413)537-5719()
PROPERTY LOCATION 54 SHERMAN AVE
MAP 25A PARCEL 113 001 ZONE URB
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Buildinjz Permit Filled out
Fee Paid
Typeof Construction: HOME OFF/OCC REG-COMPUTER CONSULTING
New Construction
Non Structural interior renovations
Addition to Existing
Accesso1y Structure
Building Plans Included•
Owner/Statement or License
3 sets of Plans/Plot Plan
THE OLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INATION 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
=-Aut from;lm Stree ss'
� K l -7 13 116) 3
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.
PXVQE MP-2004-0008
COMMONWEALTH OF MASSACHUSETTS
CITY OF NORTHAMPTON
GIS#: 4328
Map:
Block: HOME
Lot: 01
Permit: HOME OFFICE/OCC_RE OFFICE/OCC REG
Category: Home Office/Occ Registrat
Permit# MP-2004-0008 PERMISSION IS HEREBY GRANTED TO:
Project# JS-2004-0142
Est,Cost: Contractor: License:
Fee: $15.00 Homeowner as Contractor
#of Fixtures: Owner: CRAIG SAM
Applicant: CRAIG SAM
AT. 54 SHERMAN AVE
ISSUED ON. 05-Aug-2003 AMENDED ON: EXPIRES ON. 01-Jan-2004
TO PERFORM THE FOLLOWING WORK:
HOME OFF/OCC REG-COMPUTER CONSULTING
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-2004-000302 30-Jul-03 MO $15.00
212 Main Street,Phone:(413)587-1240,Fax:(413)587-1272
GeoTMS®2003 Des Lauriers Municipal Solutions,Inc.