25A-127 (2) r
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lip
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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. 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
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
ISTING PROPOSED RE BY
EX QIIIl ._R_
;Z(1rNNG
Lot Size ,
-�--
Frontage
7D
Setbacks Front
Side L: S g R: 3 L• R: L R:
Rear
Building Height / t
Building Square Footage
%Open Space: (lot area
minus building & paved
parking
#of Parking Spaces
2
#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: �( 2'1c, Applicant's Signature ` / a"� S �, '
Tra-n K LVa.roL
NOTE:Issuance of a zoning permit does not relie e 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.
W:\Documents\FORMS\original\Building-Inspector\Zoning-Permit-Application-passive_doc 8!412004
T-il L 2 L 05 ...�" File No.
-Mc-
Please type or prifift all i z1 ormation and return this form to the Building
Inspector's Office with the $15 filing fee (check or money order)payable to the
City ofNor''t//hampton
Pp A S' ✓l
1, Name of Applicant: ►>~�e���c dt_,-`_ + c..
Address: L /"LLD Xe- L?�( OeU010tk O ZL 3 Telephone: -2 C,1-S 3
+�J �._ G� 80o z 3z- ?51.91
2. Owner of Property: �nnct .f- l� -
Address:-2' S- � '- SL a���G{a Telephone:
3. Status of Applicant: Owner Contract Purchaser Lessee Other (explain).(`zDN totc. rr 4n tYmSlft�
4. Job Location: lles
..°srv„ 5.,t» Val ^-
�arce;I-�ci` �clRn><aag•I1?lap# "Parcel# -� � ' [�st�-tct s �
-
3
5. Existing Use of Structure/Property:
6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary):
6;14 9 'I,— n h �y F"L)L d-s .ro6'l
tP rJoIM�� j- hr_Anti.2_ iw C44cuise-, u�,� ►?-( C7 C Ch 40 ,� Sec. 3
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 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 DONT 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-Application-passive.doc 8/4/2004
File#MP-2006-0013
APPLICANT/CONTACT PERSON AMERICAN MOBILE HOMES INC
ADDRESS/PHONE 51 MOORE RD (781)331-0333
PROPERTY LOCATION 25 BATES ST
MAP 25A PARCEL 127 001 ZONE URB
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ONING FORM LLED OUT
ee
Building Permit Filled out
Fee Paid
Typeof Construction: ZPA-ERECT TRAILER FOR TEMPORARY LIVING QUARTERS
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/Statement or License
3 sets of Plans/Plot Plan
TH E FO OWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INFO 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 Sion
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
25 BATES ST MP-2006-0013
COMMONWEALTH OF MASSACHUSETTS
CITY OF NORTHAMPTON
GIS#: 4341
Map: 25A
Block: 127 ZONING PERMIT
Lot: 001
Permit: ZONING PERMIT APPLI APPLICATION PERMIT
Category: TEMPORARY TRAILER
Permit# MP-2006-0013 PERMISSION IS HEREBY GRANTED TO:
Project# JS-2006-0160
Est.Cost: $0.00 Contractor: License:
Fee Charged:$15.00 AMERICAN MOBILE HOMES INC
Balance Due:$.00 Owner. HILL ARTHUR B JR&AGATHA N
#of Fixtures: Applicant: AMERICAN MOBILE HOMES INC
AT: 25 BATES ST
ISSUED ON: 29-Jul-2005 AMENDED ON. EXPIRES ON. 29-Jul-2006
TO PERFORM THE FOLLOWING WORK.
ZPA-ERECT TRAILER FOR TEMPORARY LIVING QUARTERS(NOT TO EXCEED 1 YEAR)
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:
Zoning Permit Application REC-2006-000416 28-Jul-05 32161 $15.00
212 Main Street,Phone:(413)587-1240,Fax:(413)587-1272
GeoTMS®2005 Des Lauriers Municipal Solutions,Inc.