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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 i tended for the property? YES �NO
Jl.
IF YES,describe size, type and location: 5 j q /'V/�o f -.A WW
11. Will the construction activity disturb (clearing,grading, excavation,or filling)over 1 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
EXISTING PROPOSED REQUIRED BY
ZONING
Lot Size p
Frontage
S - - b 3�m
Setbacks Front /10
Side U )a3, R. 16 l L: Arr� R 1X L: R
Rear 'A rn
Building Height
Building Square Footage m p
%Open Space: (lot area
minus building ft paved 3
parking rl
#of Parking Spaces
#of Loading Docks
m �
Fill:
(volume it location
13. Certification: I hereby certify that the information contained herein is true and accurate to the best of
my knowledge.
Date. a Applicant's Signature OF
oe
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.
W:\Documcnts\FORMS\original\Building-Inspectorkzoning-Permit-Application-passive.doc 8/4/2004
Ole No. d(�
ZONnVG PERMITAPPLICA I'ION(§10.2)
Please type or print all information and return this form to the Building
Inspector's Office with the$i5fdmg►fee(check or money order)payable to the
City of Northampton
1. Name of Applicant: 1140 91'h A m f-ro-N iZ�ff h►'t G t L- 1'rj4Zj-/sy V f Z ,S ) NC— C E n lTC k_
Address: N 'n Pz 'T"h n n, p-r-4oy rV/'?-SS 0/a6 a Telephone: S& to- 33o 0
2. Owner of Property:w C R 1% A it f--c) w f4 e A 1--7-h C,13 t�r 11 LL-
Address:-7-37 GRi' ID C-C +tea rvc&fh AMP&rg Ma. Telephone:
3. Status of Applicant: Owner Contract Purchaser Lessee Other(explain)_ v f R ri VG
4. Job Location: 3`) 6 t`,f' 4 C C- Lo rl O&r h r+r*P rrV M A
Parcel ld: Zoning Map# Parcel#- District(s):
In Elm Street District . In Central Business Dbtrict
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/Property: L) ) IN G-- M 1F
6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary):
0 I^ l r�1 *1 t�S 1°� G- h,t re C.-
7. Attached Plans: Sketch Plan Site Plan / Engineered/Surveyed Plans
8. Has a Speci en-nit/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 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:\Do=ments\FORMS\original\Building-InspectorV.onm&-Permit-Application-passive.doe 8/4/2004
File#MP-2006-0050
APPLICANT/CONTACT PERSON Northampton Rehabilitation Nursing Center
ADDRESS/PHONE 737 Bridge Road 586-3300
PROPERTY LOCATION 737 BRIDGE RD
MAP 18C PARCEL 048 001 ZONE URB
THIS SECTION FOR OFFICIAL USE OVT V
PERMIT APPLICATION CHECKL
ENCLOSED
l ONING FO LED OUT
`F-1ra r--
Building Permit Filled out
Fee Paid
Typeof Construction: ZPA-FRONT GROUND SIGN
New Construction t (Il
}
Non Structural interior renovations
Addition to Existing 3 Su��7 �}� � ? 21'Y '
Accessory Structure
Building Plans Included:
Owner/Statement or License l'
3 sets of Plans/Plot Plan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLI(
INFORMATION 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: § f/
L10 ss 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
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.