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YE
10. Do any signs exist on the property? NO
IF YES, describe size, type and location:
Are there any proposed changes to or additions of signs intended for the rope 7 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
This column reserved
for use by the Building
Department
E)M=G PROPOSE
r
Lot Size
Frontage
Setbacks Front
ED
Side L: R: L:
Rear
Building Height
Building Square Footage
%Open Space: (lot area ,✓
minus budding E paved parking -
#of Parking Spaces /
#of Loading Docks
Fill- -----
(volume location)
12. Certification: I hereby certify that the information contained herein is true and accurate to the best of
my knowledge.
Date: I Applicants Signature
NOTE:Issuance of a zoning permit does not relieve an applican 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 vJorii s and other applicable permit
ranting authorities.
OOO.pdf
i
.y
;r JI 2 2008 q,
i Fite No. / o /3
ease type or print aR information and return this form to the Building
Inspector's Office with the$15,filing fee (check or -money order)payable to the
City ofNorthmnpton
1. Name of Applicant: Okut " \ ('(j c d kj
Address: J Telephone: -� - 3 (5
2. Owner of Property: �� G
Address. Telephone: 7 + c F 6ST
3. Status of Applicant: Owner on tract Purchase Lessee Other (explain)
4. Job Location:
5. Existinc Use of Structure/Property: VAC A-,
6. Description f Propose U e/Work/Project/Oc pation: (Use ad 'tional sheets if necessa
C��13 a&6� 1A "--,A
Avo s
7. Attached Planl Sketch Plan Site Plan , Engineered/Sure yed Plans
8. Has a Special Penrnt/Variance/Findina, erbeen issued forlon 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 "o
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#MP-2008-0043
APPLICANT/CONTACT PERSON MCCUTCHEON DAVID J
ADDRESS/PHONE 263 SYLVESTER RD (413)587-4570 Q
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out
Fee Paid
Tweof Construction: ZPA-5-6 1 LEVEL
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 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: § AZ? t45FI Z —riFQ�/ °i T
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 CoiWussion Permit DPW Storm Water ana ement
Signature of Building Off ial 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.