25A-181 (21) C11Y OF NORTHAMPTON TEL No .1-413-586-3726 Sep 19 ,96 14 :50 No .006 P.01
w
9 o. Do any signs e)dst on the property? YES _ NO i
IF YES,describe size,type and location:
Are there any proposed changes to or additions of signs intended for the property?Y(�ES NO
IF YES,describe size,type and location: c^J- &'q Q1 ( C� /kN.- -�
11. ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE DENIED DOS TO
LACK OF INFORMATION.
rnt. Col— Co be slued in
by the Haildlay Departwgat
_ Required
Existing Proposed By Zoning
Lot size
Frontage
Setbacks
-side L:,6�R:_L L:L�_tR:
- rear
Building height i 4 C
Bldg Square footage c�, 00c 0, 0
%Open Space:
(Lot area minus bldg S1 /a
&paved parking) '
,p 'Parking Spaces
# bt Loading Docks 0
Fill: -
�' ,
a(voI-;ime--& ZocationJ JJ
13. Certification: I hereby' certify that the in ati- ntained herein ..
Is true and ccurate to the:best of my kno 1e ge
LOWE: �%(! �(� APPLICANT's STGNATURS
°� NOTES Issu nae o a xonlnQ permit does not relieve an a oant's urden t oom
a9ninp rsqulreenents and obtain all required PH.M! x.st[ `
req permits fro the Board of Health,,:Conseirvatlan•.:
Commission, Department of Publlo Works and other app oable permit oranting.owthorltirjwi::
TVA
'^
CITY OF NORTHAMPTON TEL No .1-413-586-3726 Sep 19 ,96 14 :48 No .005 P.01
Q
File No. t
ZONING PERMIT APPLICATION (§10. 2)
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant: o'qlia V\ /I
Address: F Telephone:
2. Owner of Property:Pro e t
P
Address:
I(a,A-rs�_ Telephone:_
3. Status of Applicant: _Owner Contract Purchaser Lessee
4er(explain):_ �
4. Job Location: _ L I-) E- 'XCIA �;��1° X, 1-�'Y I Vj ? f
Parcel Id: Zoning Map#� Parcel# District(s):
(TO BE FILLED IN BY THE BUILDING EPARTMENT)
5. Existing Use of Structure/Property
6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary):
t OP
7. Attached Plans: Sketch Plan Site Plan Engineered/Surveyed Plans
Answers to the following 2 questions may be obtained by checking with the Suildirtg Dept or Planning Department Files.
8. Has a Special PermiWariance/Finding ever been issued for/on the site?
NO__� DON?KNOW YES IF YES,date Issued:
tF 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—K— DON'T KNOW YES
IF YES,has a permft been or need to be obtained from the Conselvation Commission?
Needs to be obtained Obtained ,date Issued:
(FORM CONTINUES ON OTHER SIDE)
FILE # C 15 V
APPLICANT/CONTACT PERSON: L
ADDRESS/PHONE:
PROPERTY LOCATION:
MAP � PARCEL: ZjZ ZONE 4
THIS SECTION FOR-OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FIT LED OUT
Fee PAid
'Rzd1din2 Permit Filled Alft
Fee Pnid
r
Addition
Strivrtitre
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS AP ICATION:
Approved as presentedfbased on information presented
KDenied as presented:
�Pia equired u nder: § 10•IT _> S Y SPaL2s PLANNINZONING BOARD P��
Received&Recorded at Registry of Deeds Proof Enclosed
Finding Required under.§ . 1J w/ZONING BOARD OF APPEALS
Received&Recorded at Registry of Deeds Proof Enclosed
Variance Required under: § w/ZONING BOARD OF APPEALS
Received&Recorded at Registry of Deeds Proof Enclosed
Other Permits Required: A p p ra V a of n 0��n�•�.� ��{►�0, `t
Curb Cut from DPW Water Availability Sewer Availability
Septic Approval-Bd of Health Well Water Potability-Bd Health
!Permit from Conservatio ommissio
Signature of Building ffir,or Dge
NOTE:lssuanoa of a zoning permit does not relieve an appiloant's burden to oomply with all
zoning requirements and obtain all required permits from the Board of Health, Conservation
Commission, Department of Publio Works and other applioable permit granting authoritles. —