37-130 E 1STIl'j� �ow3
I\lj t�j A
ck
,1,�
9. ALL INFORMATION MUST BE COMPLETED:PERMIT CAN BE DENIED DUE TO LACK OF INFORMATION.
This column to be filled in by
the Building Department.
Existing Proposed Required by
Zoning
Lot Size
Frontage NIA NIA N/A
Front: CJ
Setbacks:
Side: L: 10 R: 0 /cl' L: R:
Rear: C7
Height
% Open Space:
(Lot area minus bldg and
Paved parking)
10. Certification: I hereby certify that the information contained herein is true and accurate to the best
of my knowledge.
DATES APPLICANT'S
NOTE: Issuance of a permit does not relieve an applicant's burden to comply with all zoning requirements
and obtain all required permits from the Conservation Commission,Department of Public Works and other
applicable permit granting authorities.
"7FE
-- City of Northampton
Massachusetts
MAY ? Municipal y
� 2�rDEPAR T OF BvILDZNG INSPECTIONS y� �
�. � 4 212 �iNOrtheampton Northampton,
�--- Electric, Plurr,��"--
INSPECTO Ncrt� c _;
t,
ACCESSORY STRUCTURE PERMIT APPLICATION
(For freestanding structures less than 200 sq. ft., at least 5 feet from any other structure)
Permit Fee: $25.00 Check#� _
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant://b A o i E L CVaOLSS
Address: G 9 b F1 c)a k/i C F R U A v_ ) Telephone: 7 7`i -2 6
2. Owner of Property: S A n E AS A&),j e-
Address: Telephone:
3. Status of Applicant: V/Owner Contractor
4. Structure Location:
Parcel ID: Zoning Map# Parcel# District(s)
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Use of Property: Single or Two Family:_ Multifamily: Commercial:
6. Description of Proposed Structure:
One Story Shed under 200 sq.ft.:_, Freestanding Deck under 200 sq.ft., less than 30"above grade:
Other(describe): A J�:
7. Attached Plans: Sketch Plan Site Plan Plot Plan
8. Does the site contain a brook,body of water or wetlands? NO-4— 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
CONTINUED ON NEXT PAGE
File#MP-2014-0099
APPLICANT/CONTACT PERSON CROUSS DANIEL
ADDRESS/PHONE 696 FLORENCE RD (774)263-2119 Q
PROPERTY LOCATION 696 FLORENCE RD
MAP 37 PARCEL 130 001 ZONE
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out
Fee Paid
Typeof Construction: ZPA ERECT 12 X 16 SHED
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Buildine 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: §
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 Permit DPW Storm Water Management
liq
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.
696 FLORENCE RD MP-2014-0099
COMMONWEALTH OF MASSACHUSETTS
_ CITY OF NORTHAMPTON
FGIS#: _ 11305 -- --� '
�Map: 3'7
Bll ock: 130 ZONING PERMIT
Lot: 001
Permit : ZONING PERMIT APPLI APPLICATION PERMIT
Category: shed
Pew rmit#-- MP-2014-0099 PERMISSION IS HEREB Y GRANTED TO:
Project# .15-2014-002068
;Est. Cost: Contractor: License: Expires:
Fee Charged:$25.00 Homeowner as Contractor
Balance Due:$.00 Owner: CROUSS DANIEL
#of Fixtures Applicant: CROUSS DANIEL
jDigSafe# _ AT. 696 FLORENCE RD
jU_seGroup
11ConstClass
ISSUED ON. 28-May-2014 AMENDED ON. EXPIRES ON.
TO PERFORM THE FOLLOWING WORK:
ZPA ERECT 12 X 16 SHED
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:
shed REC-2014-006765 21-May-14 2558 $25.00
212 Main Street,Phone:(413)587-1240,Fax:(413)587-1272,Email:Ihasbrouck @northamptonma.gov
GeoTMS®2014 Des Lauriers Municipal Solutions,Inc.