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25C-048 (3) f � M 'Amok 1 r� Y i s I 4 u I J r V IV d � 3�! Jane M. Brodwyn 224 North Street --- Northampton, MA 01060 (413) 586-8622 J SIN 2CA May 29, 2009 City of Northampton Building Inspector 212 Main Street Northampton, MA 01060 Dear Sir: I am writing to confirm that the workshop addition that I intend to build on my house will remain workshop only and not become at any time living space. If you wish to speak to me further about this,please don't hesitate to do so. Please note that this is a notarized letter as you requested. Sin erely, J e M. Brodwyn On this; -- day of May. 2009, personally appeared before me Jane Brodwyn, proved to me by satisfactory evidence of identification, which was personal knowledge/drivers license, to be the n whose name is signed to the foregoing document, and swore to me that her st ments bove are true. Lisa an Gordon d'Errico, Esquire Notary Public, commissioned until 3/17/2011 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 y IF YES, describe size, type and location: 11. Will the construction activity disturb (clearing, grading, excavation, or filling) over 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 FAUST BE COMPLETED, or PERMIT CAN BE DENIED DUE TO LACK OF INFORMATION This column reserved for use by the Building Department EXISTING PROPOSED It V EDBY Lot Size Frontage Setbacks Front 3 1 r1 D CJI1&. 3 Side L: � R: L: R: R: jS Rear 7 Building Height 5 t ClAq„Gip J S Building�S©-uEarVlFo�tage %Open Space: (lot area minus building & paved -I S 11/,0 C��• 10 parking #of Parking Spaces n o Ck n9,c #of Loading Docks N/ ) Fill: (volume& location) 13. Certification: I hereby certify that the information contained herein is true and accurate to the best of my knowledge. Date: Applicant's Signature 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 the Board of Health, Conservation Commission, Historic and Architectural Boards,Department of Public Works and other applicable permit granting authorities. W:oocuments\FORNLS\original\Building Inspector\Zoning-Permit-Application-passive.doc 3/4/2004 U� File No. 9GCo 5.h -Please t-YgJ6 or int all information and return this form to the Building' - Inspector's Office with the $15 filing fee (check or money order)payable td the 'City ofNorthamp ton 1. Name of Applicant: Address: / �55t. W Telephone: Q-- 2. Owner of Property: �aq4j2� Address: Telephone: 3. Status of Applicant:' Owner Contract Purchaser iLLessee^►, Other (explain) 4. Job Location:--- a _ Parce< � rt>ntta� � �� Pareef AIM � rsttaett( i�i "�`Y�% "x :r.,Y ,�-d,, '�-3�y „* a.:;e�+.aa„'v,v � +. •�,'" .p � �- �, 5. Existing Use of Structure/Property: , 6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary): 61N 012 4- SVr)AOM 7. Attached Plans: Sketch Plan V/ 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 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 V 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: (Form Continues On Other Side) W:\Documents\FORMS\originaP,Building-Inspector\Zoning-Permit-Application-passive.doc 8'4/2004 File#MP-2009-0066 y �dGty' APPLICANT/CONTACT PERSON BRODWYN JANE MEYERSON �i ADDRESS/PHONE 224 NORTH ST Q 586-8622 Q PROPERTY C 3+IOR'!'i ST THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FO FILLED OUT ai Building Permit Filled out Fee Paid Typeof Construction: ZPA-SUNROOM/WORKSHOP ADDITION 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 FO LOWING 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 C ssion Permit DPW Storm Water Management Signature of Building Official Dat 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.