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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 intended for the property! YES / NO
IF YES, describe size, type and location:
11. Witt the construction activity disturb (clearing, grading, excavation, or filling) o. er 1 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 MUST BE COMPLETED, or PERMIT CAN BE DENIED DUE TO LACK OF INFORMATION
This column reserved
for use by the Building
De artment
i EXISTING PROPOSED REQUIRED BI'
ZONING
Lot Size
Frontage I
Setbacks Front j „a i J \ ' l
Side L: C R: L: R: L: R:
Rear
f
Building Height
Building Square Footage
no 1 �t
Open Space: (lot area
minus building Et paved
parking
# of Parking Spaces
# of Loading Docks
Fill:
(volume Et 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 an applicant's burden to compl),,ith all zoning
requirements and obtain all required permits from the Board of Health, Conservation Commission,
Historic and Architectural Boards, Department of Public 'ATorlcs and other applicable permit granting
authorities.
W:\DOCLIMCMS FOR1v1S\original\Building-I aspector\Zoning-Permit-Application-passive.doc 3/4/2004
File No. RP
ZONING PER-31TT APPLICATION 051 o.2)
Please type or print all information and return this form to the Building
Inspector's Office with the $15 fcliny fee (check or money order)payable e .
City o f 1Vorthampton ct �
ILI
1. Name of Applicant: � � l 1 �i �L f !�� z —��'t✓IiC1J f 1�
Address: i1 E L%G ��c`� � V l-. l T)-�Q.� 5 f4"
e ep one:
k ' \) , ,2. Owner of Property: 1` ' ao �
Address:f-1 K �_ /�l(A_C �i'1 � Q��� ephone:
3. Status of Applicant: Owner Contract Purchaser Lessee Other (explain)
4. Job Location:
— C
Parcel Id: Zoning Map# Parcel# A43 District(s)
in Elm Street District ! In Central.Business District
(TO!B EiTl LLED IN BJY. THE..BUILDING DEPA'RTME NT)
'
5. Existing Use of Structure/Property:
6. D scription f Proposed Us /W rk/Project/Occupation: (Use addit o al sheets if Pcessary):
J - �- - V 0 a6'
7. A tached Plans: Sketch Plan 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 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)
NV\Documents\FOP\IvIS\original\Building-Inspector'Zoning-Permit-Application-passivtdoc 8/4/2004
File#MP-2015-0013
APPLICANT/CONTACT PERSON LAVOICE DEBRA
ADDRESS/PHONE 142 NORWICH LAKE (413)246-8502 Q
PROPERTY LOCATION 55 LOUDVILLE RD
MAP 48 PARCEL 023 001 ZONE
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ZONING FORM FILLED OUT ENCLOSED REQUIRED DATE
Fee Paid
Building Permit Filled out
Fee Paid
Tvueof Construction: ZPA-GROOM SHOP
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 G 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: § 3 �• t t,'ar►1 E B S(NES �� ��ec-E�
�,..-- PF 2��►. Fa R �t.a�,g T FAR�
Finding Special Permit Variance*
�S V1S1Ts
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
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.