38A-032 (2) III
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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 ) 6-7 0
Frontage N/A NIA NIA
Front.
Setbacks:
Side• L• ?� R:f L: R:
Rear: 1 O
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.
DATE: � � ! APPLICANT'S SIGNATURE - 6�t1
NOTE: Issuance of a permit does not relieve an applicants 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:
City of Northampton
Massachusetts
OF BUX LDING INSPECTIONS
- r Z92p14 l Y, Street • Municipal Building
r t :
oc rthampton, MA 01060
'
INSPECTO F�ectri
c, pt�mb�n "t
Northam 9&G- I
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APt TRUCTURE PERMIT APPLICATION
(For freestanding structures less than 200 sq. ft., at least 5 feet from any other structure)
Permit Fee: $25.00 Check #6-)g5
PLEASE TYPE OR PRINT ALL INFORMATION
a. Name of Applicant: y��, ar eikJ
Address: 5 7 r 14b''Telephone:
2. Owner of Property:._
Address: Telephone:
3. Status of Applicant:Izowner 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:
Shed under 200 sq.ft. Freestanding Deck under 200 sq.ft. ' Other(describe)
7. Attached Plans: Sketch Plan Site Plan Plot Plan
8. Does the site contain a brook,body of water or wetlands? NOZDON'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-2015-0042
APPLICANT/CONTACT PERSON DION JUDITH
ADDRESS/PHONE 87 CHAPEL ST (413)584-1850 Q
PROPERTY LOCATION 87 CHAPEL ST
MAP 38A PARCEL 032 001 ZONE URB(104)
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid l
Building Permit Filled out
Fee Paid
Tvueof Construction:_ERECT 10 X 12 SHED
New Construction
Non Structural interior renovations
Addition to Existine
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
INF() ItIATION 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
oe .//_� 4/3
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.
87 CHAPEL ST MP-2015-0042
COMMONWEALTH OF MASSACHUSETTS
- CITY OF NORTHAMPTON
GIS#. - 7490—
Map: 38A
Block: 001 ZONING PERMIT
- _
Lot: 001
-----
Perm's: -- ZONING PERMIT APPLI' APPLICATION PERMIT
Category: shed
Permit# MP-2015-0042_ PERMISSION IS HEREBY GRANTED TO:
Protect# JS-2015-000939
- -� Contractor: License:
Est. Cost: Expires:
Fee Charged:$25.00 Homeowner as Contractor
Balance Due:$.00 Owner: DION JUDITH
#of Fixtures Applicant. DION JUDITH
DigSafe# _ _AT: 87 CHAPEL ST
UseGroup
ConstClass
ISSUED ON.• 06-Nov-2014 AMENDED ON.• EXPIRES ON.•
TO PERFORM THE FOLLOWING WORK:
ERECT 10 X 12 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-2015-001889 29-Oct-14 5185 $25.00
212 Main Street,Phone:(413)587-1240,Fax:(413)587-1272,Email:lhasbrouck@northamptonma.gov
GeoTMS®2014 Des Lauriers Municipal Solutions,Inc.