17C-172 (7) 03/24/98 10:17 d94135871264 NORTHARINTON. bIA 10 003
t
W2 [&,' signs�exist on the property? YES NO
-" AF 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.
ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE DENIED DUE TO
LACK OF INFORMATION.
This oo2== to be filled in
by the Buildiag Dcpartrneat
Required
Existing Proposed By Zoning
Lot size C "� �7 E± 4/0
1�
Frontage
Setbacks - r frnnt
rl
- side L: R: i q L: R:
- rear
Building height
Bldg Square footage
%Open Space:
(Lot area minus bldg
&peved parrci.n3i
# .Pf Parking spaces
%f Loading Docks - /�
Fill: /� f/
Avolume--& location)
13 - Certification: I hereby certify that the information contained herein
G is true and accurate to the best of my knowledge.
DATE: j APPLICANT'S SIGNATURE
NOTE; issu noe of a zoning permit does not r-elieve an afoiPlioanta burden to oompty
zoning r,"ufrement"s and obtain all required permits from the Board of Health, Conser'W ation
Commission. Department of Publio Works and other applloabla permit granting authorities.
FILE #
03/2 /98 10 17
n91 35871264 NORTHAMPTON. MA 0002
>j n _
.._
MAR 2 6 W C}
File No. /Cti 333, t
L
ZONING PERMI T APPLICATION (§10 . 2)
PLEASE TYPE OR PRINT ALL INFORMATION
7
1. Name of Applicant-.__ -�� r�M/�A� t^7T6/4)
Address: a7 /C.g/R/P&7 c ) Telephoner
2. Owner of Property: c3a v l& a
Address: Telephone:
3. Status of Applicant: Owner Contract Purchaser —Lessee
Other(explain):
4. Job Location: cif / G/� �� G �
Parcel Id: Zoning Nlap# Parcel#_1'7( 41Z District(s):
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
S. Existing Use of Structure/Property f -N
6. Description of Propgsed Us rk/Proje t/O upabon: (Use additional sheets if nectssary):
K - I r I � r stcL /
C r t ' : a t � t` f l S • f rIC! T�t c_G .�
i
7. Attached P ans: ketch Plan Site Plan Engineered/Surveyed Plans
Answers to the following 2 questions may be obtained by checking with the Building Dept or Planning Department Files.
S. Has a Special PermitA narlce/Finding ev r Peen issued for/-)n the site?
NO �/ 1 �N, tq �j}c ii, Fi
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? N( 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)
FILE # Q �, 22 �
_SG .� r
MAR 2 6
APPLIOANTXOr#ACT PERSON:
A.DDRESS/PH6 :
PROPERTY LOCATION:
MAP f :Z(L PARCEL: ZONE
THIS SECTION FOR-OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
EPP Paid
Tv of f onstniction-
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION'
Approved as presented/based on information presented
Denied as presented: / 11
Special Permit and/or Site Plan.Required under: §
PLANNING BOARD' ZONING BOARD Ter m i t
Received&Recorded at Registry of Deeds Proof Enclosed
Finding Required under:§ 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:
Curb Cut from DPW ter Availability Sewer Availability
Septic Approval-Bd of Health " Well Water Potability-Bd Health
nit Co�ery n n
Signature of Buildin ector Date
NOTE:issuance of to zoning permit does not relieve an applicant's burden to comply with all
zoning requirements and obtain nil required permits from the Board of Health, Conservation
Commission, Department of Publio Works and other applicable permit granting authorities.