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SEE,BOOK 5 11-PACE
PLAN BOOK 191-PAW
.G"It2-PACE
PL
PAGES 74-116
M—AM —1
91 A-
M or t1m LN
NORTHMMN,MASSACHUSEWS Iff�IJN LEY
HUHnZY ASSOCIATES,P.C.
The WZORKK FAMILY INVESTMEW TRUST
10. Do any signs exist on the property? YES NO X
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. Wilt the construction activity disturb (clearing, grading, excavation, or filling) over 1 acre or is it part of a common
plan of development that will disturb over 1 acre? YES NO X
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
Department
EXISTING PROPOSED REQUIRED BY
ZONING
Lot Size
5.029 acres 5.029 acres
Frontage
46. 15 + 173.75 46. 15 + 173.75
Setbacks Front
Side L: NA R: NA L: R: L: R:
Rear
Building Height
less than 35 feet
Building Square Footage TBD
Open Space: (lot area
minus building Et paved TBD
parking
#of Parking Spaces
TBD
#of Loading Docks
None
Fill: None
(volume Et location)
13. Certification: I hereby certify that the information contained herein is true and accurate to the best of
my knowledge. '
Date: l W6 /Applicant's Signature
NOTE:Issuance of a zoning permit does not relieve an 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 ADocuments\FORMS\original\Building-lnspector\Zoning-Permit-Application-passive.doe 8/4/2004
CE [iWE
?
File No.
i11 ,
I ING PERMIT APPLICATION(§s o.2)
�. print all information and return this form to the Building
Ins P ector's Office with the $15 filing fee (check or money order)payable to the
City of Northampton
1. Name of Applicant: William P. Wzorek c/o Thomas Miranda
Address: 64 Gothic Street Telephone: 413-584-1282
2. Owner of Property: William P. & LeeAnn Wzorek
Address: 71 Cardinal Way Telephone:
3. Status of Applicant: Owner X Contract Purchaser Lessee Other (explain)
4. Job Location: Lot 4 Cardinal Way
Parcel Id: Zoning Map# 36 Parcel# 342 District(s):
In Elm Street District In Central Business District
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/Property: vacant land
6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary):
single family home
7. Attached Plans: Sketch Plan Site Plan Engineered/Surveyed Plans X PB195 B100
8. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO X 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 DON'T KNOW YES X
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained X Possibly Obtained , date issued:
depending on proximity to construction
(Form Continues On Other Side)
W:\Documents\FORMS\original\Building-Inspector\Zoning-Permit-Application-passive.doc 8/4/2004
File#MP-2015-0076
APPLICANT/CONTACT PERSON THOMAS MIRANDA v `v
ADDRESS/PHONE 64 GOTHIC ST `d
use
PROPERTY LOCATION 29 CARDINAL WAY 1 �G
MAP 36 PARCEL 342 001 ZONE VIrJ1
a
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- SFH
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 PRF8ENTED:
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
erm Elm Street Co fission Permit DPW Storm Water Management
Sign f u' Officia 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.