38A-103 (9) t
File#MP-2007-0123
APPLICANT/CONTACT PERSON VCA INC
ADDRESS/PHONE ONE COTTAGE ST (413)527-2127()
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THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM LED OUT
ee Paid
Building Permit Filled out
Fee Paid
Typeof Construction: ZPA-FURNITURE PRODUCTION FACILITY(20,000 SO FT)
New Construction
Non Structural interior renovations
Addition to Existing
Accessoa Structure
Building Plans Included
Owner/Statement or License
3 sets of Plans/Plot Plan
THE FOLLOWING ACTWN HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INFORMATION P N.1-J:
Approved Additional permits required(see below)
PLANNING BOARD I'Z Rl1'[IT REQUIRED UNDER: § 5 jl
Intermediate Project:_,'rte Plan AND/OR _Special Permit with Site Plan
Major Project: Site Plan AND/OR Special Permit with Site Plan �o�0,:::�10
ZONING BOARD PEILr11T REQUIRED UNDER: §
Finding Special Permit Variance*
Received&Recorded at Registry of Deeds Proof Enclosed
Other Permits Required:
Curb Cut i i om 1 P A Nater Availability Sewer Availability
Septic Approval Board o1'1 lealth Well Water Potability Board of Health
Penna fi o:u Co,,.-servation Conunission Permit from CB Architecture Committee
Permit froni Elm Street Commis ' n
Z 2�
Signature of Building Oscal Date
Note:Issuance of a 7un ::g pe:.,.it (iocs 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 witci ating authorities.
*Variances aregranted only to ;hose ap;;licants who meet the strict standards ofMGL 40A.Contact the Office of
Planning&Developiner.t or rx e m,,Orm.aion.
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File ATW-09 1a73
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Please type or print all information and return this form to the Building
Inspector's Office with the $15 filing fee (check or money order)payable to the
/City of Northampton
I Name of Applicant: �� 7 ��1Z 1� t j�(it.� VULZ
Address: � ��� ��STit' 7a'� Telephone: 7 Z 7-2 f 2�
2. Owner of Property:
Address: Telephone:
3. Status of Applicant: Owner Contract Purchaser ✓/Lessee Other (explain)
OJ54. Job Location: ,�F,+j2 L E _S7- - Z-6)7-
5.
. Existing Use of Structure/Property:
6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary):
FuRNLTLkR_f ?PoQucT10-0 f-AGILI T '-t ( Zv,000 SE>
7. Attached Plans: Sketch Plan ✓ Site Plan 1/ Engineered/Surveyed Plans
&. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO DONT 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 i/ 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)
W:''�Doc_rnens',FORN,.S'w�eira;�3uiidino-Ins�Mor'Zonin?-Pe-mi±-A_�ii::ation-pzssive.doc S��2D0-.
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lO. Doany signs exbtonthe 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_LZNO______
|FvE5' describesi�e. ��e and !mcadcn:
17. Will the construction activity disturb (clearing, grading,
^ n. nrfiihng) over l acre orb /tpart ofacommon
plan ofdevelopment that will disturb over 1acre? YES -__ NO
|FYES, then aNorthampton Storm Water Management Permit from the DPW ixrequired.
12. ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE DENIED DUE TO'LACK OF INFORMATION
This column reserved
for use by the Boffdiqcr
Department
EXISTING PROPOSED
ize
Frontage
ac s rant
Rear
Building Square Footage
minus building,& paved
parking
#of Parking Spaces
of Loading Doaks
(volume & location)
13. CnTlificadnn: I hereby certify that the information contained herein is true and accurate to the best of
my knowledge.
Date: ZApplicant's Signature ' v
~
NOTEIssuance fa zoning er�� d r��e,p applicant's burden ��v���aD n��
requirements and obtain aJ1 required permits from the Board of Health, Conservation Commission,
Historic and Architectural Boards,Department of Public Works and other applicable permit granting
8/42004