31B-287 (3) File#MP-2016-0079
APPLICANT/CONTACT PERSON JAMES VAN NATTA _
ADDRESS/PHONE 403 SOUTH MOUNTAIN RD (413)834-5329 Q
PROPERTY LOCATION 40 CENTER ST
MAP 31B PARCEL 287 001 ZONE CB(100)/
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT A, .- ..�--
Fee Paid d C. '
Building Pen-nit Filled out
Fee Paid
Typeof Construction: ZPA-CONSTRUCT ADDITION FOk WHEEL CHAIR LIFT&VESTIBULE REBUILD
STEPS&RENOVATE OFFICES
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included: fl
Owner/Statement or License
3 sets of Plans/Plot Plan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INFORMATION PRESENTED:
Approved i/ 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 Ehn Street Commission Permit DPW Storm Water Management
� F
Signature'of Building Official Date i '
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.
j l
File No.
ZONING PERMITAPPLICATION(§10.2)
Please type or print all information and return this form to the Building
Inspector's Office with the$,5 filing f$e (check or money order)payable to the
JCity ofNbrthampton
1. Name of Applicant: { d N- --C zlC
Address: i4c:;� r` L�� � ��'a -- G Telephone: qlg:�
2. Owner of Property:
Address: Telephone:
3. Status of Applicant: Owner Contract Purchaser Lessee Other(explain) L-L�='rte
4. Job Location: .L tel � d�� ►
Parcel Id: Zoning Map# Parcel# District(s):
In Elm Street District In Central Business District
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/Property:
6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary):
[� C t:�:j 4A'IL .1. 1 USS c
kN,i� f - ! i `7 eZ�e r a ��R,to l t_
7. Attached 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 Plage and/or Document#
9.Does the site contain a brook, body of water or wetlands? NO 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)
W:\Documents\FORMS\original\Building-Inspector\Zoning-Permit-Application-passive.doc 8/4/2004
10. Do any signs exist on the property? YES NO
IF YES, describe size, type and location: yl A-L L_
Are there any proposed changes to or additions of signs intended for the property? YES NO
IF YES, describe size, type and location:
11. Will 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
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 �^
Frontage
5S
Setbacks Front -t- t+ .}_
Side L: Z�ii�3! R: ��?j�+ L: 2,!!>i-4"R: L• R:
, +t
Rear tl.a,-der r71
Building Height
Building Square Footage
%Open Space: (lot area : y,i o
minus building Et paved � � 57
parkin f
#of Parking Spaces
#of Loading Docks
Fill:
(volume Et location)
13. Certification: I hereby certify that the information contained herein is t ue and accurate to the best of
my knowledge.
Date: (v to Applicant's Signature
—A alk,
NOTE:Issuance of a zoning permit does not relieve an pplicant's bur en to comply with zoning
requirements and obtain all required permits firm the Board o Health,Conserva ' n Commission,
Historic and Architectural Boards,Department of Public Works and other applica a permit granting
authorities.
W:\Documents\FORMS\original\Building-Inspector\Zoning-Peimit-Application-passive.doe 8/4/2004