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30A-076 (8) s File#MP-2001-0138 APPLICANT/CONTACT PERSON Nelson Shifflett ADDRESS/PHONE THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FI LED 014,,- Fee Paid filled out Fee ai Typeof Construction: REMODEL/RESTORE EXISTING BUILDING TO CREATE OFFICE SPACE 2ND FLOOR CONFERENCE ROOM WAREHOUSE 1 ST FLOOR 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: Approved as presented/based on information presented. Denied as presented: Special Permit and/or Site Plan Required under: § PLANNING BOARD ZONING BOARD Received&Recorded at Registry of Deeds Proof Enclosed Finding Required under: § _w/ZONING BOARD OF APPEALS Received&Recorded at Registry of Deeds Proof Enclosed :.3 Variance Required under: § ;.2 � IQ_w/ZOs9NING BOARD OF APPEALS �s�i9pc •�,s ciS 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 ezr ©lal Signature of Building Official Date 1Z 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. V File No. ZONING PERMIT APPLICATION (§10.2) Please type or print all information and return t1iis form to the Building Inspector's Office with the $10. filing fee (check or money order) payable to the City of Northampton 1. Name of Applicant: Ale./l0►'1 Address: . l� i (Ff/-0L' Q /� ) /,, /C�`' �►./' J' fi x( '� 7 Telid) lephone: �/�3 •5��/` 2. Owner of Property: Address: �j /! �!c'►� Telephone: d Y 7- YV 3. Status of Applicant: Owner Contract Purchaser V"' Lessee Other(explain) 4. Job Location: ,?ylJ Parcel Id: Zoning-Map#' Parcel# District(s): In Elm Street District In Central Business District (TO BE FILLED.IN'BY THE BUILDINGDEPARTMENT) S. Existing Use of Structure/Property (IN!?CCt 2p�G-L� �J r"QIS i� /3 14 6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary): 1)&5 7. Attached Plans: Sketch Plan Site Plan _ ✓ Engineered/Surveyed Plans 18. Has a Special Perm'/Variance ding ever been issued for/on the site? NO DON'T KNOW YES �'� IF, YES,date issued: 1 f 9 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 IF YES,has a permit been or need to be obtained from the Conservation Commission? ,c) Needs to be obtained Obtained date issued: Pdpr No (Form Continues On Other Side) i - - - - - - - - - - - - - - - - - - - - - - -i 0 0 STORAGE CHRIS'S OFFICE oo DAWN'S OFFICE F7 co o NELSON'S OFFICE — — — — — — — — — - — — — — -� 4-) Ir = F - - - - - - - - - - - - - - - - - I STORAGE CONFERENCE I i ,el i ED JE ET1410E � DIME ETIaIEE SEE: WOK 2107 PAGE 33 Q C07LE-EX WILDI E ASSOCIATES SEE=B00K 2439-PA6E Z59 \ �. P.CFOSED 10'UJIDE PEDESTKIAAJEASEMENT Q �O o 141 a W CUTLEEY Za 006 SQ FT.± SEE I (SY PLAAIIMETEE) �. M t � FWPOSED VENICULAK a S EASEMEMT `� I ktfF f --�- BUIL DI1 G / A156'•Z.S'00'F Hal 75 5F -S-50' 18'-38"E 09-1M' aTAL - el VEFSIDE De VE A3 .SOD kI1DE IM, MJTY9I6PaY- UNMOMUMENTED AT T91S LDCUS ld6t DAMP RJAJ