30B-058 (4) File#MP-2016-0089 EJ
APPLICANT/CONTACT PERSON DEMARIA SUSAN
ADDRESS/PHONE 147 RIVERSIDE DR 4�1
PROPERTY LOCATION 147 RIVERSIDE DR
MAP 30B PARCEL 058 001 ZONE URB000)/
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-2ND HOUSE DIVIDE LOT OR SINGLE TO TWO
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 PRESENTED:
Approved Xlditional permits required(see below) �'—
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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 Elm Street Commission Permit DPW Storm Water Management
Sig�of Building Official Building Official 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.
File No.
IL
ZONING PERMITAPPLICATION (§10.2) !
Please type or print all information and return this form to the Building
Inspector's Office with the $30k or money payable to the
City ofNorthampton
1 Name of Applicant:
Address: Telephone:
OwIrn of Property: CA
3. Sl�i�'u of Applicant: Owner Contract Purchaser Lessee-Other (explain)
4. cation:
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/YVork/Project/Occupation: (Use additional sheets ifnecessary):
Vs
CA
7. Attached Plans: Sketch Plan Site Plan Engineered/Surveyed Pians
D. Has aSpecial Permit/Variance/Finding ever been issued for/on the site?
NO DON'T KNOW YES _ IFYES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO DON'T KNOW YES
IF YES: enter Bonk Pageand/or Document#
9.Does the site contain a brook, body of water or wetlands? NO X, DONT KNOW ________ YES
IF YES, has permit been or need to be obtained from the Conservation Commission?
Needs to be obtained Obtained , date issued:
(Form Continues on Other Side)
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10. Do any signs exist on the 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 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
Setbacks Front
Side L: R: L: R: L: R:
Rear
Building Height
Building Square Footage
Open Space: (lot area
minus building It paved
parking
#of Parking Spaces
#of Loading Docks
Fill:
(volume Et location)
13. Certification: I hereby certify that the information contained herein is true and accurate to the best of
my knowledge.
Date: 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:\Documents\FORMS\original\Building-inspector\Zoning-Permit-Application-passive.doc 8/4/2004
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