23C-073 File MP-2016-0103 .�G aNl.(C dk
APPLICANT/CONTACT PERSON DRISCOLL MICHAEL D&MICHAEL R&NANCY A DRISCOLL
ADDRESS/PHONE 56 WILLOW ST
PROPERTY LOCATION WILLOW ST
MAP 23C PARCEL 073 001 ZONE URA(100)/WSP(100);
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FIL D OUT
Fee Paid ex.- 11;1 '4130
Building Permit Filled out
Fee Paid
Typeof Construction: ZPA-POTENTIAL FUTURE BUILDING LOT FOR SINGLE FAMILY HOME
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 /gyp
INFORMATION PRESENTED:
./Approved Additional permits required(see below) (NAi N(1 Pried
PLANNING BOARD PERMIT REQUIRED UNDER: §
Intermediate Project: Site Plan AND/OR Special Permit with Site Plan %/9
Major Project: Site Plan AND/OR Special Permit with Site Plan
5e604e
ZONING BOARD PERMIT REQUIRED UNDER: §
Finding Special Permit Variance* Prne
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
Pe W. 0 Im Street Commisonn Permit DPW Storm WaterManagement
Signature of Building 0 'cial 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.
i
'yI Y'; FOP No.
(I..; 2 ZONING PERMIT APPLICATION(fiia.2) J
z a ase type or print all information and return this form to the Building
Hu-• Wisp* tor's Office with the $30Fi.lingfee(check or money order)payable to the
l az CityofNorthamnton
t. wade of Applicant o-tC. L c k2 re-- • _u.. 1A,,-(- 1 ' Cid-4-4')
')
Address: t-4.2 1.45,11tu.- Sir . A 1).0 irLi af VV\A- Telephone: UR- 'i- U
CF—CI
^'I
2. Owner of Property: //r.
til OlP 2.
U Address: V') - ( ,).ThII \ `1c.)e..S 1, -. Telephone:
rt
i'6' 3. Status of Applicant: Owner ContractttPurchaser 1C , Lessee Other(explain)
4. Job Location: (,.-c's1- .. ._t itUir� calf-_ f V tittn_ t
�-., . AUI.15t7 ..._..
Parcel Id: Zoning Map,/ Parcel# District(s):
In Elm Street District In Central Business District
(IO BE FILLED IN BYTHE BUILDING DEPARTMENT)
5, Existing Use of Structure/Property: e, t1 l pt- t it e:—✓LI 84,,. . ,r {
o
xlr,k ,� . 'fi
,re ti)wk,v-%(—viol`( ( C4(WA (f. ,SP; �� .
7cica -. .c:wj- Y
S. Oesciiptton of Proposed UselWak-y/�PrtrNet/Occupatiorn l additional sheets if necessary): w,,A G--'cYck \r& A OSF't_
f..,.rt ✓-41 I t... + -L lu� ICS e. VI.,_ ?il-i n� we .+1t 1,,—b�C JJ
4.71rifll^�° i'\. 1i is a , • . r Sr , ♦ p _....,� `.i< c...-/S ("f j
WC . i.w e,-..- tl .„ _ . _ it i r r ii... ' t( a ' �Qv....Ill
7. Attached Plans: Sketch Plan _ Site Plan Engineered/Surveyed Plans " `��L 1'
tvI Ar
8. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO -_ DONT KNOW X YES W 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 s
9.Does the site contain a brook, body of water or wetlands? NO 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 7fsncmm,tstFORMSbnginshBuiidi g-}m yorVrn ¢-Per.nit-Appisation-n av doc 9/4/24u
10. Do any signs.exist onthe 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 (c
IF YES, describe size, type and location:
11. Will the construction activity disnrb(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
fur use'a0••IheNaiitiivrg
Department
EXISTING PROPOSED REQUIRED BY
ZONING
Lot Size .c1(-1
1•rarrtage 1gl - lfl3 `��.
Setbacks Front
Side L: R: L: R: 1: R:
Rear ..
Building Height ‘,i' e)“.- p -
Stro'I
Building Square Footage
NIA A-- ZsDocei .(�
%Open Space: (lot area
minus building& paved
parking
#of Parking Spaces
2
*of loading Docks
Fill: C) O
(volume& location)
13. Certification: I hereby certify that the information contained herein is true and accurate to the best of
my knowledge.
Date: ( I (o/ I U), Applicant's Signature /(l.„--4S
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 DocumentsVC)RMStoripnal\Building-Inspalor\Zoning-Permit-Applrcation-passive doc 8/4/2004