42-049 (4) ,NC)
File#MP-2017-0019 �1(�n (. t
APPLICANT/CONTACT PERSON ROBINSON STEPHEN C&HEIDI L I V 5€E
ADDRESS/PHONE 613 WESTHAMPTON RD I, 1 �� (/ P
PROPERTY LOCATION 613 WESTHAMPTON RD �T '/ t`-
MAP 42 PARCEL 049 001 ZONE
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM F.V.LLD OUT 2 q
Fee Paid t^ /�n O `af 3D
Building Permit Filled out
Fee Paid
Typeof Construction: NEUROFEEDBACK PROVIDER IN HOME-ONE CLIENT AT A TIME
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 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 Elm Street Commission Permit DPW Storm Water Management
Signature of 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 40K Contact the Office of
Planning&Development for more information.
RCC ,-f_
File No.t SEP 2 0
ZONING PERMITAPPPLI r k 6.2)
Please type or print all information and ' athe Building
Inspector's Office with the $30 filing fee (check or money order)payable to the
City of Northampton
1. Name of Applicant: dr 5`9151/6 CV) Va.G{t"'G,-G4'}n,-t
Address: (01 Ne-S141(iL2 _p f"t1n Vd - Telephone: 1( 3 • 2-(9
2. Owner of Property:_` -
Address: LPl3 Ne ku Veer 3_ (o%ewC Telephone:.. l�(3 7o�• z&z4
3. Status of Applicant: Owner 'I Contract Purchaser Lessee Other (explain)
4. Job Location: CF3 il1FC9 l&uu. 'U- (J .
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):
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 DONT KNOW YESIF 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 .. V 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 iWemnents\FORMS or Bina lBi itdiagiutttgoAloniw_-Pormit-Applicati^mPassiveidoe 8/424P#
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 wilt disturb over 1 acre? YES NO 71—
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 & paved
parking
#of Parking Spaces
#of Loading Docks
Fill:
(volume & location)
13. Certification: I hereby certify that the information contained herein is true and accurate to the best of
my knowledge.
Date: 2I (p 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:\DocumentsNFORMS original\Building-Inspector'Zoning-Permit-Application-passive.doc 8/4R004
1W5/2016 City of Northampton Mail-Home business
�fl
m" �1y hof Louis Hasbrouck <lhasbrouck@northamptonma.gov>
Northampton
Home business
1 message
Louis Hasbrouck<lhasbrouck@northamptonma.gov> Fri, Sep 23, 2016 at 3:14 PM
To: heidilisa43@yahoo.com
Cc: Carolyn Misch <cmisch@northamptonma.gov>, Charles Miller<cmiller@northamptonma.gov>, Kyle Scott
<kscott@northam ptonma.gov>
Heidi,
We need more information about your business proposal. I've attached the zoning requirements; a home
business may be allowed by right or need a special permit.
Well need a detailed narrative that addresses the list of zoning requirements and a simple sketch of the house
floor plan to show where you'll see clients.
Louis Hasbrouck
Building Commissioner
City of Northampton
Town of Williamsburg
(413) 587-1240 office
(413) 587-1272 fax
.p 350 Home Business 2016-09-23.pdf
11K
httpsl/mai I google.can/mal/ca/ut0?ui=28ik=ecsf1 his/e8view=pt8q=in%3Asent%20hetlilisa43%40yahoo.ccm8gs=true&search=qucry8N=1525828ca2d1330... 1/1