32A-106 (2) File 4 MP-20)7-0062
APPLICANT/CONTACT PERSON ZYGMONT MARIA
ADDRESS/PHONE RI DOODY AVE
PROPERTY LOCATION 40 MARKET ST
MAP 32A PARCEL 106 001 ZONE URC(IOO)/
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
CLOSED REQUIRED DATE
ZONING FORM Ell,. ED OUT
Fee Paid
Buildin.Permit Filled out -din
Fee Paid
TvpeofConstruction: ZPA-CONVERT T WNG SINGLE FAMILY HOUSE T) MIXED USE
RESIDENTIAL/OFFICE SPACE,;SMALL LAW OFFICE AND A SINGLE FAMILY RENTAL APT
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Ouster/Statement or License
3 sets of Plans/Plot Plan
THE FOLLOWING ACTION IIAS BEEN TAKEN ON THIS APPLICATION BASED ON l 'OS
INFORMATION PRESENTED: \At 4QA a 0
Approved Additional permits required(see below //�..
000)
Intermediate Project: Site Plan AND/OR S ec�al Permit Mee 6re `N
pp
PLANNING BOARD PERMIT REQUIRED UNDER/: § (
1/ p - mit with Site Plan tt Qc#
Major Project: Site Plan AND/OR Special Permit with Site Plan f, `
ZONING BOARD PERMIT REQUIRED UNDER: § _ _-_ 00
Finding Special Permit 41' 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
•y' - •., Elm Stree Common Permit DPW Storm Water Management
.f 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. MP- / '7 - (/J JUN - I
r004110 e11W(r;iei 7UR(NUYta
Please type or print all information and return this f• -- he-Building
Inspector's Office with the$30 filing fee (check or money order)payable to the
City of Northampton
1. Name of Applicant: n 71-r. G4 J - Me/,.// -14-
Address: //G (07y, f), ��r YIN A'a �eTelephone: `767 5 �
?Y- ( 7r
2
2. Owner of Property: / ltttr u— //- 2--) 9/306o"9—
Address: /0 r�OCY+/y A [. - Telephone:
3. Status of Applicant: Owner Contract Purchaser 'x Lessee Other (explain)
4. Job Location: 47t(pf Sf'- v��/Nra.., c /., %1764. eh lir; d
Parcel Id: Zoning Map# 364 Parcel# 10 District(s):
In Elm Street District In Central Business District
(TO BE FILLED IN BY THE BUILDING DEPARTMENT) _
5. Existing Use of Structure/Property: j.7f/en . _ i/c/3e
6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary):
d.1 er"r 14 c 4-71-817/ shs/e .2 hi ezi, A
,4 l,d eh .Az / / 0/4.
c ;i // 7 a tV4 -4-h. %y re A.
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 x DONT KNOW YES IF YES, date issued:
IF YES: Was the permit recorded at t.e Registry of Deeds?
NO DONT KNOW YES
IF YES: enter Book Page and/or Document if
9.Does the site contain a brook, body of water o' 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:\Documents\FORMSIoriginal Building-InspectoriZomng-Pemm-Applicat8 1n-passive doc 8/4/2004
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10. Do any signs exist on the property? YES NO
X,
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 fitting)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
Z
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 / y _--
#of Loading Docks �(J
Fill:
(volume& location)
13. Certification: I hereby certify that the information contained herein is true and accurate to the best of
my knowledge./ //
Date: 6/l f /7 Applicant's Signature / s�
// sbturden to comply with all zoning
NOTE:Issuance of a zoning permit does not rel' applicant's
+f Health,Conservation Commission,
requirements and obtain all required p is from the Board c s and other applicable permit granting
Historic and Architectural Boards,Department of Public Work",
authorities.
1)412014
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