32A-176 (3) File#MP-2018-0065
APPLICANT/CONTACT PERSON NORTHAMPTON HISTORICAL SOCIETY THE
ADDRESS/PHONE
PROPERTY LOCATION 66 BRIDGE ST
MAP 32A PARCEL 176 001 ZONE URC(100)/
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Buildin Permit Filled out
Fee Paid
TypeofConstruction, ZPA-MODIFICATION OF DRIVEWAY ENTRANCE FOR SAFETY PURPOSES
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:
_�urb 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 40A.Contact the Office of
Planning&Development for more information.
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File No. M®- la' ( -5- Cola gqz
ZONMGPERMITAPPLIC47TON010.2)
Please type or print all information and return this form to the Building
Inspector's Office with the$3 0 filing fee(check or money order)payable to the
City of Northampton
1. Name of Applicant: I—Mi/IC
Address: N J, Telephone:
2. Owner of Property: r115 G IC-1 C /yc,�-MA M-t)Ti,,ti
Address: 4b ii ' Jdt Sj u-cS Telephone: 4( 3-- 7,Y`I-Loll
3. Status of Applicant: Owner _X Contract Purchaser_Lessee Other (explain)
4. Job Location: [3. -N Cen CN '-od 66• B1,14e 5011--T
Pamet ld: Tanlnp l#ap# penew 0 ' oistriet(s):
In Elm Street District In Central Business District.
TO BE FILLED IN BY THE BUILDING DEPARTMENT)
S. Existing Use of Structure/Property: AQjif "hn% ei J/i✓tww r'vl/.1
8. Description of Proposed Use1/Work/Project/Occupatio¢ (Use additipnal sheets if nece¢se ):
o prove slgrJ /iAtr ,j
.ree.en<t�J,yr rdoY( ke to, 5Iv '1 'vl e l(71/I✓) l
b' vLg wi hi fZ' ti ' -),) I>`2 W* (Lt. �w.:.-moi w' wnYuwn �kIS is p�T �l
-v 'IriJ-ewI „v,d pwo�+r�z l�t �rctcsiv , Prul,�X fkat kddn� i cQ.PJ'�
�VkIfl0.4c wtt.O rurUnrwl3 ��'VL'uS s�rfrrz � Sz '' ((3�� cu,�
Sketch
Plan
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 YES IF 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 X DON'T 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)
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10. Do any signs exist on the property? YES X NO
IF YES, describe size, type and location: N�a 'IV YYV)-G t r
Are there any proposed changes to or additions of signs intended for the property? YES-NO--K—
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 -4—
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
Int Size -76, DD✓ 5-
- N;
Frontage
30 3 �# Na iMan c
Setbacks Front
Side L: "�/1 R: MIA L: NIA- R: A11A L: R:
Rear
Building Height MS-m :c I'l'.
�0 ' aQ Q hi" : tvl -c
Building Square Footage ,1II y:,Id nJ s adL d
11 17 0 S . No ' 14'Z11 14'Z11rf
%Open Space: (lot area �j7
minus building & paved 71 ek
parking
#of Parking Spaces
2v ^ -2- c:
#of Loading Docks
✓1
Fill: N . A N A
volume& location)
13. Certification: I hereby certify that the information contained herein is true and accurate to the best of
my knowledge.
/� ; �Lwa[ircr
Date: 5 3 /I� 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.
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