25A-162 (14) File 9 MP-2019-0018
APPLICANT/CONTACT PERSONREI ANTONIO M&AMY E FLEIG
S O
ADDRESS/PHONE 50 DAY AVE �6L (r'�
PROPERTY LOCATION 50 DAY AVE v rO
MAP 25A PARCEL 162 001 ZONE URBO 00V
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out
Fee Paid
Tvm ofConstruction; ZPA-ADD ADDITION MEASURING 11X16 ON LEFT SIDE OF HOUSE&APPROVAL
TO ADD 3RD UNIT TO STRUCTURE ON 2ND FLOOR
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/Statement or License
3 sets of Plans/Plot Plan
U�
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ONq_
INFORMATION PRESENTED:
Approved _ILAdditional permits required(see below) Vfl�'j
1
PLANNING BOARD PERMIT REQUIRED UNDER: § O 2✓� V' ,f
Intermediate Project:_Site Plan AND/OR Special Permit with Site Plan ,r, J m'
Major Project: Site Plan AND/OR Special Permit with Site Plan /6�� pp h"
p V �� LP T
ZONING BOARD PERMIT REQUIRED UNDER: § 3�O — / ('
Finding Special Permit Variance- V'- FBA's 5
,3F-4 AN 1
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 40A.Contact the Office of
Planning&Development for more information.
m File No. - A'( 3
ZONING PERMIT APPLICA77ON(§10.2)
s —Ple a or print all information and return this form to the Building
°' Inde Office with the$30fl1ingfee(check or money order)payable to the
>9 o ffl City ofNoMhampton
oB W t
$ IQ plicant: Iq •e[ / Q
• /qY2. Telephone:
2. Owner of Property: SGL IAe as Cc.ty uy E.
Address: Telephone:
3. Status of Applicant: (�Owner A�Contract Purchaser Lessee_Other (explain)
4. Job Location: K-0 Dj1J_An:LNae4 ^eL I c .0ftari r A W 610[---- 6 d
Parcel Id: Zoning Map# Parcel# IU2-- District(,):
In Elm Street District In Central Business District
—
(TO BE FILLED IN BY THE BUILDING DEPARTMENT
5. Existing Useof Structure/Property: 2 UA (+ Y2SlC/w-hat,(
6. Description of Proposed Use/Work/P oject/o0cccupation: (Use additional sheets if necessary
OL- �- - — ^�:=.! " s add o .L "-hwf rri�stsriYis !! X /L dN
-her 1 St <Yde d� 44w hdWt.e i. here kiieHeA i.t lecal-ad
C c-_L m,rvJ '(-a ad,( a —2 12-4 u,ni4- {v q e SfyLLc.fvA
alk 441e .SP..f,d -Ftarl @'/peon a Q`I>EaEltec✓ -
7. Attached Plans: Sketch Pian V/ 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 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)
E+u; lei re 1 S @ cucu1• 0vw-
W WmumennWORMS\miginel\Building-I.sp to,, ning-Permit-Application-passive.doe 8/42W
10. Do any signs exist on the property? YES NO v
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. W111 the construction activity disturb(clearing, grading, excavation, or fitting)over acre or is it part of a common
plan of development that wilt 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
artmenf
BXISTING PROPOSED REQUIRED BY
Lot Size C�--p ZONING
(o / ' � 1 NO C-
Frontage i
IV fw '
Setbacks Front lir �� III i1 A
Side L: r R: to ! L: S t t R: (�} 1 L: R:
Rear ' 'ttq'
Buiiding Height flo �C
l S ieS 0.{f?e� '3
Building Square Footage
%Open Space: (lot area v
minus building B paved2 G�
Arkin l 2✓ 1 yl j! 6 Y
V of Parking Spaces �.. C{ftae �'tlVt'iKaNJtN
a sw=G
V of Loading Docks
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flti:
volume 8t location 0 C)
13. Certification: I hereby certify that the information contained herein is true and accurate to the best of
my knowledge.
Date: �_o__jr Applicant's Signature.,/ „
NOTE:issuance of a zoning permit does not relieve anapplicants burden to co ly with all zoning
requirements and obtain all required peanuts firom the Board of Health,Conservation Commission,
Historic and Architectural Boards,Department ofpublic Works and other applicable permit granting
authorities.
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