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00 Beaverbrook Lot 27 zpaFile # MP-2019-0035 APPLICANT/CONTACT PERSON KEITER BUILDERS ADDRESS/PHONE 35 MAIN ST (413) 586-8600 () PROPERTY LOCATION BEA VER BROOK LOOP -LOT# 27 MAP 06 PARCEL 064 000 ZONE CA X2o t: r--1 £5(;(;; EM~i~ of< THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ZONING FORM FILLED OUT Fee Paid Buildin Permit Filled out Fee Paid TypeofConstruction: ZPA-NEW PRIMARY RESIDENCE New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/ Statement or License 3 sets of Plans / Plot Plan REQUIRED DATE THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFORMATION PRESENTED: ~proved -. _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 r I 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 ofMGL 40A. Contact the Office of Planning & Development for more information. File No. t1'J t? -,. ~~ ZONING PERMIT APPLICATION (§10.2) Please type or print all information and return this form to the Building Inspector's Office with the $30/ilingfee (check or money order) payable to the 1 . 2. 3. 4. 5. City of Northampton Name of Applicant: '(._e tk: ~\~') I I i,t,(..., Address: .;!Jo M£u' :/\. &+ fI cJtG<A cg_ Telephone: s::86 z3 6 O() Owner of Property: I hoc ,I. M ovr--\l<..~ Vo'4e (/ i J. te<.... Address: ~6 ,v. s l:(;f@.. S.\-~ V:l© 'RQ/\Q ~ /JV r,st>ITelephone: 11s: qq 9-S:5]3S' Status of Applicant: Owner Contract Purchaser Lessee ___ Other (explain) ____ _ Job Location: U) .\::: ~ a;3: &2cwer: i2J@ t. lw::p Parcel Id: Zoning Map# o{p Parcel# 0 U '/ Distri In Elm Street District In Central Business District...,....__...,__ __ TO BE FILLED IN BY THE BUILDING DEPARTMENT 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 ___ _ DON'T KNOW ,/ YES ___ _ IF YES, date issued: _______ _ IF YES: Was the permit recorded at the Registry of Deeds? NO ___ _ DON'T KNOW ___ _ YES ___ _ IF YES: enter Book ____ _ Page and/or Document # ______ _ 9.Does the site contain a brook, body of water or wetlands? NO --1ct.,,.,.,./'-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) W: \D0cu111e11ts\FO RM S\origina I\Bu i Id i ng-1 nspector\Zon i ng-Perm it-Application-passive.doc 8/4/2004 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? IF YES, describe size, type and location: __________________________ _ 11. Will the construction activity disturb (clearing, grading, excavation, or filling) over ;/acre or is it part of a common plan of development that will disturb over 1 acre? YES ___ NO -\,..L 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 ~ S\ ,01 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: w/r1 /r 'b App[;cant's s;gnatu,~/;;;e f'«-J1M NOTE: Issuance of a zoning permit does not reh ~ :::ant'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 • \Docu ments\FO RM S\origi na I\Bu i Id i ng-1 nspeclor\Zon i ng-Perm it-Application-passive.doc 8/4/2004