31B-310 71 State ZBA 2015-05-21------
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Building Plans Included:
File # MP-2015-0081
APPLICANT/CONTACT PERSON MICHAEL'S HOUSE LLC
ADDRESSIPHONE 480 HAMPDEN ST
PROPERTY LOCATION 71 STATE ST
MAP 3IB PARCEL 310 001 ZONE URC(100)!
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Typeof Construction: ZP A -ADD 20 PARKING SPACES
New Construction
Owner! Statement or License
3 sets ofPlans / Plot Plan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INFORMATION PRESENTED:
__Approved ---tL'Additional permits required (see below)
PLANNING BOARD PERMIT REQUIRED UNDER: § :35 0 ---!l·~
Intermediate Project: ,. Site Plan AND/OR'--__Special Permit with Site Plan
Major Project: 12'" 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 ofBuilding Official
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.
Please type or print all information and return this form to the Building
Inspector's Office with the $1sfilingfee (check or money order) payable to the
City ofNorthampton
1. Name of Applicant: K\d.~'s h1>S>$<Z LL~ -&'\d~ (~t~ls\
Address: c..(~ Ltoo t\QA/~~6~v\ 61= Telephone: Y.\;).... S=Q4 ,...~a~
2. Owner of Property: M) (1Ub.-s1;::"J B~"E>s:. LLC
Address: '-I:~ \j~'-I~~~'-\ 6t) b:",t:f~Il'1 ATelephone: y \2> -03 't-OJ-tt3
3. Status of Applicant: Owner p-(Contract Purchaser 1essee___ Other (explain)_____
Job Location: ______-I-__~4.
5. Existing Use of Structure/Property.·_-'---"-"'''-'--''-'---'-=~--'-''-"''-''''1t---\f--4'=-='~~~-1r-----=--='''':C.~-'..::..~
6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary):
Add C\-"'1 Qc\t\ \~~l Q,\ 2:n.... rQ.{KI~~ 'S ~"'--~~ ,
7. Attached Plans: Sketch Plan Site Plan .X Engineered/Surveyed Plans
8. Has a Special PermitlVariance/Finding ever been issued for/on the site?
NO DONT KNOW YES IF YES, date issued: _______;x.
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~ 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)
8/412004W;\Documents\FORMS\original\Building-InspectorlZoning-Permit-Application-passive.doc
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NO ____10.· Do any signs exist on the property? YES --t~-
IF YES, describe size, type and location:.________-r-___...-___---,_______ I.Q"'ntl~Cc:ht:n:'\ 'b'esY\ it C0{ ~ 0..)1=
Are there any proposed changes to or additions of signs intended for the property? YES ___NO~
IF YES, describe size, type and \U"'(l~IUI • _________________________
11. Will the construction activity disturb (clearing, grading, excavation, or filling) o.;f? 1 acre or is it part of a common
plan of development that will disturb over 1 acre? YES __ NO....p...
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
I.ty_ qb{Qac) Sf"-+(-qD,O<X) ~f
Frontage 35~\35(f
Setbacks Front 5d-\s;t'
L: R:Side L: \ C \ \ R: \D\'L: \C>\' R: \t:t \ .
Rear I3'{ \ 3~'
Building Height 45' 4S'
Building Square Footage ILL 5+7-6r I']J J5.::r ~ SF I
% Open Space: (lot area Iminus building a: paved 3lt(S/6~ LtQc5joI (!arking
# of Parking Spaces
"Zc Q.Q:\\~D\,\ C\\~\
# of Loading Docks cpcp
Fill: cp(volume a: location) -,4
13. Certification: I hereby certify that the information contained herein is true and accurate to the best of
my knowledge.
Oat.: 51 k:21 10. AppUcant" Signature (L~t: ~~.p
NOTE: Issuance ofa zoning permit does not relieve an applicant's rdento comply with all zomng
requirements and obtain all required permits from the Board ofHealth, Conservation Commission,
Historic and Architectural Boards, Department ofPublic Works and other applicable permit granting
authorities.
8/412004W:\Documents\FQRMS\origina1\Building-InspectorlZoning-Permit-Application-passive.doc
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