32C-241 118 Hawley St ZPA 2011-06-09---
File # MP-20ll-0098
APPLICANT/CONTACT PERSON WESTBURG MARIE
ADDRESSIPHONE POBOX 84 (413) 268-7899 0
PROPERTY LOCATION EASTERN AVE
MAP 32C PARCEL 238 001 ZONE URC(lOO)/
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid /607 <iixY
Building Permit Filled out
Fee Paid
Typeof Construction: ZP A -ACCESS TO REAR LOTS
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/ Statement or License
3 sets ofPlans / 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· 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 ofHealth ____Well Water Potability Board of Health
___.Permit from Conservation Commission ___Permit from CB Architecture Committee
from Elm Street Commission ____Permit DPW Storm Water Management
Signature ofBuilding 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 ofMGL 40A. Contact the Office of
Planning & Development for more information.
ZonillgMap#
FileNo. tilt1/97
GPERMITAPPLJCATION(§10.2)
Please tYPe or print all information and return this form to the Building
Inspector'siOffice with the $1s1iling/ee (check or lp.oney order) payable to the
i City o/Northampton
1. NameOfAp~icant: ~t<JesiJ>lkt3J-tz fA -M40tD'1C,
AddresS:IIJ k0~&7: {Po.~fiJl~:~~q
2. Owner of Prbperty: Ctld-:O ~ WU~
Address: //8 H.ftl,JL-Ji!3.~S~ Telephone: ;!.... , ~~~-~
3. '"Status of Applicant: Owner X; ontract Purchaser Lessee Other (explain) _____
4. Job Location;_-=:.......!.-----:.;._.::.-..--"-___-<--_________~__________
___--....;;..;..-_ Parcell.....· ___......... .,... ~..• District(s):----,._....;..-.--.;.,______
In··Elm Street Dh,trlct In.CentralBusiness District_............__
o BE FILLEDINBY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/Property: /'kol ~-W}ro cl.Ld. tol
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 >< DONT KNOW ____ YES ____ IF YES, date issued: _______
IF YES: Was the permit recorded at the Registry of Deeds?
NO ____ DONT KNOW ____ YES ____
Book ____iF YES: enter Page ____ and/or Document# ______
YES __9.Does the site contain a brook, body of water or wetlands? DONT KNOW ___NO~./
IF YES, has a permit been or need to be c;IDtained from the Conservation Commission?
Needs to be obtained ____ Obtained _____, date issued:._______
(Form Continues On Other Side)
W:\Documents\FORMS\Original\Building-lnspectOOZonirt;Pennit.Application-passive.doc
YES ____10. ~any signs exist on the property? 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 ,K
IF YES, describe size, type and location;. _________________________
11. Will the construction activity disturb (clearing, grading, excavation, or filling)})Vftr 1 acre or is it part of a common
plan of development that will disturb over 1 acre? YES No--X""_,-",-,,,_
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 reseMJed
for use by the Building
L oc....n /l-"'L¥.) Department
EXISTING PROPOSED REQIDREDBY
ZONING
Lot Size ( (pry..Cj~. 7 K 19. I.f X ~tf')
Frontage uS-P+. ./
Setbacks Front
Side
Rear
L: R: L: R: L: R:
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: 5/tR /2rJ // Applicant's Sfgnature,c.1.1.t:4~ . ~1-6~
NOTE: Issuan: ofa zoningpermit does not relieve an applicant's burden toCPlY with all zoning
requirements and obtainall required permits from the Board ofHealth, Conservation Commission,
Historic andArchitectural Boards, Department ofPublicWorks and otherapplicable permit granting
authorities.
W;\Documents\FORMS\Original\Building-IlISpector\Zoning-PemUt-Application-passive.doc 8/412004
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