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25C-105 (3)izz HIM r �/ISLIL/. y � 70 �z izz HIM r �/ISLIL/. ®TJ./ILJI/� 1 i !! 11 i i a� U DCJ r i !! 11 i i fA S O T 7 n N 1S M N r � � S O T 7 n N 1S M N fjA�l�!��I cl y w� Z v� r M p tU r LOWS DEFERENCE Book 4468 Page 287 ` see also: ' Pian Book 42 Page 33 Book 270 Pages 190 4.191 w/F Nj til. vw4eswy Li = .�J^LJD �iE JTKE6T 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? YES NO IF YES, descrihp ci-7a, type and location: 11. Will the construction activity disturb (clearing, grading, excavation, or filling) ve ,1 acre or is it part of a common plan of development that will 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 Department 13. Certification: I hereby certify that the informationntai ed herein is rue an accur to to the best of my knowledge. '% Date: " Applicant's Signature (f 1AC' _..-N-`aTE-lsng permit does not relieve an applicant's burden to comply with all zoning ------regmrernerrts-and-obtain-all-r�d-per-units-from-the-Board-ofHealth Conservation Commission, Historic and Architectural Boards, Department of Public Works and other applicable permit granting authorities. W: Docaments',FGR.�vIS'original`Bwiding-Inspector Zoning -Permit AppiicaEon-passive.doc &4i-'004 EXISTL" iG PROPOSED REQUMED BY ZONING Lot Size w:J j AaX 1�MIE Frontage C c.rL(�(?- i3OT _ 17�l�i�2 , Z62 G (L Setbacks Front 13J Side L: R: L: R: r R: Rear Building Height 1 -2ii i / 1 351 Building Square Footage c/ 2Y�O�S C• I xLiS Z LOOT -S � t,.r� � i'TI GIC�t3 % Open Space: (lot area S minus building &paved v4� parking # of Parking Spaces # of Loading Docks Fill: (volume & location) 13. Certification: I hereby certify that the informationntai ed herein is rue an accur to to the best of my knowledge. '% Date: " Applicant's Signature (f 1AC' _..-N-`aTE-lsng permit does not relieve an applicant's burden to comply with all zoning ------regmrernerrts-and-obtain-all-r�d-per-units-from-the-Board-ofHealth Conservation Commission, Historic and Architectural Boards, Department of Public Works and other applicable permit granting authorities. W: Docaments',FGR.�vIS'original`Bwiding-Inspector Zoning -Permit AppiicaEon-passive.doc &4i-'004 1. 2. 3. 4. Pieasel .pe, or p # all, information and return this form to the Building Ips 2e i6r's Off e:.'iih-th� $15 fl-13ng- fee (check or money order) payable to the Name of Applicant:_ l� `' 1 � � � 1�-- Cl e Uv \ 2 �j � � � -.-x-.>Address Z !oE �� Telephone: �� S 0� i Owner of Property:'1 Address: -_ 'Telephone: - Status Telephone:Status of Applicant: Owner_ Contract Purchaser Lessee Other (explain) Job Location: �; P( 4 -A 5. Existing Use of Structure/Property: 6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary): S 6- i o jr L' v4' i iv L. 1� 0 icitcc 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 _X 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 DON'T KNOW IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained YES Obtained date issued: (Form Continues On Other Side) W:`Documents', FO R-MS'ori,-mai,Building- Ins pectorZonin_-Per.nit-application-passive.doc 3,4i_004 File # MP -2008-0077 APPLICANT/CONTACT PERSON RAPTELIS NICHOLAS SCOTT ADDRESS.!PHONE 236 BRIDGE ST (413) 586-5106 O Moo -follow THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE Building Permit Filled out Fee Paid Tyneof Construction:_ZPA - STUDIO/LIVING SPACE 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: § A%�/J Finding Special Permit Variance* Received & Recorded at Registry of Deeds Proof Enclosed Other Permits Required: Curb Cut from DPW Septic Approval Board of Health Water Availability Sewer Availability Permit from Conservation Commission Well Water Potability Board of Health Permit from CB Architecture Committee Permit from Elm Street Co ssion Permit DPW Storm Water Manage ent X00 Signa re 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. f ,may/04-ft,dl