05-059 (17)File 9 MP -2017-0001
APPLICANT/CONTACT PERSON NEW SOME BARRETT & ELIZABETH V IZENTIN
ADDRESS/PHONE 341 AUDUBON RD (413) 727-3835 O
PROPERTY LOCATION 341 AUDUBON RD
MAP 05 PARCEL 059 001 ZONE RR(94)/WP(I5)/
TI IIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FOR FILLED OUT
Fee Paid �,0•
BuildingPermit Pilled out
Fee Paid
Tvoeof Construction: ZPA- PERSONAL ART STUDIO ABOVE THE GARAGE - KIDS SUMMER CAMP
Non Structural interior renovations
Addition to Evistine
Building Plans Included'
Owner/ Statement or License
3 sets of Plans / Plot Plan
UCcNSE
(FEMA-) cNtLO �R-E ofC
v ok fwil-c) cn cpm
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INFORMATION PRESENTED: e
Approved Additional INF°2MNT(Pt'r ' DEE
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: § 3,50 _ 10 r 1 Zi
Finding Special Permit_ Variance"
---
Receiveda, Recorded at Registry of Deeds Proof Enclosed
Other Permits Required:
Curb Cut from DPW
__. septic Approval Board of l health
Water Availability Sewer Availability
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
Seuilding Officia� Date ,
NoteIssuance 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.
Iu
File
7,01V --ENG PERMI i PLICATI tN (-$10,.2) 30
Please tyke or prirt f m!Oirma oaa d ret-=, this form to the Bc aldS'na
Inspector's fdf ce wzlh or moa exy crder)rpcycble to t e
Status Of Appear,; Owner Contract Pur hisser __ Zessse Other (exp[am)
Job Location: Y�- A d 1A L 0C (-� G c�_,,,,,...
Parcel Id: Zoning Map# �� Parce(#-05.2.._ District(s):�
In Elm Street District In Central Business District
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure; Property: Fc
b. Description of Proposed U'se/Work/Project/Occupation: (Use addnioral sheets if necessary):
il-
A I CAyj i1L'LUY v Y IY � 1 Q' S
vw COY"4 U i f 6r) ii ��K S 2 �7 SU_Y eme(2-
-- NJ
7. Attached Pfans: Sketch Plan ._ Site Plan Engineered/Surveyed Plans ..
8. Han a Speciat Permit/Variance/Finding ever been issued £anon the site?
NO DONT KNOW YES _._,— IF YES, date
IF YES: Was the permit recerded at the ,Registry of Deeds?
NO DONT KNOW YES ..,.,....—
IF YES: enter Book Page m and/or Document #
9.Does the site contain a crack, body of water or Wetlands? NO _ 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 issue(: .�
(Frmr kOntues On Other Side)
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W D" o,n'oF0c2'.S1m nawu ' _ ° r- uv n_ urn 1 E � i amu ax 1 8;4"2 0 c
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10. Do any signs exist on the property? YES NO
IF YES, describe size, type and
Are there any proposed changes to or additions of signs intended for the property? YES NO
IF YES, describe size, type and
11. Will the construction activity disturb (clearing, grading, excavation, or filling) over 1 acre or Is 1t 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 columrz rese,,ced
for use by the Building
Department
13. Certification: I hereby certify that the information contained herein is true and accurate to the best of
my knowledge.
Date:
Applicant's Signature
NOTE: Issuance of a zoning permit does not relieve an applicant's burden to comply vith 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.
Wdoc 8/4/2004
E%LSTuNG PROPOSED
REQUIRED BY
ZONING
Lot Size
Frontage
Setbacks Front
Side
Rear
L: R: L: R:
L: R:
Building Height
Building Square Footage
% Open Space: (tot area
minus building E paved
Darking
# of Parking Spaces
# of Loading Docks
Fill
(volume Fc location)
13. Certification: I hereby certify that the information contained herein is true and accurate to the best of
my knowledge.
Date:
Applicant's Signature
NOTE: Issuance of a zoning permit does not relieve an applicant's burden to comply vith 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.
Wdoc 8/4/2004