36-039 File#MP-2020-0033
APPLICANT/CONTACT PERSON BLAKESLEY DARLENE
ADDRESS/PHONE 19 WINCHESTER TERR
PROPERTY LOCATION BURTS PIT RD
MAP 36 PARCEL 039 001 ZONE
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
SED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Buildinp,Permit Filled out
Fee Paid
T_ypeof Construction:_ZPA-BUILD A 864 SO FT DETACHED ACCESSORY DWELLING WITH FRONTAGE
ON BURTS PIT RD
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 V Additional permits required(see below)
PLANNING BOARD PERMI REQUIRED UNDER:
Intermediate Project Site Plan AND/OR Special
ecial Permit with
�Site Plan
Major Project: Site Plan AND/OR Special Permit with Site Plan
ZONING BOARD PERMIT REQUIRED UNDER: § � �Z '¢��
Finding Special Permit vl-� 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
2/!;11
Signature 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.
File No.—M P– a0-
050 LOVtN NOLdV�HH1HON
Please type or print all information and return isorp o� ke&ildin
Inspectors Office with the $30 filing fee (check or n y or payab e t the
City of Northampton
1. Name of Applicant: 117r/efie
Address: Telephone:_%�J
2. Owner of Property:
/
Ale
,[
Address: //i/r/I f'S/ ei - �f'/,� (e Telephone: s � l - 9'6 3 :31
3. Status of Applicant: Owner X Contract Purchaser Lessee Other (explain)
4. Job Location: Burts Pit Road Map 36 Lot 39
6 .6 is 11+ Pr ..,7, ;
P.drCel"yd.� ZOn1nM #4�'.a , } �� # r.s $ �# '� s . '
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gap�4 ---� -- Parcel# `Distet(s,)� aYr��
'tq r t 4, '4 •"`a. �,r•v �...^u .r Wh i 4 d,k'N.v
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In El t e/e{t >I ttri t in,,Central Bunn ss DistFi� � M
a; q T E* EMU IN,.BYTHE,g[JILDING DEPARTMENT �io"
5. Existing Use of Structure/Property: None Vacant Lot
6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary):
This property owner owns the dwelling at 19 Winchester Terrace Map 36 Lot 44 and also owns the
vacant lot behind the Winchester Terrace dwelling Map 36 Lot 39 that has frontage on Burts Pit Road.
The property owner would like to build an 864 SgFt detached accessory dwelling on the lot with
frontage on Burts Pit Road. We understand we will need a permit for the driveway on Burts Pit Road.
7. Attached Plans: Sketch Plan X Site Plan Engineered/Surveyed Plans
8. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO X 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 X 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)
1)C&AK65L-FT' i CTMAiLeCCoIv,
W:\Documents\FORMS\original\Building-Inspector\Zoning-Permit-Application-passive.doc 8/4/2004
10. Do any signs exist on the property? YES 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
IF YES, describe size, type and location:
11. Will the construction activity disturb (clearing, grading, excavation, or filling) over 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 reserved
for use by the Building
Department
EXISTING PROPOSED REQUIRED BY
ZONING
Lot Size
6000 SgFt
Frontage
60 Feet
Setbacks Front 25 Feet
Side L: R: L: 18Ft R: 18Ft L: R:
Rear 39 Feet
Building Height
One Story
Building Square Footage
864 SgFt
% Open Space: (lot area
minus building Et paved 75.6%
parking
#of Parking Spaces
Two
#of Loading Docks
None
Fill: N/A
(volume Et location)
13. Certification: I hereby certify that the information contained herein is true and accurate to the best of
my knowledge. - n
i
Date: �` Applicant's Signature �..Y
NOTE: Issuance of a zoning permit does not relieve an applicant'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:\Documents\FORMS\original\Building-Hispector\Zoning-Permit-Application-passive.doc 8/4/2004
SKETCH/AREA TABLE ADDENDUM
Property Address Burts Pit Accessory Dwelling
City Northampton State MA Zip
Borrower
Lender/Client
Appraiser Name
Map 36 Lot 44
60.0'
Map 36 Lot 39
Rear Setback 39'
Side Setback 18' Ranch Style Home Side Setback 18'
24x36
864 SgFt
Driveway
•
Setback 25'
60.0Scale V 25'
Burts Pit Road
Northampton Appraisal Associates APEX SOFTWARE 800-858-9958 Apx7200-w ApeY2
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