39A-018 (6) 1-001 vq APP"V66
File#MP-2020-0028 ,
T015 'DdES No-t &ff RF LA` &
APPLICANT/CONTACT PERSON RAISLER CAROLINE E
ADDRESS/PHONE 9 WRIGHTAVE To fuNy `BwLbiN{,t coo E coo
PROPERTY LOCATION 9 WRIGHT AVE �'1DERfbT�oIJS W ISL P
MAP 39A PARCEL 018 001 ZONE URC(100)/ V( 14 � L`(l. p,ELfA51N6f TN&
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out
Fee Paid
peof Construction: ZPA-2 FAMILY HOUSE J A ffOveb 1=O R w
New Construction tN��
Non Structural interior renovations FArv+t��-j wE�L ,J
Addition to Existin
Accessory Structure
Buiidinp,Plans Included:
Owner/Statement or License
3 sets of Plans/Plot Plan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INFQRrMATION PRESENTED:
Approved Additional permits required(see below) `S►.% f vim`
PLANNING BOARD PERMIT REQUIRED UNDER: § of
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: §
Finding Special Permit Variance*
Received&Recorded at Registry of Deeds Proof Enclosed
Other Permits Required:
Curb Cut from PW Water Availability Sewer Availability
Septic Approval oard of Health Well Water Potability Board of Health
Permit from Con ervation Commission Permit from CB Architecture Committee
Permit from Elm Street Commission Permit DPW Storm Water Management
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.
NQ N NG PERMIT APPLICATION (§Y o.2)
Ple e o print all information and return this form to the Building
a�aT°F ctor's ffi a with the X30 filing fee (check or money order)payable to the
�oATygMn)"o M,sp4 of qti City of Northampton
01
0� 3
1. Name of nt: 4
Address: ��` 7 /VOith S �n�. �� /�/,�I- (����,.� Telephone(y �3>s $y- �7�9
2. Owner of Property: C cw 1:-1v_ 's lei rt-
Address: �� 7 Ny?- �`� �f,cc f , �✓o���<�PF,� Telephone: �� )
3. Status of Applicant: Owne� �� Contract Purchaser Lessee Other (explain)
4. Job Location: I,/ f ve ? ,e /V, L,� c) tor d
Parcel Id: Zoning Map# 9 A Parcel#39/4-Cs I � -dCDistrict(s):
In Elm Street District In Central Business District
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/Property: s cc PSS 0!�4 4 F I,'-
6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary):
T wv -, /VD C cai1
7. Attached Plans: Sketch Plan Site Plan Engineered/Surveyed Plans
P- y -
8. Has a Special Permit/Variance/Finding ever been issued for/on the site? aovooaa
��r �ccefSo''r aec,i-fi.wcnl-,
NO 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, boo y of water or wetlands? NO k 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)
W:ADocuments\FORMS\original\Building-lnspectorA7,oning-Permit-Application-passive.doe 8/4/2004
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, 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 �f
/"/
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 J
• I Ll A�/ C�
Frontage
S 7. 5
Setbacks Front S {et- r- NO c �5•, �
Side L: I 0 f+ R: 15 F+ L: R: L: R:
Rear 50 t
Building Height
No c2�—
Building Square Footage
% Open Space: (lot area
minus building & paved
parkin NJ C
#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: , Applicant's Signature ��,, 1/�+
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-Inspector\Zoning-Permit-Application-passive.doc 8/4/2004
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