25C-052 (7) File#MP-2020-0046
APPLICANT/CONTACT PERSON GRINDAL JACOB
ADDRESS/PHONE 55 LINCOLN AVE (207)266-9948 Q
PROPERTY LOCATION 55 LINCOLN AVE
MAP 25C PARCEL 052 001 ZONE URB(100)/
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
SED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Buildin Permit Filled out
Fee Paid
TypeofConstruction: BUILD ADD A LEVEL ADD ION OVER EXISTING 18X14 ADDITION
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
INF MATION 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: §
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 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
--,/, - /L--" l
Signatur 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. (!� ED
ZONING PERMIT APPLICATION (§' O:2)
Please type or print all information and return this form to he Buildin
Inspector's Office with the $30 filing fee (check or money ordef part. the
1 ,rn
City of Northampton o.ti.�,q PF: ory
1. Name of Applicant: tAa\SQAG,. izw\�y\ - S c resv� T *I�n
Address: CJS �v�c-o�r1 Plea N0 4,k- lQ•kch--� Telephone:
2. Owner of Property: N\&o cka ,
Address: S 01yyN4---1 Telephone:
3. Status of Applicant: Owner __)k____ Contract Purchaser ------- Lessee------- Other (explain)_____________
4. Job Location:__ __l-�\.v . \v_� U �-------------------------
Parcel Id: Zoning Map# Parcel# C) District(s): U
In Elm Street District In Central Business District
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/Property: YDS\G�n�r�l1A�
6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary):
l 1
\A YNi 1d) GIG - A' eve rzc �k•�1�1 �l ,Q �( ,(�'. `� ��
7. Attached Plans: Sketch Plan 0 Ste Plan Engineered/Surveyed Plans
8. Hasa Special Permit/Variance/Finding ever been issued for/on the site?
NO DON'T 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 _y__ 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:\Documents\FORMS\original\Building-Inspector\Zoning-Permit-Application-passive.doc 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 _2�__
IFYES, 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 1(9 i L-Av-0
Frontage
Setbacks Front Zq
Side L: }rj R L: R 1 L: R:
Rear ,1,,O l
Building Height Zn
Building Square Footage
% Open Space: (lot area
minus building& paved SDI.
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: Applicant's Signature
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
-NOTE-
THIS PLAT IS COMPILED FROM DEEDS, PLANS AND OTHER SOURCES AND IS NOT
TO BE CONSTRUED AS AN ACCURATE SURVEY AND IS NOT TO BE RECORDED.
BUILDING LOCATION ACCURACY IS NOT GUARANTEED
W
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w 256'±
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Q +I #55
BOOK 11267, PAGE 177
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O b 257.99'
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Z PLAN BOOK 71, PAGE 110
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TO: BERKSHIRE BANK AND
FIRST AMERICAN TITLE INSURANCE COMPANY —NOTE—
TO THE BEST OF MY INFORMATION, KNOWLEDGE AND BELIEF THIS PLAT FOR MORTGAGE LOAN PURPOSES ONLY
I HEREBY REPORT THAT I HAVE EXAMINED THE PREMISES AND BASED ON EXISTING AND DOES NOT CONSTITUTE A PROPERTY SURVEY
MONUMENTATION ALL VISIBLE EASEMENTS, ENCROACHMENTS AND BUILDINGS ARE LOCATED ON �N of
THE GROUND AS SHOWN AND THAT THE BUILDINGS ARE ENTIRELY WITHIN THE LOT LINE-S, ,scQ' S'oy —MORTGAGE LOAN INSPECTION PLAT—
EXCEPT AS NOTED. I FURTHER REPORT THAT THE PROPERTY IS NOT LOCATED WITHIN RANDALL 'o, NORTHAMPTON, MASSACHUSETTS
A FLOOD PRONE AREA AS SHOWN ON FEDERAL FLOOD INSURANCE MAPS FOR E•
COMMUNITY #250167 S IZER N PREPARED FOR
#35032
1-fsa� MARISELA FERMIN-SCHON & JACOB GRINDAL
4,3sURVE�° SCALE: 1"=,30' AUGUST 5, 2015
SURVEYOR: 47- HAROLD L. EATON AND ASSOCIATES, INC.
REGISTERED PROFESSIONAL LAND SURVEYORS
235 RUSSELL STREET — HADLEY — MASSACHUSETTS-,