18D-035 (41) f �C
File#MP-2020-0076
APPLICANT/CONTACT PERSON COUSINS INVESTMENTS LLC
ADDRESS/PHONE PO BOX 547 (413)774-3121
PROPERTY LOCATION 48 DAMON RD g2io�iy O�
MAP 18D PARCEL 035 001 ZONE GB000)/
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Buildiniz Permit Filled out
Fee Paid
Tvpeof Construction:_ZPA-NEW CAR DEALER
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 P: FR 1�NTED:
Approved ✓✓ Additional permits required(see below)
PLANNING BOARD PERMIT REQUIRED UNDER: § 5/aPGiN./ rbV1i�' �Br �C� t06Zt vT u5�
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✓ r 450 1-3 Special Permit Variance*
-A- 7 ,
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
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.
i
HLULIVED
JUN -42020
File No. fn0- a0-76
IF- ZONING PERMIT APPLICATION
Please type or print all information and return this form to the Building
Inspector's Office with the X30 filing fee (check or money order)payable to the
4 City ofNorthampton
1. Name of Applicant:L 6y,5/Al c,5 3.1 V i���1�/ —
Address: �v ) ��`� w1mL lephone: `��� 7T -�✓o��
2. Owner off�roperty /0'68/ASS
Address! Qq L 4LN6� Telephone:
3. Status of Applicant: Owner 1�Contract Purchaser Lessee/ Other (explain)
4. Job Location: "�d bfb�l ) /�-vU ��[1/G1��Z�/U�� 14,1
Parcel Id: Zoning Map# Parcel# ✓ District(s):
In Elm Street District In Central Business District
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/Property: — V Z
6. Description of Proposed Use/WWork7//PProject/Occupation: (Use additional sheets if necessary):
A A 'Bal LG
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 YES IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO DONT KNOW YES
IF YES: enter Book Page and/or Document#
9.Does the site contain a brook, body of water or wetlands? NO DONT 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:\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
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
Frontage
Setbacks Front /.
Side L: R: L: R: L: R:
Rear
Building Height
Building Square Footage
�W
Open Space: (lot area
minus building li paved
parking
#of Parking Spaces
#of Loading Docks
Fill:
(volume & location)
13. Certification: I hereby certify that the information contain d her in is tru n a urate to the best of
my knowledge.
Date: ' Applicant's Signat
NOTE:Issuance of a zoning permit does not relieve an applic nt' burden to comply wi all zoning
requirements and obtain all required permits from the rd 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
Your Confirmation number is 20200525907237
Date of Confirmation:5/25/2020
NOTE:When paying by ACH (Checking)it will take two business days for the payment to be debited from your
bank account.Your account number is not verified until this payment is presented to your bank.They have the
right to return this payment if unable to process this transaction against your account.
Your request for payment(s)of$30.00 has been received and is subject to approval by your financial institution.
Account Information Payment Information
Name: Gayle Bover Payment Credit Card
Address: PO Box 547 Type:
City: Hadley Payer Name: Gayle Bover
Card '**'***'***5034
State: MA Number:
Zip: 01035
Email: gbover@tommycarmgt.com
Transaction Information
Transaction Quantity Amount Fee Payment
Northampton Planning and 1 $30.00 $0.00 Type
Sustainability Credit Card
Planning Permits
Permit:Other
Property Owner Name:Cousins
Investments LLC
Permit Application Name:Cousins
Investments LLC
Assessors Map#for Work
Location:48 Damon Rd
Assessors Block#Work Location:
18D-035-001
ssessors Lot#for Work Location
13186/304
Email Address:
gbover@tommycarmgt.com
Total:$30.00
Gayle Bover
From: adelisle=northamptonma.gov@mg.unibank.net on behalf of adelisle@northamptonma.gov
Sent: Monday, May 25, 2020 12:17 PM
To: Gayle Bover
Subject: Planning Permits - Your payment has been confirmed!
Your Confirmation number is 20200525907237
Date of Confirmation: 5/25/2020
NOTE: When paying by ACH (Checking) it will take two business days for the payment to be debited from your bank
account.Your account number is not verified until this payment is presented to your bank.They have the right to
return this payment if unable to process this transaction against your account.
Your request for payment(s) of$30.00 has been received and is subject to approval by your financial institution.
Account • •
Name: Gayle Bover
Address: PO Box 547
City: Hadley
State: MA
Zip: 01035
Email: gbover@tommycarmgt.com
Payment Information
Payment Type: Credit Card
Payer Name: Gayle Bover
Card Number: ***********5034
Transaction • •
Northampton Planning and Sustainability
Planning Permits Quantity: 1
Permit: Other Amount: $30.00
Property Owner Name: Cousins Investments LLC Fee: $0.00
Permit Application Name: Cousins Investments LLC Payment Type: Credit Card
1
Assessors Map#for Work Location : 48 Damon Rd
Assessors Block#Work Location: 18D-035-001
ssessors Lot#for Work Location : 13186/304
Email Address: gbover@tommycarmgt.com
Total: 00
2