31B-290 (5) File# P-202,1-00$0
APPLICANT/CONTACT PERSON Charlie Conan %S/Y►)k, agiec4e._
ADDRESS/PHONE (z(, 122 f St/ Wir-Hriar,r►p irrin q(- -32S-5nS (cell)
PROPERTY LOCATION
MAP 3 1(3 'ARCEL•2Q0 ZONE
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT „
Fee Paid t 3 Dv r/c,#l 44 S
Building Permit Filled out
Fee Paid
TypeofConstruction: DiEIY)D STRYI<y'Vles/R'tpLAGE LJITH Slrote-A-g, SIZE Re
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 1( 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
Pe om Elm Street Commission Permit DPW Storm Water Management
Demolition DeCDI
ay
riA /al
Sign re of Building Official ,0 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 Office of
Planning&Development for more information.
f'1 "L2
---,Cru% File No. U)p-ZoZl-bosa
NING PERMIT APPLICATION (§i o.2)
Please OP or print all information and return this form to the Building
pe4or's ce with the $30 filing fee (check or money order)payable to the
City of Northampton
•
nt: CLI&el.I E. COI..id. S M IT 4 CoLLEGE
1,LI EST T. Klolz114a.tAPTa6 Telephone:413'�j2�' G 2-2-S(c u )
2. Owner of Property:T�hE T .IE TE ES OF MAE S i I-T a CO L LEG E
Address: Telephone:
3. Status of Applicant: Owner Contract Purchaser Lessee Other (explain)
4. Job Location:7 C' OLL_EGF LL1 E Ab M 1 SS I O I i S BUILD 1 OCT
Parcel Id: Zoning Map# 31 B Parcel# 2 9 O District(s):
In Elm Street District In Central Business District
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/Property:•.M Lt 4T 1 U'E O F
6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary):
�.e,otvlicA Q /S/; ( Si' cIo/t oiv (' /ctC,� w;111
new 0 S; wt.liqte size . eahs vr74-t2✓'
ef2..01/4-t-I (fed •
7. Attached Plans: Sketch Plan -ti • Site Plan Y. Engineered/Surveyed Plans
( /S7% 2 )
8. Has a Special Permit/Variance/Finding ever been issued for/on`fhe site?
NO DONT KNOW X 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 o1-need to be obtained from the,Conservation Commission? •
Needs to be obtained __X Obtained_ _ , date issued:
(Form Continues On Other Side)
W:\Documents\FORMS\original\Building-Inspector\Zoning-Pemrit-Application-passive.doc 8/4/2004
10. Do any signs exist on the property? YES X NO
IF YES, describe size, type and location: BU I LID) 1& KI bM E Oh I v i.r&i cS( 'r
f y `< ,-ds f
Are there any proposed changes to or additions of signs intended for the property? YES k,g://. NO
IF YES, describe size, type and location:
11. Will the construction activity disturb (clearing, grading, excavation, or filling)oval 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 2 q)1A G g Id,as TV •�.e
Frontage
COLLEGI. L41.1E- tZ5 Sa- .�
Setbacks Front
Side L: R: L: 140. R: ! ! J L: R:
Rear •
Building Height
2 sToelEs .
Building Square Footage
Cn,cI s �. 7-7/l
•
%Open Space: (lot area
minus building a paved z4 714 c .v.
parking
#of Parking Spaces
8
#of Loading Docks
Fill: ap
(volume a location)
13. Certification: I hereby certify that the information contained herein is true and accurate to the best of
my knowledge.
/9 777--
Date: C l0 ZoZ-i Applicant's Signature /a'f-,1-1-14/
( vJ
'TOTE: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\origina!\Building-inspector\Zoning-Permit-Application-passive.doc 8/4/2004
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