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23D-214 File #5 `o K APPLICANT/CONTACT PERSON:NU-WAY HOMES INC 10 WHITE ST EAST LONGMEADOW, MA 01028 PROPERTY LOCATION 61 WARNER MAP:LOT 23D-214-001 ZONE THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Building Permit Filled out Fee Paid $30.00 Type of Construction: ZPA -NEW HOUSE New Construction Non Structural 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 Additional permits required (see below) PLANNING BOARD PERMIT REQUIRED UNDER:§ Intermediate Project: Site Plan AND/OR Special Penn it With Site Plan Major Project: Site Plan AND/OR Special Perm it With Site Plan ZONING BOARD PERMIT REQUIRED UNDER: § Finding Special Permit Variance* Received&Recorded at Registry of Deeds Proof Enclosed Other Penn its Required: Curb Cut from DPW Water Availability Sewer Av a ila bility 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 Demolition Delay , 1. 13-1d 3/46/a, Sia ature of Building Official op 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. File No. SEP 1 5 �021 ZONING PERMIT APPLICATIO r� � 7 1SPECTi _ Please type or print all information and return this form • Inspector's Office with the $30 filing fee (check or money order)payable to the ( City of Northampton cc,.(I 0'-1 0 1. Name of Applicant: JO/1A/ /44 ✓19d(V " Address: / 0 Zt/l'I/ %e i' /e :/14e6lepho g(y/.�j 563`_�jD8S- 2. Owner of Property: V U "0,�4 /747.+i ,mC.,r "I o/ate 3 JS��3-00� Address: IC Lie � 1'¢(�'f� • L��/�Ie�c��L,L Telephone: ( �J 3. Status of Applicant: Owner Contract Purchaser Lessee Other(explain) 4. Job Location: (0,/ A"fl Ie'verl <S`` ZO T"' '2"-- O0/ Parcel Id: Zoning Map# a �� Parcel# a I "I District(s): , In Elm Street District In Central Business District (TO BE FILLED IN BY THE BUILDING DEPARTMENT) 5. Existing Use of Structure/Propert : 5X ;5t-y oo SP be fie! " 6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary): 70 /3Ui'//J iq ,iJt ,"-' /74:14, 7. Attached Plans: Sketch Plan Site Plan Engineered/Surveyed Plans L----' 8. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO DONT KNOW r''' '' 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 1---------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\FORM.S\original\Building-Inspector\Zoning-Permit-Application-passive.doc 8/4/2004 10. Do anysigns exist on theproperty? 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 -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 5D,50 Setbacks Front Side L:c.3 R: /.S, L: R: L: R: Rear �2�;� Building Height e H' 3° f Building Square Footage %Open Space: (tot area minus building Et paved parking #of Parking Spaces #of Loading Docks Fill: (volume Et location) 13. Certification: I hereby certify that the information co herein is true and accurate t t e best of my knowledge. Date: d 2 Applicant's Signature /01 NOTE:Issuance of a zoning permit does not reli ve appli ant' urden to comply all zoning requirements and obtain all required pe from the Board of Health,Conse ation 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