23D-060 File No. .0('.P9 =—isEp
Lti)
ZONING PERMIT APPLICATION (§10 . PVT OF BUILDING INSPECTIONS
NORTHAMPTON,MA 01060
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant: No (2. T—f( vt 07- 'N �re-kJ Er I kl G-
Address: % J O NS) 3 )_/�(RV I E?.v 7�V�j NId�Telephone: ,SS' —O 6 q L1
2. Owner of Property: M (CI4AEL PO N NE LL
Address: g R1V P1(�S I DC (11 lta ki Telephone: —(813
3. Status of Applicant: Owner 1-6ontract Purchaser Lessee
Other(explain):
4. Street Address: a f2iVE2S/DE DR(ye fv021 ffH-MP ION. (a3 P, Qot59f100 _
Parcel Id: Zoning Map# Parcel# �� �� District(s): �[ ei:3
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/Property R'e5 JCE
6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary):
CL ANC- Di U5> V/20M Ru5rDqvcE TO QV/41;€R /1EETINGE{OuSE) t,Jl'ti4 Ci-(URci-(
�r�oFT(Ce51 SuNV 5ct p
doL RonmS) LTG. ! 2eSENi DW LING (5 No mcdNr0(2G(,( ((1�C�
7. Attached Plans: Sketch Plan /Site Plan Engineered/Surveyed Plans
Answers to the following 2 questions may be obtained by checking with the Building Dept or Planning Department Files.
,26
8. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO v ? DONT KNOW YES IF YES,date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO V DONT KNOW YES
IF YES: enter Book Page and/or Document#
9. Does the site contain a brook, body of water or wetlands? NO V 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)
FILE #
960289
APPLICANT/CONTA T ERSON: 4G�;G1"
ADDRESS/PHONE: C� OIa-S
PROPERTY LOCATION: o?/ j-t4(
MAP c,.),3J) PARCEL: /0 ZONE C.1
THIS SECTION FOR OFFICIAL USE ONLY: •
PERMIT APPLICATION CHECKLIST
Ty
ENCLOSED REQUIRED DATE -
7ONTNC FORM FTT,I FT? 0TTT i? 1 f."(4d---C
Fee Pair)
Rnilding Permit Filled not
Fee Paid
Type of C'nnctrnctinn•
New C'nnctrnrtinn
Remodeling Interior
Additinn to Existing
Accessory Strnctnre
J3nilding'Plans Tnrinded•
nwnerIflrrtpant Statement nr licence 1
3 Sets of Plans I Pint Plan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION:
Approved as presented/based on information presented
Denied as presented:
Special Permit and/or Site Plan Required under:§
PLANNING BOARD ZONING BOARD
/ Received&Recorded at Registry of Deeds Proof Enclosed__
t/ Finding Required under:§ cZ3-agw/ZONING BOARD OF APPEALS
Received&Recorded at Registry of Deeds Proof Enclosed
Variance Required under: § w/ZONING BOARD OF APPEALS
Received&Recorded at Registry of Deeds Proof Enclosed
Other Permits Required:
Curb Cut from DPW Water Availability Sewer Availability
- Septic Approval-Bd of Health Well Water Potability-Bd Health
Permit f Conservation Commission
igaature f ding for Dat
NOTE:issuanoe of a zoning permit does not relieve an epplioants burden to comply with all
_ zoning requirements end obtain all required permits from the Board of Health, Conservation
Commission, Department of Publio Works and other applicable permit granting authorities.