18-022 (6) 5er coMVIc„%. TS 11J
File #44 NUNICIT2
APPLICANT/CONTACT PERSON:CITY OF NORTHAMPTON CONSERVATION COMMISSION CITY
HALL
210 MAIN ST NORTHAMPTON, MA 01060
PROPERTY LOCATION 196 COOKE AVE
MAP:LOT 18-022-001 ZONE
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATI()N CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Building Permit Filled out
Fee Paid $
Type of Construction: ZPA -DEMOLITION OF THE MOOSE LODGE
New Construction 4 CI 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 SpecialPermi With Site Plan
Major Project: Site Plan AND/OR Specia1Pennil 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 'ewer Avaliability
Septic Approval Board of Health Well Water Potabilit Board of Health
Permit from Conservation Commission Permit from CB • 1 hitecture Committee
Permit from Elm Street Commission , Permit DPW Sto Water Management
xDemolition Delay
a
4i ,.9i . r 5- '3 .
Si:p ature of Building Official j t Date
Note: Issuance of a Zoning permit does not relieve a applicant's burden to com•ly with all zoning
requirements and obtain all required permits from Board of Health, Conserva ion Commission,Department
of public works and other applicable permit granting authorities.
*Variances are granted only to those applicants who meet the strict standards of M ,L 40A.Contact Office of
Planning&Development for more information.
RECFWED
File No.
MAY 1 3 �0?2
ZONING PERMIT APPLICATION ( Y o.2 s
Please type or print all information and return this form toy h d&,Mitit ;i gNs
Inspector's Office with the $30 filing fee (check or money order)payable to the
City of Northampton
1. Name of Applicant: City of Northampton, through Planning Et Sustainability
Address: 210 Main St., Northampton, MA 01060 Telephone: 413-587-1265
2. Owner of Property: _ City of Northampton
Address: 210 Main St„ Northampton, MA 01060 Telephone: 413-587-1265
3. Status of Applicant: Owner XX Contract Purchaser Lessee Other (explain)
4. Job Location: 196 Cooke Avenue (Boggy Meadow Road)
Parcel Id: Zoning Map# 18 Parcel# 022 District(s):
In Elm Street District In Central Business District
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/Property: Parking Lot and old Moose Lodge
6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary):
Demolition of the Moose Lodge. A demolition contract will apply for the demolition permit but we are
applying now so that we can receive any required demolition delay review
7. Attached Plans: Sketch Plan Site Plan XX Engineered/Surveyed Plans
8. Has a Special Permit/Variance/Finding ever been issued for/on the site?
XX
NO DON'T KNOW 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 YES XX
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained Obtained XX , date issued: 5/12/2022
(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 XX
IF YES, describe size, type and location:
Are there any proposed changes to or additions of signs intended for the property? YES NO XX
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 XX
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
3.07 3.07
Frontage 316'on Boggy Meadow Rd
316'on Boggy Meadow Rd.
Setbacks Front 200+
NOT APPLICABLE
Side L: 300'+ R: 10' +/- L: R: L: R:
Rear 10' +/-
Building Height
20' +/- Not applicable
Building Square Footage
2,000 sq ft +/- not applicable
% Open Space: (lot area
minus building Et paved 80% 80%
parking
#of Parking Spaces
40 no change
#of Loading Docks 0 0
Fill: 0 0
(volume Et location)
13. Certification: I hereby certify that the information contained herein is true and accurate to the best of
my knowledge.
Date: 5/13/22 Applicant's Signatur- A ,
NOTE: Issuance of a zoning permit does not relieve an ap i icant'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
VG PLOT OATS 3/21/2022
:i: i:: i:zIIII1J
1
I
I
1
1
. 1
♦ I
44,
•
I
ti
•
I
/
• 4 / I
• 100 I
I •4 I
•
I
L I
I
•
1
/
•
s �
a
� ^ 1
�F I
•
I
/ '� \ I
\ 1