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23B-094 (3) File #45 APPLICANT/CONTACT PERSON:KENT HICKS P O Box 57 WEST CHESTERFIELD, MA 01084(413)296-0123 PROPERTY LOCATION 200 NORTH ELM ST MAP:LOT 23B-094-001 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 -SINGLE FAMILY TO DUPLEX .. New Construction // Non Structural Renovationst?://- Addition to Existing Accessory Structure Building Plans Included: Owner/ Statement or License 3 sets of Plans/Plot Plan TH FOLLOWING ACTIONo HAS BEEN TAKEN ON THIS APPLICATION BASED ON FORMATION PRESENTED: J Approved Additional permits required (see below) PLANNING BOARD PERMIT REQUIRED UNDER:§ Intermediate Project: Site Plan AND/OR Special Permit With Site Plan MajorProject: Site Plan AND/OR SpecialPermit 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 Permit from Elm Street Commission , Permit DPW Storm Water Management Demolition Delay L S 11 9/)-a v Si, ature 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 Office of Planning&Development for more information. File No. `Trc AY 1 8 ail zONI,NG PERMIT APPLICATION (§10.2) Please y c r print all information and return this form to the Building Inspector's Office 2 j,ith the $30 filing fee (check or money order)payable to the City of Northampton 1. Name of Applicant: -Easy \- SA-40 C Kt-NA k C,KS CaAkS lvr apt. ) Address: PA3D . — 1 L O��e e-rt '�A )1� Telephone: / I3'a.�lo - 0 1a3 2. Owner of Property: J CCe- 'k(_ � Address: Telephone: I E 3 —o '6' ` I `in 3. Status of Applicant: Owner Contract Purchaser Lessee Other (explain)/ !?-ott..exa.1 4. Job Location: 02 6b N . I'wt SA'�r"-e--i± Ca'�,ra e r Parcel Id: Zoning Map# �� Parcel# 62q District(s): In Elm Street District In Central Business District (TO BE FILLED IN BY THE BUILDING DEPARTMENT)it_ 5. Existing Use of Structure/Property: S.; i vtti `) 6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary): S) fia- ;l,, 4-01)i,1 te_y, ears o\A txt, a\1 5-e,fdt_r&'i 6,115 +- ;`t,rc Y� Dct��q w► tc rt5s --br St-CwKJQ +11- 1 c, }de- bA't„� t+C � , 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 DON'T KNOW tX. 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 x DON'T 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 X IF YES, describe size, type and location: Are there any proposed changes to or additions of signs intended for the property? YES NO X. 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 3C it-cro _ -e Frontage / b 0 f-1- 5 mac{ Setbacks Front 1/5— i/ Side L: / b R: '/0 ya lc'' L: `` R: ' L: R: Rear Building Height 21 ,S/a Building Square Footage 0 00 bw1(1 ; i�w.t //lc a 9 ) sawte. %Open Space: (lot area minus building a paved '" 9 06 /-P*1- SG t parking #of Parking Spaces #of Loading Docks NA Fill: (volume Et location) I)p- NA 13. Certification: I hereby certify that the information contained herein is true and accurate to the best of my knowledge. Date: / ao;, Applicant's Signature NOTE:Issuance of a zoning permit does not relieve licant's burde o comply with all zoning requirements and obtain all required permits m t oard of He ,Conservation Commission, Historic and Architectural Boards,Department of Public Wor er applicable permit granting authorities. W:\Documcnts\FORMS\original\Building-Inspector\Zoning-Permit-Application-passive.doc 8/4/2004 FrO b 5 C V`o--)4 v-. l 1-10. ©c NB2 i I I}} �/ FIRST FLOOR ABOVE II _ I I n REF. 8'-2 1/4"1 I B09 I t + 1 rn I I / R„ 5 4" I 1 A - - 1 _ \ 1 I / I' \ ) 1 . U +— -- __ 1 jr C) 3'-3114" 1'-4" h i Lo- L4 i 1 f e 11a^ 0'-91/2" 2'-8" 0'-21/4" rcif I' Tye c Q ' .\\ hl } Sv.Kv roow Ur ; ,. , . ` °IW2I 3-91/2' 4_—&fit— e 2'-101/2" °'� CCK. / Iw11 N V\ Ei17 � - - O O 98f0 ON \ `.[-1 REF, I I O0O I&a I 1 EN 1 �. 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