JFK ZPA 2015-12-21File# MP-2016-0055
APPLICANT/CONTACT PERSON NORTHAMPTON CITY OF J F KENNEDY SCHOOL
ADDRESS/PHONE 210 MAIN ST
PROPERTY LOCATION 100 BRIDGE RD
MAP 16B PARCEL 003 001 ZONE URA(100)/RI(81)/WSP(44)/SR(O)/
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out
Fee Paid
TypeofConstruction: ZPA-36 X 60 MODULAR BLDG FOR RECREATION OFFICE SPACE
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/ Statement or License
3 sets of Plans I 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 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 ---
___ Permit from Elm Street Commission ____ Permit DPW Storm Water Management
Signature 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 ofMGL 40A. Contact the Office of
Planning & Development for more information.
II
Please type or print all information and return this form to the Building
Inspector's Office with the $30filingfee ( check or money order) payable to the
City of Northampton
1. Name of Applicant: l>\1--'\ rS't \JOleffi;A'>J'tlH I ~r::t'.ffi..Ak ~M.)~ \\ \ ~
Address: 2,AD "'\~\•·\~· )~O~"u&'rH·} ,J,>k Telephone: 6~1· \y~t>
2. ONner of A'operty: V\ t:\ ~ N6\t\\\A\>.-\l:t~ \~'
Address: rt' Tel ephone:5__..._,,· ~'-:J-'--'.'-'\_..,'Uc,~o,c__ ____ _
3. S:atus of Applicant: ONner -+---Contract Purchaser ___ Lessee ___ a her (explain) ____ _
4. Job Location: \DD ~H~ '\tu.
5. Existing Use of Sructure/ A'operty: ~~~. \.kk.\t::} \) \ 1¢ ~(MQl)l..,
6. Description of A'oposed Use/ Work/ A-oj ect/ Occupation: (Use additional sheets if necessary):
CM~~~~\~ i~'llD6 N\OOULAIL~\_.\\Lt)\~ \&titt t(t\km£-S::'.ffi \A\\LL
~ ~~ :2;)'i ~ ~Jft1\ 'PIU~"::>-s, ~ ~re: ::fd~ ov'?~ · 'z> r~ ..
7. Attached Rans: S<etch Ran Ste Ran Engineered/ 9.Jrveyed Rans __ _
8. Has a ~ecial Permit/ Variance/ Fin ing ever been issued for/ on the site?
NO ___ _ YES ___ _ IF YES, date issued:. ______ _
IF YE& Was the permit recorded'? the Registry of Deeds?
NO DON'T KNOW YES ___ _
IF YES enter Book Page and/ or D:>cument # _____ _
9.D:>es the site contain a brook, body of water or wetlands? NO ~ DON'T KNON YES __ _
IF YES, has a permit been or need to be obtained from the C.onservation C.ommission?
Needs to be obtained ___ _ Cbtained _____ , date issued: ______ _
(Form Continues 0, Other Sde)
W:\Documents\FORMS\original\Building-Inspector\Zoning-Permit-Application-passive.doc 8/4/2004
I
10. Cb any sgns exist on the property? YES ___ _ NO ___ _
11.
12.
IF YE$ describe sze, type and location: _________________________ _
he there any proposed changes to or additions of signs intended for the property? YES __ ~NO __ ~
IF YE$ describe sze, type and location: _________________________ _
\/Viii the construction activity disturb (clearing, grading, excavation, or fillin~ 1 acre or is it part of a common
plan of development that will disturb over 1 acre? YES NO F-
IF YES, then a Northampton Sorm Water Management Permit from the rP.JV is required.
ALL INFORMATION MUSf BE COMPLETED, or PERMIT CAN BE DENIED DUE TO LACK OF INFORMATION
Lot Size
Frontage
Setbacks Front
Side
Rear
Building Height
Building Square Footage
%Open Space: (lot area
minus building & paved
parking
# of Parking Spaces
# of Loading Docks
Fill:
(volume & location)
EXISTING
L: R:
PROPOSED
R: \5
This column reseMJed
for use by the Building
De artment
REQlJIRED BY .
. ZONING
13. Certification: I hereby certify that the informati n contained herein is true and accurate to the best of
my knowledge.
Date:~.\!\·\~ Applicant's Signatur
NOTE: Issuance of a zoning permit does not rel
requirements and obtain all required pe •ts fr
Historic and Architectural Boards, Departm
authorities.
W:\Documents\FORMS\original\Building-JnspectonZoning-Permit-Application-passive.doc
t's burden to comply with all zoning
ard of Health, Conservation Commission,
Works and other applicable permit granting
8/4/2004