18D-010 (8) 7-0K
File #5
APPLICANT/CONTACT PERSON:BURIS GENERATION HI&GC
31 EXETER ST EASTHAMPTON, MA 01027(413)222-2914
PROPERTY LOCATION 3 COOKE AVE
MAP:LOT 18D-010-001 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: 12X27'ADDITION FOR 2 BEDROOMS &BATH
New Construction
Non Structural Renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/ Statement or License
3 sets of Plans/Plot Plan
Driveway Grade%
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INFORMATION PRESENTED:
X 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
Demolition Delay
TO V 812.11
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. 5 LI (�°
3D .
ZONING PERMIT APPLICATION (350.4.4)1
Please type in this fillable PDF or print and hand-write all information and return to
the Building Inspector at the Building Department (212 Main St.) with the $30 filing fee by
check and money order ayable to the Cit of Northampton) or credit card (in person� only).
buy-1 Email: II (� ri /� Y(oo•C OYY1
1. Name of Applicant: �f 1 c� r(,t� �ll Sar b ( Q
Address: 3 , f�)(e 1 e r Telephone: 11i3— Z ^ 2 /1-
2. Owner of Property:11)15 1{0 JAC 0 d'iovel nos / )(Wend de) 1i l/r
f� fl evl vTelephone: 4'13- 310 -5' 11
Address: 3 Coo \ V �
3. Status of Applicant: Owner ❑ Contract Purchaser ❑ Lessee Li Other (explain) C �r U G'vtf-
4. Job Location: 3 (.. O o e / V eYl U P.
Parcel Id: Zoning Map# Parcel#j 2'� -010 D( District(s): c fS'
In Elm Street District In Central Business District
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/Property: A? ,51 cI ajI 1(o I
6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary):
rele,4r0W5
7. Attached Plans: Sketch Plan ❑ Site Plan Pr Engineered/Surveyed Plans ❑
8. Has a Special Permit/Variance/Finding ev r been issued for/on the site?
NO ❑ DONT KNOW YES ❑ IF YES, date issued:
IF YES: Was the permit recorded at the egistry of Deeds?
NO ❑ DON'T KNOW YES ❑
IF YES: enter Book Page and/or Document # n
9.Does the site contain a brook, body of water or wetlands? NO I-J DONT KNOW El YES l 1
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)
6/7/2023
10. Do any signs exist on the property? YES NO E
IF YES, describe size, type and location:
Are there any proposed changes to or additions of signs intended for the property? YES I 1 NO I "
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 Er
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 Dept.only.
EXISTING PROPOSED REQUIRED BY
ZONING
Lot Size
Frontage
Setbacks Front
Side L: R: L: R: L: R:
Rear
Building Height
Building Square Footage
%Open Space:
(lot area minus building Et
paved parking)
#of Parking Spaces
#of Loading Docks
Fill:
(volume Et location)
Driveway Grade%
13. Certification: I hereby certify that the information contained h= • ue d accurate to the best of my knowledge.
LI 'OFE--\--
Date: 1 /l/� Applicant's Signature i
NOTE: Issuance of a zoning permit does not relieve an applicant's burden to corn.1 with all zoning requirements and
obtain all required permits from theeBoard of Health,Conservation Commission, sH Commission and Architectural
Boards,{Department of Public Works and other applicable permit granting authorities.
6/7/2023
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