10B-007 (3) File #23
APPLICANT/CONTACT PERSON:STAUB ADRIAN B&SARAH P
74 AUDUBON RD LEEDS, MA 01053
PROPERTY LOCATION 74 AUDUBON RD
MAP:LOT 10B-007-001 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 -ADU
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:
Approved j/ Additional permits required(see below) For all projects that need additional reviews Ei+,ti;}iE
as checked below,please see the Office of Planning& Sustainability Permit page or scan here T
PLANNING BOARD PERMIT REQUIRED UNDER:§ i06 U5C— 'QQ y•
Intermediate Project: Site Plan AND/OR Special Permit With Site Plan
Major Project: Site Plan AND/OR SpecialPermit With Site Plan
ZONING BOARD PERMIT REQUIRED UNDER: §
Finding SpecialPermit 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
//�? • 3-Zq-2o2y
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 of MGL 40A.Contact Office of Planning&
Development for more information.
File No. R
Ck,I 4/`f 19 490 MAR 2 6 2024 ,,II
ZONING PERMIT APPLIC lTIQN j350.4.4)1
c
Please type in this fillable PDF or print and hand-write all intoP_ri i.i `�1 n and° return to
the Building Inspector at the Building Department (212 Main St.) with the $30 filing fee by
check and money order ((payable to the City of Northampton) or credit card (in T%/1person only).
1. Name of Applicant: v a- I Iy j 4 a u- (0 Email: S a I l S�Ct,u.to� ail.co✓vl
Address: gi /U.dI,C(o U✓1 i?.a acl ,L<Pd s Telephone: 4113 - 3 2 6- 9 L/C ;
2. Owner of Property: A ox I. a.VI arty sally 5.-I-- u- b
Address:�1 d uAh 6r1 Cc (�-� S 1/14/-}- Telephone: / 13 " 32 6 �`7
3. Status of Applicant: Owner fs0"
Contract Purchaser ❑ Lessee ❑ Other (explain)
4. Job Location: C.-wA'' a- above_
Parcel Id: Zoning Map# Parcel# District(s):
In Elm Street District In Central Business District
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/Property: p1(lw QN( y- S'l d en C,2.
6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary):
fThI h ua Io a oC atioc -1. w o u.l of Lie_L Io bt i ( off o vi
AID fit. 6►l our prop-ev.(y -ro v- my -e x p'C c..k l p(a c )J, i "
a.v) d h-e.,v- iik s ba n.h a . ' i e house 11vou-1 of b �'P ro K. 7-oOs-r.
7. Attached Plans: Sketch Plan l I Site Plan Engineered/Surveyed Plans ❑
8. Has a Spe ial Permit/Variance/Finding ever been issued for/on the site?
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#um _
9 Does the site contain a brook, body of water or wetlands? NO DON'T KNOW I I YES
-0-
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained ❑ Obtained n , date issued:
(Form Continues On Other Side)
6/7/2023
10. Do any signs exist on the property? YES 1111 NO
IF YES, describe size, type and location:
Are there any proposed changes to or additions of signs intended for the property? YES 0 NO El
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
I
plan of development that will disturb over 1 acre? YES I NO V
IF YES, then a Northampton Storm Water Management Permit from the DPW is required.
12. ALL INFORMATION,p MUST� BE COMA PLETED, or PERMIT CAN BE DENIED DUE TO LACK OF INFORMATION
c-e ` �If aC kled 191 (- p! CtfrL
This column reserved for use
by the Building Dept.only.
EXISTING PROPOSED REQUIRED BY
ZONING
Lot Size i
Frontage
Setbacks Front
Side L: R: L: R: L: R:
Rear
Building Height
Building Square Footage
%Open Space:
(lot area minus building E
paved parking)
#of Parking Spaces
#of Loading Docks
Fill:
(volume Et location)
Driveway Grade %
13. Certification: I hereby certify that the information contained herein is true and accurate to the best of my knowledge.
Date: 3 5 2 Applicant's Signature
NOTE: Issuance of a zoning permit does not relieve an applicant's burden to com 1 'with all zoning requirements and
obtain all required permits from the oard of Health,Conservation Commission, 1 istorica Commission and Architectural
Boards, Department of Public Work and other applicable permit granting authorities.
6/7/2023
,
MORTGAGE LOAN INSPECTION
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I hereby report that the premises shown on this plan is not located within a Flood
Hazard Area as shown on Department of H.U.D. Federal Insurance Administration Maps,
Community Number 250167n0001A
Identif icat• = Date April 3, 1978
By: ��.-. ?anr.nIu i i •.a•
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