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PermitApplication_Frank Newhall Look Park Board of TrusteesPermit Application Todav's Date- 12/03/2010 Owner Applicant Frank Newhall Look Park Board of Trustees Frank Newhall Look Park Board of Trustees 300 North Main Street 300 North Main Street Florence, Massachusetts 01062 Florence, Massachusetts 01062 413 -584 -5457 rellerbrookI@comcast.net City of Northampton department: Yes Work Location Information How many lots involved in the project: 1 Map / Block Lots of all lots in project: 16A- 002 -001 Deed Book of all lots in project: 1416/194, 1745/309, 940/262, 1047/187 Project work address: 300 North Main Street City / State / Zip: Florence 01062 Zoning District: none Application for following Permit Types ❑ Planning Bd. Special Permit w/ Site Plan ❑ Planning Bd. Special Permit w/ MAJOR Site Plan NO Special Permit ❑ Planning Bd. Major Site Plan Approval (No Special Permit), including 40R projects ❑ Subdivision Preliminary ❑ Planning Bd. Special Permit w/ Site Plan for flag lots ❑ Planning Bd. Site Plan (NO Special Permit) ❑ Approval Not Required Plans ❑ Subdivision Definitive with Preliminary Approved ❑ Subdivision Definitive with no Preliminary Approved ❑ Zoning Board Special Permit ❑ Appeal of Building Commissioner - Zoning ❑ Variance ❑ Historic District (Elm St) Determination of Appropriateness ❑X Wetlands Notice of Intent IF state wetlands ❑ Wetlands Request for Determination OR Resource Delineation ❑ Wetlands Certificate of Compliance reauest ❑ Subdivision Definitive Amendment ❑ Zoning Board Finding ❑ Comprehensive Permit (40B) ❑ Demolition (Demolition Delav) ❑ Central Business Architecture ❑ Wetlands Notice of Intent IF ONLY local wetlands ❑ Wetlands Amendment or extension 210 Main St., Rm. 11, City Hall, Northampton, MA 01060 (413) 587 -1262 Fee Information Total Fee Amount: Existing Use park Planned Use dredging Willow Pond. See NOI for additional description Detailed Project Information Wetlands Description: see NOI hardcopy Files Uploaded: $0.00 By typing my name in the signature box, I certify that all the information above is accurate to the best of my knowledge, I am the property owner or have permission from the property owner to apply for this permit. I also grant permission to the City of Northampton to inspect the proposed work Signature: Anthony Zerilli Date Signed: 12/03/2010 210 Main St., Rm. 11, City Hall, Northampton, MA 01060 (413) 587 -1262