23D-114 File # MP- 2012 -0005
APPLICANT /CONTACT PERSON VITOLS ELSA C
ADDRESS/PHONE 216 FEDERAL ST
PROPERTY LOCATION 216 FEDERAL ST
MAP 23D PARCEL 114 001 ZONE URB(100)//
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZON ING FORM FILLED OUT
Fee Paid .Qd 19T - 7 - 77-
Building Permit Filled out
Fee Paid
Typeof Construction: Zoning Permit Application
New Construction
Non Structural interior renovations
Addition to Existing
Accesso1y Structure
Building Plans Included:
Owner/ Statement or License
3 sets of Plans / 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
f 7 / 1 5 - A
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 the Office of
Planning & Development for more information.
File No.
Please type or print all information an re u hits form t e Building
Inspector's Office with the $15filingfee (c c o r) ayable to the
CityofNorth � HAMP'rON�'0106°
1. Name of Applicant: Vi 110L
Address: 021 G -DeR A L S - r FLag6M_& �p q � elephone: r3 S Y
2. • Owner of Property: 4 -74 -5 ,4 V1 7 T 0 L 5
Address: o2 /(D /GI�,�E/e�L ,�TT G12,4l�CEr ,nn Telephone /
3. Status of Applicant: Owner_ Contract Purchaser Lessee Other (explain)
4. Job Location /ls MA 4 /210/4 Z.
azrw' y
pi1�C @M�f(JCaCe� , e ctl�s.
;�n�m 5tbl �i °+rat a3tlsss ��
5. Existing Use of Structure /Property: 67A iR A 6 6
6. Des iption of Proposed Use /Work /Project /Occupation: (Use additional sheets if necessary):
z ONU & gmoo ?" /N& r Pouu �f `t �R�S T cuA tL J 1A' C4 4�V C(d P'?
(� u�TS f�lZ M &a BAcnG.[ 6ytg1 �O- 0 N$ui e,u 6-11A 6L F04-
IAJS I 1=1.0d R, COAAAd C Z: 1800 & LO / n < fe rnES H
7. Attached Plans: Sketch Plan Site Plan V Engineered /Surveyed Plans
8. Has a Special Permit /Variance /Finding ever been issued for /on the site?
NO ✓ DONT 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 #
9.Does the site contain a brook, body of water or wetlands? NO ✓ 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
ti..
10. Do any signs exist on the property? - YES.. NO ✓
IF YES, describe size, type and loh
(r
a
Are there any proposed changes to or additions of signs intended for the property? YES NO
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 V
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 ..REQUIREDBY
�( ZONMG
Lot Size
Frontage r
[ oil NO Okovl''e
Setbacks Front 4�*' loo q 5 '
Side L: T i R: 10C L: / U ` R: (1 d L: R:
Rear 4 7
Building Height i S a I
Building Square Footage
,
% Open Space: (lot area (_
minus building & paved f) ? /U // G� 0
p arkin g
# of Parking Spaces
# of Loading Docks
v �
Fill:
(volume & location) _
13. Certification: I hereby certify that the information contained herein is true and accurate to the best of
my knowledge.
Date: 7 Applicant's Signatur
NOTE: Issuance of a zoning permit does not relieve an applicant's burden to comply with all zoning
requirements and obtain all required permits from the Board of Health, Conservation Commission,
Historic and Architectural Boards, Department of Public Works and other applicable permit granting
authorities.
W:\Documents\ FORMS\ original \Building- Inspector\Zoning- Permit- Application- passive.doc 8/4/2004
' to
x
It
a t
0
N A CD
x
N �
24.00' ro o
g' o
10Z L
cT
ro
0
0
9.00 '
w
� N
Q+ J
CD
`v.
98'
Gladstone Ave
/�,.,
�, ,
-� f� i"h Y; £ r- � Y �C�
,,,��
g
9'
G ALVIN Q S MAS
AND CONSTRUCTION
41 3.253.6585
AMHERST, MA
Proposal — Elsa's Home — Garage
• Remove old garage
• Dispose at landfill
• Remove old footings and concrete floor
• Excavate the ground for garage 24' x 24'
• Pour new concrete footings
• Pour 4' frost wall
• Install anchor bolts in new concrete for silplate
• Back -fill garage and haul in gravel for inside floor
• Compact inside
• Pour new concrete floor 5" thick with wire mesh
Cost: $11, 300
;rs
� vz
y 5 31Y
vow
,
•$ Y
a ddyy �
r
• fi � �k � �'�.
�o-
ti
^� • '� g bh. -. - ._. gg �:. k .t 7 t�:`L 1�
P1'y�"J' :;i `€'Y �• {. i - i
t
iv
, yam • f. q r a {f� 1 '��' I T N.` �� 4yr,
`+
AV I
- g,« I It`_ y { .•�- L �..� `n + . �: Iy ++� y '�� € � i rte FI�r yy ,gyp .0
* t a
,
�' � � � '° �si *. ♦' rs a, sy� y' � ° Asti ,�r ` ° ,i:
if , a r + t€ e. �•
J . l
i T4
ff
_ ✓ � Yf� ..Ir d � 3 �r '. e4 �Ji /ti �� I Q + . N f ` r V �:. y 4 ,�� is 'a�i ,J
1!
1 � 0.1 % � r � _ r, � •� �'� }� � r � 4 ,
t s