35-050 City. of Northampton •
` RECEIV -_
Massachusetts � ' .
r { ,- 0 • 9 .1EPI RT10ONT OF BUILDING INSPECTIONS • ?,,,k i ¢t r
'� ' 212 Mai i Street • Municipal Building C ' .
=r tea )rthampton, MA 01060
L INSPECTOR pEPx NORTHAMPTON. MA 01080
ACCESSORY STRUCTURE PERMIT APPLICATION
(For freestanding structures less than 200 sq. ft., at least 5 feet from any other structure)
Permit Fee: $25.00 Check # 3 ) t(�
o p l
PLEA E TYPE OR PRINT ALL INFORMATION
1. Name of Applicant: I UN F.
a
f
Address: / 1 v i �M. Telephone: ` / J o� - (��
2. Owner of Property: : � / 1 I �! /� � 'L�
Address: G� G Telephone: 13 - 7(37 - e• /
3. Status of Applicant Owner Contractor
4. Structure Location: !3t'
yzAri-
Parcel ID: Zoning Map # Parcel # District(s)
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Use of Property: Single or Two Family: V
Multifamily: Commercial: ,
6. Description of Proposed Structure / :
Shed under 200 sq. ft. (/ Freestanding Deck under 200 sq. ft. Other (describe)
/ ) /�
7. Attached Plans: Sketch Plan Site Plan Plot Plan 1
8. Does the site contain a brook, body of water or wetlands? NO k 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
CONTINUED ON NEXT PAGE
File # MP- 2012 -0046
APPLICANT /CONTACT PERSON JONES MICHAEL E
ADDRESS/PHONE 966 RYAN RD (413) 727 -8669 0
PROPERTY LOCATION 966 RYAN RD
MAP 35 PARCEL 050 001 ZONE SR(100) //WSP II
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT Lg�
Fee Paid
Building Permit Filled out
Fee Paid
Typeof Construction: _ZPA - 10 X 16 SHED
New Construction
Non Structural interior renovations
Addition to Existing
Accessory 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
INFO ATION 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 of MGL 40A. Contact the Office of
Planning & Development for more information.