38B-183 (3) 10. Do any signs exist on the property? YES NO x
IF YES, describe size, type and location:
Are there any proposed changes to or additions of signs intended for the property? YES NO X
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 X
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 cohonn reserved
for use by the Building
Department
EXISTING PROPOSED REQUIRED BY •
' ZONING.
Lot Size
14,065 sq. ft. 14,065 sq. ft. (sam .
Frontage
145 feet 145 feet (same)
Setbacks Front 2 3 ('
Side L: R: L �`� R: : 2s S L . g
Rear `7 c�
Building Height '
'Building Square Footage
% Open Space: (lot area
minus building & paved ) __,�, /a.7�) '
parking l � ?i;., irk)
# of Parking Spaces
# of Loading Docks
Fill: h Jam ,, „ �
(volume location) � v� /1,U V./ i
13. Certification: I hereby certify that the information contained herein is true and accurate to the best of
my knowledge.
Date: g 3 2012 Applicant's Signature �/ ii ANu. -1-1-----1(QL
r .es Cohn " Ca H. Smith
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 :\DocumentsWFORMSbrigina \Building- 1nspectoriZoning- Permit - Application- passive.doc 8/4/2004
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APR ' 3 2012 •
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T Please type or prinf all information and return form to the S>axIdiizg
Inspector's Office with the $l5fllingfee (cheek or money or—
der) payable to the
City ofNorthampton .
1. Name of Applicant: CHART.RS M. C,f1T N and CATHERINE R. • SMTTA
Address: 226 Cooper Lane, Shelburne Falls, MA • Telephone: cell
2. •Owner of Property: Charles M. Cohn & Catherine H. Smith •
Address: 226 Copper Lane, Shelburne Falls, MA Telephone: cell .
3. Status of Applicant: Owner X Contract Purchaser Lessee Other (explain)
4. J Location: 27 Fort Street,. N
. Northampton `.
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5. Existing Use of Structure /Property: Vacant lot with two ex{ st ing r „rh r,tr� fns 7 i„
recent, permitted demolition of single family _ house and two 'separate garages.,.
6. Description of Proposed Use/Work/P.roject/Occupation: (Use additional sheets if necessary):
Request is made to•continue u - o .. , .•
' lots to accomodate'proposed one —way driveway as shown on attached Sketch
. .
7. Attached Plans: Sketch Plan X Site Plan Engineered /Surveyed Plans
• 8. Has a Special Permit/Variance/Finding ever been issued for /on the site?
NO X DONT KNOW YES_ - IF YES, date - issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO X DONT KNOW YES
W YES: enter Book Page and /or Document i¢
9.Does the site contain a brook, body of water or wetlands? NO X _ 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:
(Forte Continues On Other Side)
S/4J�(n 4
wAlaoauna�tslFORMSloriginall Building- Inapectorkzon g- Pemtit- Application-passivadoc
File # MP- 2012 -0098
APPLICANT /CONTACT PERSON ANDREWS ROBERT G & BESSIE 0 C/0 CHARLES M COHN
ADDRESS/PHONE 226 COOPER LN
PROPERTY LOCATION 27 FORT ST
MAP 38B PARCEL 183 001 ZONE URB(100)/
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid ( 6, 5 4 0 / 75 —
Building Permit Filled out
Fee Paid
Typeof Construction: ZPA - CONTINUED USE OF 2 CURB CUTS & SFH
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
INFORMATION PRES ATED:
Approved IVAdditional 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: § 3S0 — 9. 3 (A) (
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
(OP I Ali 2-
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.