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32A-185 (3) 10. Do any signs exist on the property? YES NO � � /14f S �1T� . IF YES, describe size, type and location: ' t�J � � 0)1'4;1 Lb H t) 1 i Are there any proposed changes to or additions of signs intended for the property? YES NO IF YES, describe size, type and location: 1 1 . Will the construction activity disturb (clearing, grading, excavation, or filling) ove cre or is it part of a common plan of development that will disturb over 1 acre? YES NO i 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 REQUIRED BY ZONING Lot Size (/ 6 Frontage l (2 �J Setbacks Front 0 Side L:16 R: /64 L: R: L: R: Rear 3 ' Building Height j V Building Square Footage `� j � % Open Space: (lot area minus building Et paved 3 / 3 parking J # of Parking Spaces / # of Loading Docks (P 6 Fill: (volume Et location) 0 13. Certification: I hereby certify that the information contained hefein is true and acc to to the best of my knowledge. /` Applicant's Signature ' .1/ 1/ /e" e. °'/ - I c NOTE: Issuance of a zoning permit does no • • . app�icant's,b`urde,,n o mply with all zoning requirements and obtain all required permits from the Board of H , Conservation Commission, Historic and Architectural Boards, Department of Public Works and other applicable permit granting authorities. W:\ Documents\ FORMS\ original\ Building- Inspector\Zoning- Pemtit- Application- passive.doc 8/4/2004 k 'yI - 1 2012 �.� File No. r� - 13'� DE T 'OF l�ulunn • o � �, - ,- . .I.NG PE. ' 11 17A.PPLIC TION ( 1o Please type or print all information and return this form to the Building Inspector's Office with the $15 filing fee (check or money order) payable to the City of Northapton 1. Name of Applican . N 1 0 9 _ I ✓ / Li) Address:_ / //Z 01 /h'e / /? Telephone: b/ U 6 2. Owner of Property: ,4 `� / �J�949 , 9 , 1 r L E A '. ddress: db, : a/0 ► ,7 3. Status of Applicant: Owner Contract Purchaser Lesse Other (explain) 4. Job Location: f al ✓- /L1 1 / /5(2/ 6I �G Parcel Id Zonin Map# Parcel# Distric °In Elm. Street' Distri In CentraL;Bu (TO" BE FILLED IN BY,THE:BUILDING. DEPARTMENT y-- � ) 5. Existing Use of Structure /Property: /IA (. jq ma/ 5 /4/9 mac' /Wo rii J 'i2t6 6. Description of Proposed Use /Work /Project /Occupation: (Use additional sheets if necessary): V iH Sf ■ /i D r te-- g 7 Fatter 57 ✓tf ji, • r?(zap / eACTV 4) q 6,/, ///g- 040/ ' l � / Uf/ /6 7 01-l(e0 c q POiVie0y 7w/4- 7. Attached Plans: Sketch Plan Site Plan Engineered /Surveyed Plans 8. Has a Special Permit /Variance /Finding ever been issued for /on the site? NO DONT KNOW r/ YES IF YES, date issued: IF YES: Was the permit recorded at t he Registry of Deeds? NO DONT KNOW /� / YES IF YES: enter Book Page and /or Document # 9.Does the site contain a brook, body of water or wetlands? NO 1-° D)N'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 File # MP- 2013 -0055 APPLICANT /CONTACT PERSON FITZGERALD HAROLD R ADDRESS/PHONE 37 MARY JANE LANE (413) 586 -2529 0 PROPERTY LOCATION 87 BRIDGE ST - SHAW'S MAP 32A PARCEL 185 001 ZONE URC(100)/ ' THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out T 49 ( f) Fee Paid `-' Typeof Construction: ZPA - DEMO SHAW'S MOTEL & ALL PROPERTY ON SAME LOT (7 & 9 POMEROY TERR) New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/ Statement or License 3 sets of Plans 1 Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFORMATION PRESENTED: Approved 1/ 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: ? f,, {,kI1a 'CLAq ftE ill © \CA's 6 d'tv+ "&i d C') 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.