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10. Do any signs exist on the property? YES NO 1Z '
IF YES, describe size, type and location:
Are there any proposed changes to or additions of signs intended for the property? YES �� NO
IF YES, describe size, type and location: t s - _-
t--_ _ __ ✓_ _ a ..--. ;__ - _ -� __.,_ -— vim.%.=-_.--�-- _ �
11. ALL INFQRMATION 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 J1
Lot Size �. � �, /��• � I`
Frontage
Setbacks Front
Side L: ,' R: ✓" L.. . R: J p L: R:
Rear I
5Z)f 6
Building Height
Building Square Footage -
Open Space: (lot area
minus building 8 paved parking
# of Parking Spaces
# of Loading Docks
Fill:
(volume Et location)
12. Certification: l hereby certify that the information contained herein is true and accurate to the best of
my knowledge.
Date: � _ �, 2-,12-0 Applicant's Signature
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.
OOO.pdf
File No.
PJIT APPLICATION
1 '�rat all information and return this form to the Building
pector's Office ,tt' the$5.filing fee (check or money order)payable to the
J U N - 9 2004 City of Northamp ton
IA4 ��A,
S
N,n_,R?N,S
ress: Telephone: ,5�i3 -Ja r�%/L 3o zzxe
2. Owner of Property: A
Address: Telephone: -58 DZ o2-fit S��- �l co-O
3. Status of Applicant: Owner Contract Purchaser Lessee V Other (explain)
4. Job Location:� 3 �L �i—�J .t
Parcel Id: Zoning Map# Parcel# District(s):
In Elm Street District In Central Business,District
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/Property:
6. Description of Proposed se/Workjec Occupat (Use addit�heets i necessary):
�3A
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 DON'T KNOW YES 1/ IF YES, date issued:
IF YES: Was he permit recorded at the Registry of Deeds?
NO DON'T KNOW N O YES
IF YES: enter Book Page and/or Document#
9. Does the site contain a brook, body of water or wetlands? NO DONT 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)
File#MP-2004-0175
APPLICANT/CONTACT PERSON JONES JUDY
ADDRESS/PHONE 63 CENTRAL PARK DR (413)538-8912 Q ,J'30 -a -2 /g
PROPERTY LOCATION 332 PLEASANT ST
MAP 32C PARCEL 179' 001 ZONE GB
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ONING FORM F LED OUT
ee ai
Building Permit Filled out
Fee Paid
T_ypeof Construction:_ZPA-TRAILER,TABLES, STORAGE SHED&BBQ PIT
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 PRESENTED:
Approved Additional permits required(see below)
PLANNING BOARD PERMIT REQUIRED UNDER: § o 2-,
Intermediate Project: Site Plan AND/OR Special Permit with Site Plan %9 `
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 Commis ' n
60 Lo0`'
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.