32C-224 (12) 10. Do any signs exist on the property? YES NO V
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:
11 . ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE DENIED DUE TO
LACK OF INFORMATION.
This col— to be filled in
by the Building Department
Required
Existing Proposed By Zoning
Lot size
Frontage 62,
Setbacks - fmnt 727
- side L:0� R: L: R:
- rear p
Building height
Bldg Square footage
%Open Space:
'(Lot area minus bldg
&paved parking)
# of Parking spaces
t
x
# of Loading Docks
Fill:
(volume & location)
13 . Certification: I hereby certify that the information contained herein
is true and accurate to the best of my knowledge. j
DATE: �
APPLICANT's SIGNATURE
NOTE: leaua ce a �n g -✓ I
permit does not relieve an pli nt's b en to ply with all
zoning requirements and obtain all required permits from the Board of Ith, Conservation
Commission, Department of Public Works and other applicable permit OpAnting authorities.
FILE #
1`
File No.
DEPT OF BUIL D lNG INSPECTIONS
NORTHAMPTON MA 0106Q
ZONING PERMIT APPLICATION (§10 .
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant: CVIQY�f� Wa r LL
Address: 6 9 acoo "P m -d>/Z • Telephone:
2. Owner of Property: � ,c/
6�'��r�-X>
Address: As e*-< ,y-4 9"006_)— Telephone:64-e/3,/
3. Status of Applicant: V Owner Contract Purchaser Lessee
Other(explain): 1
4. Street Address: :f p h0(g/L1,,YdZ
Parcel Id: Zoning Map# Parcel# District(s):
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/Property �Sr6/Z/�fi'�
6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary):
7. Attached Plans: Sketch Plan Site Plan Engineered/Surveyed Plans
Answers to the following 2 questions may be obtained by checking with the Building Dept or Planning Department Files.
8. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO----V-'
O DON'T 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#
S. Does the site contain a brook,body of water or wetlands? NO V DON'T KNOW YES
t
{
`,AF"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
APPLICANT/CONTACT PERSO .
ADDRESS/PHONE: _ O�
PROPERTY LOCATION:
MAP ` PARCEL: ZONE
THIS SECTION FOR.�OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DA
RiiildinZ Permit Filled alit
EP-P Enid
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION:
Approved as presented/based on information presented
Denied as presented:
Special Permit and/or Site Plan Required under:§
PLANNING BOARD ZONING BOARD
Received&Recorded at Registry of Deeds Proof Enclosed
Finding Required under:§ w/ZONING BOARD OF APPEALS
Received&Recorded at Registry of Deeds Proof Enclosed
/Variance Required under: w/ZONING BOARD OF APPEALS
Received&Recorded at Registry of Deeds Proof Enclosed
Other Permits Required:
Curb Cut from DPW Water Availability Sewer Availability
Septic Approval-Bd of Health Well Water Potability-Bd Health
ermit Co rvation Commission
ignahue g ector a
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, Department of Public Works and other applicable permit granting authorities.