32C-341 (2) 10. Do any signs exist on the property? YES NO
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 column reserved
for use by the Building
Department
EXI[STING PROPOSED
Lot Size
Frontage
Setbacks Front
Side L: R: L: R:
Rear
f
Building Height
Building Square Footage
Open Space: (tot area
minus building Ft paved parking
#of Parking Spaces
#of Loading Docks
Fill:
(volume It location)
12. Certification: I hereby certify that the information contained herein is true and accurate to the best of
my knowledge.
Date: �' 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
i
I
i
File No.
M
r
- ,
w
MOR
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 Northampton
1. Name of Applicant: l�t,�(�,( ,C� c� i j/ 1`✓�
Address: � � (sL � �Jl c� Telephone:_ V � y � f /
2. Owner of Property:-4h2 2a
Address: Telephone:
5 + r-
3. Status of Applicant: Owner Contract Purchaser Lessee Other(explain)
4. Job Location: r0 LkJ"'S
. 5. Existing Use of Structure/Property:
6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary):
A
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 YES IF YES, date issued:
IF YES: Was the permit recorded at the 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 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)
1
P119
Date Filed n) 0 AUG 1 File No.
A
1
REGISTRATIOq O CCU ATION (§10.2 & 11_ 11)
WiTH �y k84 ing I spector
1_ Name of A plican (' j �
Address: ) Telephone: ^ S�
2_ Owner of Property: �� r
Address: Telephone:
3 . Status of Applicant: Owner Contract Purchaser Lessee
Other (explain: !n 6"ha -
4 . Parcel Identification: Map JA�e_Parcel
Zoning Districts (include overlays)
Street Address
5. Narrative Description of Proposed Home Office: (Use additional beets
if necessary) S j C' /'� r G2/7�
< Y:
1"
/ji A g)Yrr C! &r ( rer rY")
G. Is this a legal residential building. YE ' NO
7_ Will there be an employee/owner who doesn't live in the home YES 0
8. Will you ever see clients or customers at your site? YES O
How often
For what purposes
9. Will there be any signs for the Home Office? YES NO
10. Will there be any goods sold from the premises or any sale of
goods stored on premises, either retail or wholesale, or any
display of goods on premises? YES NO
11. Will there be any outdoor storage of materials? YES
12 . Will your use be totally within a building and not cause any
outward manifestation (including traffic generation, parkin
congestion, noise, air pollution, and materials storage) ? YES NO
If NO explain:
13 _ Attach Plans (if applicable)
14 . Certification: I hereby certify that the information contained herein
is true and accurate. I understand that if any information is incorrect,
my permit is null and void and I may be liable for non-criminal fines and
criminal and civil actions.
Date: � Applicant's Signatuzi�:
THIS SECTION FOR OFFICIAL USE ONLY:
Approved as presented/based on information presented
APPROVAL EXPIRES ON DECEMBER 31 OF THIS YEAR AND HUST THEN BE RENEWED
Denied as presented---Reason: -
Signature of Building Inspector Date
MOTE: t:suanoo of it pecmtt doe:not relieve an applicant's burden to comply with all zoning requirements and obtain all roquirod pormlts
from the Board of Hoatth,Conaorvatlon Commission, Dopamment of Public Works and ottior applicable pormit granting authorttlos.
File#MP-2005-0026
APPLICANT/CONTACT PERSON STEINER REBECCA
ADDRESS/PHONE 41 WILLIAMS ST 2RR (413)585-8255 Q
PROPERTY LOCATION 41 WILLIAMS ST
MAP 32C PARCEL 341 001 ZONE URC
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Buildina Permit Filled out
Fee Paid 77 —
Typeof Construction: HOME OFF/OCC REG-DESIGN
New Construction
Non Structural interior renovations
Addition to Existin¢
Accessory Structure -
Building Plans Included•
Owner/Statement or License
3 sets of Plans/Plot Plan
i THE F LOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INF ATION PRESENTED:
THE
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 Commis
Zoo
Signature of Building Official Date
Note:Issuance of a Zoning pernut 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.
;-4V 1AMS ST -- MP-2005-0026
COMMONWEALTH OF MASSACHUSETTS
CITY OF NORTHAMPTON
GIS#: 10259
Map:
Block: HOME
�L t 001--
Permit: HOME OFFICE/OCC_RE OFFICE/OCC REG
Category: Home Office/Occ Registrat
Permit# MP-2005-0026 PERMISSION IS HEREBY GRANTED TO:
Project# JS-2005-0210
r�Cost: Contractor: License:
Fee: $15.00 Homeowner as Contractor
#of Fixturesa Owner: WILLIAMS ST LAND TRUST
Applicant: STEINER REBECCA
AT. 41 WILLIAMS ST
ISSUED ON. 24-Aug-2004 AMENDED ON: EXPIRES ON: 01-Jan-2005
TO PERFORM THE FOLLOWING WORK.
HOME OFF/OCC REG-DESIGN
THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF
ANY OF ITS RULES AND REGULATIONS.
Signature:
Fee Type: Receipt No: Date Paid: Check No: Amount:
Home Office/Occ Registration REC-2005-000542 12-Aug-04 1517 $15.00
212 Main Street,Phone:(413)587-1240,Fax:(413)587-1272
GeoTMS®2004 Des Lauriers Municipal Solutions,Inc.