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29-030 (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 y 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 ✓ 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 O Frontage Setbacks Front Side L. R: C: R: L: R: Rear Building Height D Building Square Footage %Open Space: (lot area minus building &paved Parking #of Parking Spaces #of Loading Docks G Fill: (volume&location) 13. Certification: I hereby certify that the information contained herein is true and accurate to the best of my.knowledge. Date: � 5- I - Applicant's SignaturQ' 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:\Documents\FORMS\original\Building-Inspector\Zoning Permit-Applicalion passive.doc 8/4/2004 �i ( - U: CLr4 , E;ec,;; _ ----___ I File No. PERMIT APPICA TION:�.�10 2).: :.. :.•:.:' Please type or print all information and return this form to the Building Inspector's Office with the $15filingfee (check or money or der)payable to the (I City ofNorthamp ton 1.. Name of Applicant:J U Address: eOQ Telephone:11!3 2. Owner of Property: go U A/ Address: -,/ �dlc� Telephone: x//51 03�5--/677 3. Status of Applicant: Owner N Contract Purchaser Lessee Other (explain) 4. Job Location:-C?gz/ Parcel Id: ' Zbhing Map# Parcel# District(s): In Elm Street-District - In'Central Business District TO BE:FILLED IN BY-THE BUILbING DEPARTMENT) . 5. Existing Use of Structure/Property: ��N�'1 r�� 1 i vl 6 roz dN1 6. De cription of Proposed Use/Work/ProJect/Occupation: (Use additional sheets if necessary) % MLOP ot,!S� S / om a. -L o �' L Aa- no pie- Iq dr6�/l 1;A;iA pel, W e e k 4, ©O-e Z!l L l &Peso �-Gt-/�'L 'J• d .yL . o t� cis / l2�' _ /`?i�d� l� lG 7. Att hed Plans: Sketch Plan Site Plan Engineered/Surveyed Plans S. Has a Special Perm ft/Varia nce/Fin ding ever been issued for/on the site? NO DON'T KNOW YES IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO Z DON'T KNOW YES IF YES: enter Book Page and/or Document# 9.Does the site contain a brook, body of water or wetlands? NO _ e! 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) W:\Documents\FORV2 original�Building-Inspector�Zoning-Permit-Application-passive.doc 8/4/2004 File#MP-2014-0068 APPLICANT/CONTACT PERSON CHEA ROEUN&SOVANNARY ADDRESS/PHONE 284 RYAN RD (413) 835-1085 Q PROPERTY LOCATION 284 RYAN RD MAP 29 PARCEL 030 001 ZONE THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out Fee Paid Typeof Construction: ZPA-NAIL SALON 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: § 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: § 7 5O 2"1 1 .j S ' V 2 �Nd r�r� �� `'7 TC 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 3 (3 i• . 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.