36-086 (8) JAN 1 6 2004
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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:_4:
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
EXISTING PROPOSED REQUIRED BY
ZONING
Lot Size
J°I QQQ IS F 3c1 0M 'S F 30 00
Frontage ,
Setbacks Front l l-+, 9a�
Side L: l y(p� R: 161 L: X33, R:d0' L: Z° R:
Rear dp` 30 YO
Building Height
Building Square Footage
x000 5� a��0•s S F
%Open Space: (lot area
minus building Et paved parking
#of Parking Spaces
#of Loading Docks /
Fitt:
(volume It location) N011-- for s� �,c lr\.Syk\k0&
12. Certification: I hereby certify that the information contained herein is true and accurate to the best of
my knowledge.
Date: / Applicant's Signature 11 /&
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.&A
ZONING PERMIT APPLICATION (§10.2)
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 oMorthampton
1. Name of Applicant: Swo 'm� "o V
Address:_ i 7A, U4 Telephone: y I 1�b
2. Owner of Property:--��bc_'(--�-
Address: �I`j �l�i�fi c Telephone: q 15 `,�W10 D_R05
3. Status of Applicant: Owner '1� Contract Purchaser Lessee Other(explain)
4. Job Location: AM\ CG lO(Qp
Parcel Id: Zoning Map# Parcel# W District(s): L>
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 Propos Use/Work/Project/Occupation: (Us additional sheets if necessary):
po-�
�{ U4VOLek _ WA\ aAiuC,h 0 U�/ C, IQQ S r� 1kC eS"
e f C�c�vewa O.r\d Ir-a�nc�SCO�Q2
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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 A DONT 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#
9. Does the site contain a brook, body of water or wetlands? NO X 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-2004-0076
APPLICANT/CONTACT PERSON HOYE SEAN
ADDRESS/PHONE 41 SOUTH ST#42 (413)563-9903 Q
PROPERTY LOCATION 195 WESTHAMPTON RD
MAP 36 PARCEL 086 001 ZONE SR
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM ILLED OUT , i CLL
�- otrariu Div
Building Permit Filled out
Fee Paid
T_ypeof Construction: ZPA-DEMO EXISTING HOUSE&REBUILD W/ATT GARAGE&ACCESSORY
APARTMENT
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
INF ATION PRESENTED:
roved 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
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.
195 WESTHAMPTON RD MP-2004-0076
COMMONWEALTH OF MASSACHUSETTS
CITY OF NORTHAMPTON
GIS# 7172
Map: 36
Block: _N6 ZONING PERMIT
'Lot: 001
Pet: �z°N�NG PERMIT APPS APPLICATION PERMIT
Category: Zoning Permit
Permit# NIP-2-2004-0076 _ PERMISSIONIS HEREBY GRANTED TO:
# �M - 0
'Project# 'JS-2004-1079
Est. Cost: $0.00 Contractor: License:
Fee: $15.00 Homeowner as Contractor
#of Fixtures: (Owner: CRAFTS ROBERT W
Applicant: HOYE SEAN
AT., 195 WESTHAMPTON RD
ISSUED ON: 20-Jan-2004 AMENDED ON: EXPIRES ON.
TO PERFORM THE FOLLOWING WORK:
ZPA-DEMO EXISTING HOUSE&REBUILD W/ATT GARAGE&ACCESSORY APARTMENT
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:
Zoning Permit Application REC-2004-002070 14-Jan-04 2668 $15.00
212 Main Street,Phone:(413)587-1240,Fax:(413)587-1272
GeoTMS®2004 Des Lauriers Municipal Solutions,Inc.