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4
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 It 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 to be filled in
by the Building Department
EXISTING PROPOSED REQUIRED BY
ZONING
Lot Size
Frontage
Setbacks Front
Side L• R• L• R• k' L• R:
Rear ��,U v
Building Height
Building Square Footage
% Open Space: (lot area
minus building&paved parking N- � �CD
( `(' iJ
#of Parking Spaces
q N`
#of Loading Docks
Fill:
(volume& location)
12. Certification: I hereby certify that the information contained erein is flue an accurate t the best of my knowledge.
Date: Applicant's Signature ! R .
NOTE: Issuance of a zoning permit does not relieve an applicant's burden comply with all zoning requirements and obtain ow,*,
all required permits from the Board of Health, Conservation Commission, Historic and Architectural Boards, _
Department of Public Works and other applicable permit granting authorities.
d � � l�
MAY 9- 200p File No.
k
nEsr or BF,, G PERMIT APPLICATION (§10.2)
Please type or print all information and return this form to the Building Inspector's Office with the
$10. filing fee (check or money order) payable to the City of Northampton
{
n
1. Name of Applicant:
Address: /0 1-1 E r E I Telephone:
2. Owner of Property:
Address: �(�%Y�-2 Telephone:_
3. Status of Applica : Owner ,'�, Contract Purchaser / Lessee Other(explain)
4. Job Location: (t) -- If(. /�
Parcel Id: Zoning Map# 5 C Parcel# .3 -71 31 District(s): (/
In Elm Street District In Central Business District
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/Property (J
6. Descripti Qn of Proposed Use/Work/Project/Occupation: (Use additional she is if necessary): r
RC9UESL/V6 r)E�f.",�} r,jn) �b �d S6-C6/u, 45 T L'�f C,z zp- C/U QN : l rC/4 �(
R"f( If NG /dc, X RAfhF TlHti t�ti 6 4 � 7�v.4! f>I
2 -(IZ6N� o ��U ��x S �t; r+.r:_ iG J J� (C SFA£ 1i 3
7. Attached Plans: Sketch Plan Site Plan 1,� Engineered/Surveyed Plans
8. Has a Special Pe tfYariance/Finding 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 DON'T KNOW YES
IF YES: enter Book Page and/or Document#
9. Does the si e ccontai4ii brook,body of water or wetlands? NO DON'T KNOW YES _
IF YES,has a permit been or need to be obtained from the Conservation Commission? V;
Needs to be obtained Obtained date issued:
(Form Continues On Other Side)
File#MP-2000-0167
APPLICANT/CONTACT PERSON David McCutcheon
ADDAESS/PHONE 12 TURKEY HILL RD (413)529-9973
PROPERTY LOCATION NORTHERN AVE
MAP 25C PARCEL 017 ZONE URB
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM ILLED OUT
Fee a� e
Building Permit Filled out
Fee Paid
Typeof Construction:_REQUEST A 2ND CURB CUT
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:
Approved as presented/based on information presented.
Denied as presented:
co 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 Board of Health Well Water Potability Board of Health
Permit from Conservation Commission Permit from CB Architecture Committee
Signature of Building Wficial 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.