25C-095 (38) 9. ALL INFORMATION MUST BE COMPLETED: 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 NIA NIA NIA
Front:
Setbacks: / r Q
Side: L• R: / L: Rz /
Rear:
Height
% Open Space:
(Lot area minus bldg and
Paved parking)
10. 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 permit does not relieve an applicant's burden to comply with all zoning requirements
and obtain all required permits from the Conservation Commission, Department of Public Works and other
applicable permit granting authorities.
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Massachusetts _
g DEPARTMENT OF BUILDING INSPECTIONS ;
212 Main Street • Municipal Building
Northampton, MA 01060
INSPECTOR
ACCESSORY STRUCTURE PERMIT APPLICATION
(For freestanding structures less than 200 sq. ft., at least 5 feet from any other structure)
Permit Fee: $25.00 Check
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant: DA Q+Q 4- WELL L -e N81AITO"
Address: 2/1 1V 0 R 14 e f°FT UP-) _ T- Telephone: q 1 71 SI,5 Q 12 4
2. Owner of Property: 1)jz u t1l + I F'W c.'Lf Lp 1
Address: KT' zTp-r- T 4�)W Telephone: �✓ `" '
3. Status of Applicant: Owner Contractor
4. Structure Location: O,!. /2c(/ /L/IV��'/2 L-b
Parcel ID: Zoning Map# Parcel# District(s) 3
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
/
5. Use of Property: ,/Single oo Two Family: Multifamily:_ commercial:
6. Description of Proposed Structure: WwY A►
One Story Shed under 200 sq.ft.: Freestanding De vV
Other(describe):
7. Attached Plans: Sketch Plan X Site Plan
8. Does the site contain a brook, body of water or wetlands? NO DON'i
IF YES: Has a permit been,or need to be, obtained from the Conservation Commission?
Needs to be obtained Obtained , Date issued
CONTINUED ON NEXT PAGE
File#MP-2015-0008
APPLICANT/CONTACT PERSON NEWTON DAVID&WENDY
ADDRESS/PHONE 211 NORTH ST#5 (413)585-0127 Q
PROPERTY LOCATION 211 NORTH ST-UNIT 5
MAP 25C PARCEL 095 005 ZONE URB
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out rzaa
Fee Paid
Typeof Construction: ZPA-SHED
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: §
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
Signa re 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.
211 NORTH ST - UNIT 5 MP-2015-0008
COMMONWEALTH OF MASSACHUSETTS
_ CITY OF NORTHAMPTON
GIS# 11946
Map. 25C
Block:, ZONING PERMIT
Lot: 005
Permit: ZONING PERMITAPPLI yl���.,,, APPLICATION PERMIT
Category: shed
Permit# MP-2015=0008 PERMISSION IS HEREBY GRANTED TO:
Project# JS-2015-0.00156
Est.Cost: Contractor: License: Expires:
Fee Charged:$50:00 Homeowner as Contractor
Balance Due:$.00 Owner: NEWTON DAVID&WENDY
of Fixtures J Applicant., NEWTON DAVID&WENDY
DigSafe# 'A T: 211 NORTH ST-UNIT 5
UseGroup -
�ConstClass
ISSUED ON: 25-Jul-2014 AMENDED ON: EXPIRES ON:
TO PERFORM THE FOLLOWING WORK:
ZPA-SHED
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:
shed REC-2015-000317 23-Jul-14 792 $50.00
212 Main Street,Phone:(413)587-1240,Fax:(413)587-1272,Email:Ihasbrouck @ northamptonma.gov
GcoTMS®2014 Des Lauriers Municipal Solutions,Inc.
211 NORTH ST - UNIT 5 MP-2015-0008
COMMONWEALTH OF MASSACHUSETTS
CITY OF NORTHAMPTON
GIS#: 11946
Map: 25C ------ -- >h
Block:— 095 - -
Lot: ONING PERMIT
,,..
Permit: ZONING PERMIT APPL "` APPLICATION PERMIT
Category: shed
Permit# � MP-2015-0008 �-_-_�
Project# JS-2015-000056 PERMISSION IS HEREBY GRANTED TO:
Est.Cost: Contractor: License: Expires:
Fee Charged:$50.00 Homeowner as Contractor
Balance Due:$.00 Owner: NEWTON DAVID&WENDY
#of Fixtures Applicant: NEWTON DAVID&WENDY
DigSafe# AT. 211 NORTH ST-UNIT 5
UseGroup
ConstClass
ISSUED ON.• 25-Jul-2014 AMENDED ON. EXPIRES ON:
TO PERFORM THE FOLLOWING WORK:
ZPA-SHED
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:
shed REC-2015-000317 23-Jul-14 792 $50.00
212 Main Street,Phone:(413)587-1240,Fax:(413)587-1272,Email:Ihasbrouck @ northamptonma.gov
GeoTMS®2014 Des Lauriers Municipal Solutions,Inc.