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18D-055 (12) 10. Do any signs exist on the property? YES NO IF YES, describe size, ty e and location: D r7 C� j� \ - - i l 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)overt 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 Frontage Setbacks Front Side L: R: L: R: L: R: Rear Building Height Building Square Footage Open Space: (lot area minus building Et paved parking #of Parking Spaces #of Loading Docks Fill: (volume Et location) 13. Certification: I hereby certify that the information contained herein is true and accurate to the best of my knowledge. Date: (93-23-- 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. W ADocuments\FORMS\original\Building-InspectorVoning-Permit-Application-passive.doc 8/4/2004 THIS FORM IS PART OF THE SIGN PERMIT APPLICATION �� File No. lap—15 252015 !1` ZONING PERMIT APPLICATION Electric, Piu;Z PLEASE TYPE OR PRINT ALL INFORMATION NorthamptonMg07p6E f1Ons 1. a nt: W Address: ` e-e^Lc' ;4e$ `t> Telephone: 2. Owner of Property: M fi tT fil)EV Address: � ��s I� �SI��ephone: / j - 23 6 [ 3. Status of Applicant: Owner Contract Purchaser 'Lessee ^Other(explain): 4. Job Location:I qj �t Parcel ID: Zoning Map# Parcel# District(s) (TO BE FILLED IN BY THE BUILDING DEPARTMENT) 5. Existing Use of Structure/Property: b 1- l ''- UNS-<:f— 6. Description of Proposed UseNVork/Project/Occupation:(Use additional sheets if necessary) 7. Attached Plans: Sketch Plan Site Plan Engineered/Surveyed Plans 8. Has a Speci I Permit/Variance/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 site contain a 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? Needs to be obtained Obtained ,Date issued 10. Do any signs exist on the property? YES ✓ NO IF YES: Describe the size,type and location: U ��� �'✓`~' Are there any proposed changes to,or additions of,signs intended for the property? YES/'U,-"- , NO IF YES: Describe the size,type and location: dzi-21W Page 2of3 File#MP-2015-0068 APPLICANT/CONTACT PERSON BEWRY OWEN ADDRESS/PHONE 38 GREENLEAVES DR (413)387-0600 Q PROPERTY LOCATION 141 D DAMON RD MAP 1813 PARCEL 055 001 ZONE GB(100)/URA(0)/ THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Buildinp,Permit Filled out Fee Paid Typeof Construction: ZPA-SERVICE ON SUNDAYS&BIBLE STUDIES ONCE A WEEK New Construction Non Structural interior renovations Addition to Existing AccessoKy 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: tfjApproved 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 '7 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. 141D DAMON RD MP-2015-0068 COMMONWEALTH OF MASSACHUSETTS CITY OF NORTHAMPTON GIS 8953 �Map�, 18D _ Block _ 055 Lot: 001 ,. ZONING PERMIT Permit: ZONING PERMIT APPLI APPLICATION PERMIT Category: Zoning Permit Permit# MP-2015-006$ PERMISSION IS HEREBY GRANTED TO: Project# JS-2015.001729 Est. Cost: Contractor: License: Expires: Fee Charged:$15.00 Homeowner as Contractor Balance Due.$,00 Owner: BOYLE RICHARD R #of Fixtures Applicant: BEWRY OWEN DigSafe# AT: 141D DAMON RD UseGroup ConstClass ISSUED ON: 06-Apr-2015 AMENDED ON.• EXPIRES ON.• TO PERFORM THE FOLLOWING WORK: ZPA-SERVICE ON SUNDAYS&BIBLE STUDIES ONCE A WEEK 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-2015-004748 25-Mar-15 MO $15.00 212 Main Street,Phone:(413)587-1240,Fax:(413)587-1272,Email:lhasbrouck @ northamptonma.gov GeoTMS®2015 Des Lauriers Municipal Solutions,Inc.