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15B-025 (3) File#MP-2016-0077 i APPLICANT/CONTACT PERSON SCHRADER ROBERT VII&CAREN M WEINER ADDRESS/PHONE 112 CHESTERFIELD RD PROPERTY LOCATION 112 CHESTERFIELD RD MAP 15B PARCEL 025 001 ZONE URAUQa 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-DIVIDE INTO 2 BLDG LOTS New Construction Non Structural interior renovations Addition to Existing Accesso1y 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 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. File IV G'.1V lld V G HJi E1NIT Ti l Ci Please type ar print PIT L f,a rmn at,io n =,.L Yet=thlis f6rm to the Lni-spectar's Of ce with the $3G,GTLH-,-,Lgfee (chi?ck or money o-rdc7°)payer&He to thae Ci f, 0,�No1r°tu� pto�n 1. Name of Applicant: ko�cr-/-- 5chr� lewlll' Address: /fd\ eAIf� reY?'--e-Idp 91( Telephone: 713 F7 2. Owner of Property: e C)�-en-'-7 5 chi r R Wer -,,- Coe,) �e,) Address: Il9 CX e5 ,��,'7-11 /"' /V Telephone: 3. Status of Applicant: Owned. Contract Purchaser Lessee Other (explain) 4. Job Location: 2 c e /C /'�rl✓I 1"cd° - Parcel Id:. Zoning Map# Parcel# District(s): In Elm Street District In Central Business District (TO BE FILLED IN BY�THE �BUILDING DEPARTMENT)` . . 5. Existing Use of Structure/Property: /`��� P��� ' � - QNB = X-7,7 6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary): Ila 7A-20 o 7T L 115- Z' Z',Vw s 7. Attached Plans: Sketch Plan �_ Site Plan Engineered/Surveyed Plans S. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO DON'T KNOW \>e- YES IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO DONT KNOW YES IF YES: enter Book Page and/or Document# 9.Does the site contain a brook, body of water or wetlands? N0 �— 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.- (Form ssued:(Form Continues On Other Side) W:1Documents\FOPMSloriginal\Bui din,InspectorlZoning-Permit-Application-passive.doc 8/4/2004 10. Do any signs exist on the property? YES NO x 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: 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 coZZumn reserved for use by the Building Ike artment =STDITG PROPOSED PioREQ= BY �o ase Lot Size Frontage `?e Setbacks Front I y �v �'w �' % 6e de&�P%d Side L 3 b R: yd L: 1D R: L/Q L: R: Rear 30v' Building Height 7-o berermoo� Building Square Footage Open Space: (lot area t� pminus a king building Et paved # of Parking Spaces b p9�d�r NrQ� #of Loading Docks FiIL• (volume Et location) /V0►'�� Nom- A) 13. Certification: I hereby certify that the information contained herein is true and accurate to the best of my knowledge. Date: f Applicant's Signature 1�ClTE: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. u7;lDocumentsTORMSIoripginallBuildino InspectorConing-Permit-Appiicarion-passive.doc 8/4/2004 CityMap http://vuearc.windpw.locaUarcgis/apps/webappviewer/index.html?i... f I E 1 � I ! r r i } f. f i i.4 II zOm aott 1 of 1 3/25/2016 9:46 AM