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