30A-024 (2) File#MP-2016-0104 J1 �j<` �,
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APPLICANT/CONTACT PERSON Debra Truskinoff
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ADDRESS/PHONE 102 Black Birch Trail (413)584-4654 Q
PROPERTY LOCATION 42 LEXINGTON AVE
MAP 30A PARCEL 024 001 ZONE URB(100)/
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid C K./At .city <)f go
Building Permit Filled out
Fee Paid
Tvoeof Construction: ZPA -BUILD BEDROOM OVER EXISTING KITCHEN AT REAR OF HOUSE
New Construction
Non Structural interior r-novati.ns
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/Statement or License
3 sets of Plans/Plot Plan
THE FOL OWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INFO IATION 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
-riff
IImm Street Commission Permit DPW Storm Water Management
� /O -/>S
S t re of ,'Sftic . 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 No. 5 #30
Liess:
ZONING PE 'ITAPPLICATION(§1o.2)
ease type or print alt infoxncation and return this form to the Brefdng
ctor's Oi ce with the $30 fling fee (cheek or money crder)payable to the
City ofNorthampton
I e of Applicant' bet?ra ( v-u514✓N"I r
L Lek/19zn AV-e• ow/meTelephone: 4i3- 3Q-6J1
R II
er of Property:
Address: ) ( Telephone:
3. Status of Applicant: Owner ✓ Contract Purchaser Lessee Other (explain)
4. Job Location: h)2 Ler ; nj4o•-' ktc S. lb) rt - e v'JA— 6 ) 06t
Parcel Id: Zoning Map# ie/4 ie/4Parcel# lJ 2^/ District(s):
In Elm Street District In Central Business District
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/Property: C £'S r die -^ '�' +6c4 t
6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary):
In 1
7. Attached Plans: Sketch Plan r Site Plan Engineered/Surveyed Plans
8. Has a Special Permit/Varance/Findin�g//ever been issued for/on the site?
NO DONT KNOW X 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 C
9.Does the site contain a brook, body of water or wetlands? NO >e DONT 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 Continues On Other Side)
W:Doc;nears!FORMSo ignal•Building-Inspeem]Zoning-Pena it-Applmatia i pessive.doc 8/42004
10. Do any signs exist on the property? YES _ NO s
IF YES, describe size, type and location:
Are there any proposed changes to or additions of signs intended for the property? YES ND
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? YE NO E/
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
0 235 qe- . v. z9 .
Frontage
Setbacks Front k r ' 7r '
Side L: S ) R: $ L: 3 1 R: $' L: R:
Rear 70 ' 70
Building Height hr a ) Y(�. If , I ' c, t I
Building Square Footage
1327
I s 7
Open Space: (lot area CE17 6 1 0. 176 a< .
minus building a paved n
parking 'ISO 93. 4 . ?‘$g 5., AL
#of Parking Spaces
Z 2
#of Loading Docks
b 0
Fill:
(volume & location) (J O
13. Certification: I hereby certify that the information contained herein is true and accurate to the best of
my knowltedge.
Date: G/✓ /1(9 Applicant's Signature A .J.r '/
NOTE:Issuance of a zoning permit does not relieve an applicant's burden to complyy. .14 zoning
requirements and obtain all required permits from the Board of Health,Cons•rvation Commission,
Historic and Architectural Boards,Department of Public Works and other applicable permit granting
authorities.
WADocumentsTORMS1onginalBuilding-I specrorZonicg-Perrdt-Applicanao-vusive dac 8/4/2004
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Debra Truskinoff Bedroom/Bathroom Remodel
Add 2nd floor bathroom to existing floor LIVING AREA
footprint, and add 18' x 18' bedroom to back of 875 sq n
structure over existing kitchen.
Truskinoff Second Floor Existing
II
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A
91-6" • 4'-9 1/2" --> < 11'-1"
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LIVING AREA
501 sq ft
45'-0 1/2"
261.3" 1 -9>< 17'-0 1/2"
2'-61/1"-119 ®112,1 ,121.111
-�6'-5 15/1611—, ‹21.62„ 21-6,1 3'-71/2"� 11 1/ 3' _X21.811 21.61,,.,‹21.611 21.611 2,_11"'-
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13'-11 5/8" — 15'-19 crit - - 10'-2 3/4" 5'-9" >
45'-0 1/2"
45'-0 1/2"
10' 6'-41/2" 11'-1" — 61-4" 11'-3"
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F 4'-0 5/6" 9'-3 3/6" 1 4145 f2" > 13'-4" r
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