23D-149 (2) File#MP-2017-0004
APPLICANT/CONTACT PERSON WRIGHT BUILDERS
ADDRESS/PHONE 48 Bates St (413)586-8287(116)
PROPERTY LOCATION 121 HINCKLEY ST
MAP 23D PARCEL 149 001 ZONE URB(100)/
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid .,7 ,'<h.
Building Permit Filled out
Fee Paid
Typeof Construction:_ZPA-CONSTRUCT 4 DUPLEX RES BLDGS&3 GARAGES
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) •
'� tt�� q`
PLANNING BOARD PERMIT REQUIRED UNDER : § 01 C �r /U ' i'
lto
Intermediate Project : Site Plan AND/OR ecial 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
7721//
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.
• � r
‘ ,5 v
/
File No.I//P-P
ZONING PERMIT APPLICATION ( i0.2) l '
Please type or print all information and return this form to the Building
nnspector's Office with the $30 filing fee (check or money order)payable to the
Vic, City of Northampton
i Name of Applicant: & ' _ A OA. Risi .c
��-}fir i I . Jai s ' elephone: 913—c -<i2 -
—2 `owner of Property: / ylk e- c-i,--
Address: q(-1:) 0'0Y"�� Telephone: 41:5-.3")--0--(2S5 7
3. 'Status of App icant: Owner Contract Purchaser Lessee Other (e%pl.ain)_
4. Job Location: 1 z. I
Parcel id: Zoning Map# Parcel# District(s):_
In Elm Sweet District in Central.Business.District
(TO BE FILLED-IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/Property: pejo)\ i ,>Y ��>>� Ir �at•a-���y
6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary):
- CC`r���c] re s.c -i a 9 '54 o r ; r ,�c �
`�
etiA. aSSD -c . L 1l
3 i .
7. Attached Plans: Sketch Plan Site Plan Engineered/Surveyed Plans
8_ Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO____X__ DON'T KNOW YES IF YES, date issued:
1F YES: Was the permit recorded at the Registry of Deeds?
NO DONT KNOW - YES
IF YES: enter Book Page and/or Document!i
9.Does the site contain a brook, body of water or wetlands? NO A 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)
-r v ' ^' Jr c:712( 2Y�1� rr rr�, corp?
W:\Documents\FORMS\original`sBuilding-Inspector\Zoning-Permit-Application-passive.doc 8'4%2004
1-4: Do any signs exist on the property? YES NO Kv
IF YES, describe size, type and location:
Are there any proposed changesto or additions of signs intended for the.property? YES NO T�
IF YES, describe size, type and location:
11. Will the construction activity disturb (clearing, grading, exc v tion, or filling) over 1 acre or is it part of a common
plan of development that will disturb over 1 acre? YES ?l _ NO
IF YES, then a Northampton Star Water Management Perit f om the DPWisrequired.
12. ALL tt OPMAT(01•t MUST BE COMPLETED, or RERMITCAII BE DEISIEI3 DUE TO LACK OF.INFORMATION
This column reserved
for use by the Building
Department
]EXISTING PROPOSED REQUIRED BY }
ZONING ;
Lot Size
Frontage
Setbacks Front ZO
Side L: 1 7 R: L L: )01 5 R: L: R:
Rear 2 - D
Building height
(Y� 7 / )0/1-7
Building Square Footage 1,10n;.'c 1. 9 2 S.r
•
13�� Fmk � }z=t5+=
% Open Space: (lot area
minus building a paved
parking,
#of Parking Spaces
• Lll ;t
#of Loading Docks
. •..I
Fill:
(volume a location)
13. Certification: I hereby certify that the information contained herein is true and accurate•to the best of
my knowledge.
Date:
7/(//e Appiidant's Signature _ i ��-
1
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 Arthitectural Boards,-Department ofPublic lArorks.and other applicable-permit granting
authorities.
W-Momments\FORMS\originai Building-Inspector\Zoning-Permit-Application.-passive.doc 8/4/2004
K.
p
$
{
$
�
E
/
•
ƒ
ƒ
�\