23D-064 (7) n
File f MP-2017-0011 MI Pad ff •*.r
sts
APPLICANT/CONTACT PERSON KAJKA JARED A S' t D.6:
ADDRESS/PHONE 40 NUTTING AVE (413)584-6440()
PROPERTY LOCATION 40 NUTTING AVE
MAP 23D PARCEL 064 001 ZONE URB(100J
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT ) /
Fee Paid �a70F7 #431O
Bung Permit Filled out
Fee Paid
Typeof Construction: ZPA-GARAGE ADDITION
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Bailflans Included:
Owner/Statement or License
3 sets of Plans/Plot Plan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON V�
INFORMATION PRESENTED: / ,�{p`19
I/Approved __Additional permits required(see below) v
PLANNING BOARD PERMIT REQUIRED UNDER: §
Intermediate Project: Site Plan AND/OR -Special Permit with Site Plan
Major Project: Site Pian AND/OR Special Pennit with Site Plan
ZONING BOARD PERMIT REQUIRED UNDER: §
Finding Special Pennit Variance"
Received R.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
gig i3jik
Sisrture 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.
RECEIVED
INAi 6 2016
' D'Nra ;;;;71,.or..
File No. nI /7//
O AM�ON ""n liT NG PERMIT APPLICATION W®.2)
Please type or print ail information and return this form to the Building
Inspector's Office with the $30 fling fee (cheek or money order)payable to the
City of Northampton
r L
1. Name of Applicant: �JAfcd kA�k1_
Address: '10 A)Ulll^y l�Vc `JJ Telephone: yl3. Sly-6'15O
J L
2. Owner of Property: JArp k+pt ng
Address: 4P AJUttH RV< J Telephone:
3. Status of Applicant: Owner V-- Contract Purchaser Lessee Other (explain)
4. Job Location: Lb fiJ t q p vc
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: IKrrc_ , n (rqr?9c
6. Descriptionpf,Proposed Use/Work/Project/Occupation: (Use addition l sheets if necessary):
AY Xa`tr .45 .k5-lewp GprASe ACJ4�r•✓,
7. Attached Plans: Sketch PlanI/ Site Plan Engineered/Surveyed Plans
8. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO '� DONT 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 (sr 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)
tnvail : _4jkm )1 COtICOO NCT
w'Documents[FORMsmnginalVBuiiding-rnspectoriZoning-Penna-App'icaion-passiye.dnc 8/4)2004
10. Do any signs exist on the property? YES NO
IF YES, describe size, type and location:,.
Are there any proposed changes to or additions of signs intended for the property? YES_ NO L-
IF YES, describe size, type and location:
it. Wilt the construction activity disturb (clearing, grading, excavation, or filling)aver cre 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
E.SISTH G I PROPOSED REQUIRED BY
ZONING
Lot Size
laC6o
Frontage
157 157r
Setbacks Front I'i r
Side t: f7/ 1, R: a) L: r 1 R: 1 'y / 1: R:
Rear I Ur ✓.
Building Height /
Building Square Footage
%Open Space: (lot area D
minus kingbuilding&paved �t 7X f7 j /O 1
#of Parking Spaces 4 J I !
3
#of loading Docks (hl
6
Fitt:
(volume e Location)
13. Certification: ;hereby certify that the information contained herein is true and accurate to the best of
my knowledge.
Date: p"/4)-16 Applicant's Signature Lam.// 2;I .....
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.
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