32A-177 (3)10. Do any signs exist on the property? YES I NO
IF YES, describe size, typel and location:Ill G'; 2 L, S T
I/euU i l7
Are there any proposed changes to or additions of signs intended for the property? YES NO L,
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 L�
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
De artment
13. Certification: I hereby certify that the information contained herein is true and accurate to the best of
my knowledge.
Date: 5 - / ' (3 Applicant's Signature
NOTE: Issuance of a zoning permit does not relieve apyh"c t burden to comply with all zoning
requirements and obtain all required permi from-�he Board of Health, Conservation Commission,
Historic and Architectural Boards, Depa ent/of Public Works and other applicable permit granting
authorities.
W:\Documents\FORMS\original\Bui]ding-Inspector\Zoning-Permit-Application-passive.doc 8/4/2004
EXISTING
PROPOSED
REQUIRED BY
ZONING
Lot Size
�/
l
4��
SCd� CZca
Frontage
G't '
�tct'4
Setbacks Front
Side
L: 15— R: 2,b
L: S R:
L: R:
Rear
Building Height
rr
Building Square Footage
% Open Space: (lot area
minus building Et paved
(0
2 �i
parking
# of Parking Spaces
# of Loading Docks
A
4/4
M
Fill:
(volume Et location)
13. Certification: I hereby certify that the information contained herein is true and accurate to the best of
my knowledge.
Date: 5 - / ' (3 Applicant's Signature
NOTE: Issuance of a zoning permit does not relieve apyh"c t burden to comply with all zoning
requirements and obtain all required permi from-�he Board of Health, Conservation Commission,
Historic and Architectural Boards, Depa ent/of Public Works and other applicable permit granting
authorities.
W:\Documents\FORMS\original\Bui]ding-Inspector\Zoning-Permit-Application-passive.doc 8/4/2004
rt7r-%b-'ii . L� 0 -
MAY 162013 File No. _ l N/9: 3_ /}�
o BUILDING INSPECTIONS rrONING PERMIT APPLICATION (§10. 2)
NOR HAMPTON MA 01060
Please type or print all information and return this form to the Building
Inspector's Office with the $15 filing fee (check or money order) payable to the
City ofNorthampton
1. Name of Applicant:
Address: //��i 1 Telephone:
2. Owner of Property:
Address: —�--e �_ Telephone:
3. Status of Applicant: Owner Contract Purchaser Lessee Other (explain)
4. Job Location: Gz
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: Lr
6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary):
;i� A�L !/Jri f 17L I
C 4)V1
,Gr
t
o 0�t 7�t�i irye �O. Ac/ r -C i ra ei Su /7e- 1) 17 em
Q' H C,-,� e tl C
7. Attached Plans: Sket Plan */ Site Plan 'J— Engineered/Surveyed Plans^ 1/_1
8. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO DON'T KNOW YES IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
ll
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 DONT KNOW
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained Obtained , date issued:_
YES
(Form Continues On Other Side)
W:\Documents\FORMS\original\Building-Inspector\Zoning-Permit-Application-passive.doc 8/4/2004
File # MP -2013-0114
APPLICANT/CONTACT PERSON UNIQUE LODGING LLC
ADDRESS/PHONE 74 BRIDGE ST (413) 237-5555 ()
PROPERTY LOCATION 74 BRIDGE ST
MAP 32A PARCEL 177 001 ZONE URC(100)
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out
Fee Paid
Tyneof Construction: ZPA - REAR ADDITION
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Owner/ Statement or License
3 sets of Plans / Plot Plan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INFORMATION PRENTED:
Approved Additional permits required (see below)
PLANNING BOARD PERMIT REQUIRED UNDER: §
Intermediate Project : Site Plan AND/OR�pecial Permit with Site Plan Q�-c
Major Project: Site Plan AND/OR Special Permit with Site Plan �.,a ��✓�, �..
ZONING BOARD PERMIT REQUIRED UNDER: § /�
"c0 v
Finding Special Permit
Variance*
Received & Recorded at Registry of Deeds Proof Enclosed
Other Permits Required:
Curb Cut from DPW
Septic Approval Board of Health
Water Availability Sewer Availability
Permit from Conservation Commission
Permit from Elm Street Commission
Signature of Building Of ficial
Well Water Potability Board of Health
Permit from CB Architecture Committee
Permit DPW Storm Water Management
S-11 7
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.