17A-226 117 Lake St zpa 2017-09-21File# MP-2o18-0015
APPLICANT/CONTACT PERSON MALONE PATRICK M & SHERYL A
ADDRESS/PHONE 167 AUDUBON RD (413) 584-6679 ()
PROPERTY LOCATION 117 LAKE ST
MAP 17APARCEL226 001 ZONE URB{lOO)/
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out
Fee Paid
TypeofConstruction: ZPA-CREATE 3RD DETACHED UNIT STRUCTURE
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 PRES~NTED:
__ Approved _~/_A4•dditional permits required (see below)
PLANNING BOARD PERMIT REQUIRED UNDER: §
Intermediate Project : v'site Plan AND/OR ___ SpecialPermit with Site Plan
Major Ptoject: ___ 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
3 5 O ./ irJJ CJA h.,r,
0-..\\'
Permit from Conservation Commission ---___ Permit from CB Architecture Committee
Permit from Elm Street Commission ---Permit DPW Storm Water Management ----
9 /31 I
Date I f\7 Signature of Building Official
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 ofMGL 40A. Contact the Office of ·
Planning & Development for more information.
Please type or print all information and return this form to the Building
Inspector's Office with the $15.filingfee (check or money order) payable to the
City of Northampton
1. Name of Applicant: fa-f:r; ( h a,.,j ~ ~ I?/' 71 f14{(J)1 f,
Address: It 7 Ave! vktm Rd} LeedsMIJTelephone: 'ilJ s,;;.o-r;rJt/
2. Owner of Property:fllfc,'ch..Ovt) <iili,ujL ~ ,
Address:/ 2 7 &dkc ,Sf-cee + Ror/l,1(-f' Telephone:{j;i}3}_d-~~(Jr:
3. Status of Applicant: Owner ~ Contract Purchaser Lessee Other (explain) ____ _
4. Job Location: r r 7 Lah. e... Sr te.e f:
5. Existing Use of Structure/Property: .:;_ t:kn? ~ 11 Ce.S; cJ-f:t, k uJ kJ ,I) 5L
6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary):
7. Attached Plans: Sketch Plan X Site Plan _tf~--Engineered/Surveyed Plans __ _
8. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO ___,)c'-'--_ DON'T KNOW ___ _ YES ___ _ IF YES, date issued:,,-------
IF YES: Was the permit recorded at the Registry of Deeds?
NO ___ _ DON'T KNOW ___ _ YES ___ _
IF YES: enter Book ___ _ Page ____ and/or Document# _____ _
9.Does the site contain a brook, body of water or wetlands? NO DON'T KNOW __ _ YES __ _
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained ___ _ Obtained _____ , date issued: ______ _
(Form Continues On Other Side)
W:\Documents\FORMS\original\Building-Inspector\Zoning-Permit-Application-passive,doc 8/4/2004
10. bo any i.tgns exlston the property? Y£s ---· NO ,~ ;;....:...;c;
IF YES, d~rtbe size, type and location: .. ·. ..· . . _ . __ . ~ . . ·-------,s .. _ • .;.~, •. d . . . __
Are there any proposed changes to or additions of signs fntended for the property?
IF YES, de$Cfibe slz~. type and iocatlon: _________ ....,...... ________________ ...__-,-..,...__~-.....;...
11. wm lhe construction actMty'dlstvrb {Clearing, grading, excavation, orflUlng} over 1 acre or is Jt part ma.~
plan of development that will <.flsturb.over 1 acre? YES_ NO ~ ·
lF YES,theo a Northampton Storm Water Management Permit from the OPW is required.
12. ALL lNFORMATION MUS,T BE .COMPLETED; or PERMIT CAN SE DENIED OUE TO LACK OF INFORMATION
· · ·· 7hltil colwn:n rssen-ea
·for wie by tbe Blllldlng 'lh .... .. ioartiilent
EXISTING l'ROPOSED ' REQti1RBD BY .. ZONING
Lot Size ':2.,q, ~b'S' SQ~T ,Z..0 I 't £. 4i -sq ,rT
(,) . I./, (4 O,...~r(} 0-.,., i ~Of<.\
Frontage ?fJ,-.;( r
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Setbacks Front 't_ 'L, ,I
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I I Side L: R: :2_ I L: R: L: R:
:;.or;-" .
Rear
. . . ..
. . Building Height 3 ~ 3 )_
.
· aundtng square Footage
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..
. % Qpen Space: (lot area 1, /. .,.
minus f:>uildfng & paved b] I ... patkina .. ...
# of Parking Spaces • :s 6 . ...
# oftoading DocK$' (J C)
. ..
F ill: 0 0 (volume & location) .
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