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00 Glendale 42-167 ZPA 2020W:\Documents\FORMS\original\Building-Inspector\Zoning-Permit-Application-passive.doc 8/4/20 04 File No.__________ ZONING PERMIT APPLICATION (§10.2) 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 of Northampton 1. Name of Applicant:____Carolyn Misch, Assistant Director Office of Planning & Sustainability____________________ Address:____210 Main St, Room 11 Northampton MA__________Telephone:______413-587-1287_______________ 2. Owner of Property:___City of Northampton Office of Planning & Sustainability______________________________ Address:__SAME________________________________Telephone:_______SAME______________ 3.Status of Applicant: Owner _X_ Contract Purchaser _______ Lessee_______ Other (explain)_____________ 4. Job Location:___________Glendale Road (abutting #24)_ADDRESS TO BE ASSIGNED_____________________ Parcel Id: Zoning Map#__42______ Parcel#__167_______ District(s):_____WSP___________ In Elm Street District In Central Business District___________ (TO BE FILLED IN BY THE BUILDING DEPARTMENT) 5.Existing Use of Structure/Property:_______Vacant Flag Lot approved in 2003_______________________________ _________________________________________________________________________________________________ 6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary): _________________________________________________________________________________________________ _________Confirm allowed use of lot for Single Family Home_______________________________________________ _________________________________________________________________________________________________ _________________________________________________________________________________________________ 7.Attached Plans: Sketch Plan ___________ Site Plan ______ Engineered/Surveyed Plans _X__ 8. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO __________ DON'T KNOW ___________ YES ____X___ IF YES, date issued:__Jan, 2003 Comprehensive Permit_ IF YES: Was the permit recorded at the Registry of Deeds? NO __________ DON'T KNOW ___________ YES __X_ IF YES: enter Book _7133___ Page _23_ and/or Document # _________________ 9. Does the site contain a brook, body of water or wetlands? NO _X___ 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) 30 Approved as a Buildable Lot 05/14/2020 Needs Driveway permit, water and sewer/septic availability Louis Hasbrouck W:\Documents\FORMS\original\Building-Inspector\Zoning-Permit-Application-passive.doc 8/4/20 04 10. Do any signs exist on the property? YES __________ NO ____X___ IF YES, describe size, type and location:______________________________________________________________ _________________________________________________________________________________________________ _________________________________________________________________________________________________ Are there any proposed changes to or additions of signs intended for the property? YES ________NO________ 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 X 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 1.587 ACRES Frontage 123' Setbacks Front Side Rear L: R: L: R: L: R: Building Height Building Square Footage % Open Space: (lot area minus building & paved parking # of Parking Spaces 2 # of Loading Docks Fill: (volume & location) 13. Certification: I hereby certify that the information contained herein is true and accurate to the best of my knowledge. Date:______________________ Applicant’s Signature ____________________________________________ 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. ÒÑÒÛ Ú®±²¬æ ëðõ Ôæ ïëõ Îæ ïëõ Î»¿®æ îëõ Ó¿¨æ íëù ïîíù Í¿³» éëû ßÐ»®Ý±³° Ð»®³·¬·«»¼·² îððíò Ó¿§ïìô îðîð Ý¿®±´§² Ó·½¸ Ü·¹·¬¿´´§ ·¹²»¼ ¾§ Ý¿®±´§² Ó·½¸ ÜÒæ ½²ãÝ¿®±´§² Ó·½¸ô ±ãÝ·¬§ ±º Ò±®¬¸¿³°¬±²ô ±«ãÑºº·½» ±º Ð´¿²²·²¹ ú Í«¬¿·²¿¾·´·¬§ô »³¿·´ã½³·½¸à²±®¬¸¿³°¬±²³¿ò¹±ªô ½ãËÍ Ü¿¬»æ îðîðòðëòïì ðçæîçæëç óðìùððù